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Bruno FP, Degani-Costa LH, Kandipudi KLP, Gushken F, Szlejf C, Tokeshi AB, Tehrani YF, Kaufman D, Kumar PSS, Jamir L, Benesch MG, Ryan MG, Lotay H, Fuld JP, Fidalgo TM. Medical Trainees' Knowledge and Attitudes Towards Electronic Cigarettes and Hookah: A Multinational Survey Study. Respir Care 2024; 69:306-316. [PMID: 38416660 PMCID: PMC10984587 DOI: 10.4187/respcare.11042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
BACKGROUND The rising prevalence of electronic cigarette (e-cigarette) and hookah use among youth raises questions about medical trainees' views of these products. We aimed to investigate medical trainees' knowledge and attitudes toward e-cigarette and hookah use. METHODS We used data from a large cross-sectional survey of medical trainees in Brazil, the United States, and India. We investigated demographic and mental health aspects, history of e-cigarettes and tobacco use, knowledge and attitudes toward e-cigarettes and hookah, and sources of information on e-cigarettes and hookah. Although all medical trainees were eligible for the original study, only senior students and physicians-in-training were included in the present analysis. RESULTS Of 2,036 senior students and physicians-in-training, 27.4% believed e-cigarette use to be less harmful than tobacco smoking. As for hookah use, 14.9% believed it posed a lower risk than cigarettes. More than a third of trainees did not acknowledge the risks of passive e-cigarette use (42.9%) or hookah smoking (35.1%). Also, 32.4% endorsed e-cigarettes to quit smoking, whereas 22.5% felt ill equipped to discuss these tobacco products with patients. Fewer than half recalled attending lectures on these topics, and their most common sources of information were social media (54.5%), Google (40.8%), and friends and relatives (40.3%). CONCLUSIONS Medical trainees often reported incorrect or biased perceptions of e-cigarettes and hookah, resorted to unreliable sources of information, and lacked the confidence to discuss the topic with patients. An expanded curriculum emphasis on e-cigarette and hookah use might be necessary because failing to address these educational gaps could risk years of efforts against smoking normalization.
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Affiliation(s)
- Fernando P Bruno
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
| | - Luiza Helena Degani-Costa
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Kesava Lakshmi Prasad Kandipudi
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Fernanda Gushken
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Claudia Szlejf
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Ana B Tokeshi
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Yasmin F Tehrani
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Daniel Kaufman
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Pentapati Siva Santosh Kumar
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Limalemla Jamir
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Matthew Gk Benesch
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Morag G Ryan
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Hardeep Lotay
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
| | - Jonathan P Fuld
- Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil
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Degani-Costa LH, Bruno FP, Gushken F, Szlejf C, Tokeshi AB, Tehrani YF, Kaufman D, Prasad KKL, Kumar PSS, Jamir L, Benesch MGK, Ryan MG, Lotay H, Fuld JP, Fidalgo TM. Vaping and Hookah Use Among Medical Trainees: A Multinational Survey Study. Am J Prev Med 2023; 65:940-949. [PMID: 37178979 DOI: 10.1016/j.amepre.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
The increased use of E-cigarettes and hookah among young consumers represents a public health concern. This study aimed to investigate the frequency and patterns of use of E-cigarettes and hookah among medical trainees. This cross-sectional multinational online survey included medical students, residents, and fellows in Brazil, the U.S., and India between October 2020 and November 2021. Information on sociodemographics; mental health; and E-cigarettes, hookah, tobacco, marijuana, and alcohol use were collected. Generalized structural equation models were used in 2022 to explore the factors associated with current vaping and current hookah use (ongoing monthly/weekly/daily use). People reporting previous sporadic/frequent use or those who never used/only tried it once were the reference group. Overall, 7,526 participants were recruited (Brazil=3,093; U.S.=3,067; India=1,366). The frequency of current vaping was 20% (Brazil), 11% (U.S.), and <1% (India), and current hookah use was 10% (Brazil), 6% (U.S.), and 1% (India). Higher family income (OR=6.35, 95% CI=4.42, 9.12), smoking cigarettes (OR=5.88, 95% CI=4.88, 7.09) and marijuana (OR=2.8, 95% CI=2.35, 3.34), and binge drinking (OR=3.03, 95% CI=2.56, 3.59) were associated with current vaping. The same was true for hookah use: higher family income (OR=2.69, 95% CI=1.75, 4.14), smoking cigarettes (OR=3.20, 95% CI=2.53, 4.06), smoking marijuana (OR=4.17, 95% CI=3.35, 4.19), and binge drinking (OR=2.42, 95% CI=1.96, 2.99). In conclusion, E-cigarettes and hookah were frequently used by Brazilian and American trainees, sharply contrasting with data from India. Cultural aspects and public health policies may explain the differences among countries. Addressing the problems of hookah and E-cigarette smoking in this population is relevant to avoid the renormalization of smoking.
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Affiliation(s)
- Luiza Helena Degani-Costa
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - Fernando P Bruno
- Touro College of Osteopathic Medicine, Touro University, Middletown, New York; Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, NY, USA
| | - Fernanda Gushken
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Claudia Szlejf
- Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Ana B Tokeshi
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Yasmin F Tehrani
- Touro College of Osteopathic Medicine, Touro University, Middletown, New York
| | - Daniel Kaufman
- Touro College of Osteopathic Medicine, Touro University, Middletown, New York
| | | | | | | | | | - Morag G Ryan
- Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | | | | | - Thiago M Fidalgo
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil; National Academy of Medicine, Rio de Janeiro, Brazil
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Alvares LAM, Ferreira RES, Nakamoto FP, Dos Santos Quaresma MVL, Santos LM, Degani-Costa LH, Navarro LS, Navarro GS, Oliveira-Junior AA, Barbosa RCC, Lima FM. Physical fitness, hormonal profile, nutritional and psychological aspects assessment of transgender women volleyball players submitted to physical tests: protocol paper of a prospective cohort. BMJ Open Sport Exerc Med 2023; 9:e001641. [PMID: 37485006 PMCID: PMC10357769 DOI: 10.1136/bmjsem-2023-001641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/25/2023] Open
Abstract
To evaluate aerobic capacity, strength and other physiological, nutritional, and psychological variables which may influence the performance of transgender women (TW) athletes and compare them to cisgender women (CW) and cisgender men (CM) athletes, as well as changes in TW performance over the course of a year. Prospective cohort study including three groups: TW, CW and CM volleyball athletes. Subjects will be comprehensively assessed at two different moments: baseline and after 6-12 months of adequate hormonal therapy. Evaluation will comprise clinical, medical, nutritional and psychological interviews, incremental treadmill cardiopulmonary exercise testing, hand grip strength test, vertical jump test, analysis of sleep quality (Pittsburgh Sleep Quality Index), hormonal profile, echocardiogram, analysis of resting energy expenditure, assessment of bone mass and body composition through dual-energy X-ray absorptiometry scans, and untargeted metabolomic analysis. CW and CM matched by age, body mass index and level of physical activity will undergo a similar evaluation. The assessment of the strength, aerobic capacity, haematological, nutritional and psychological status of TW using gold-standard tests will contribute to understanding the impact of oestrogen therapy on the exercise performance of these athletes and how they compare with CW and CM.
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Lima TACD, Bruno FP, Gushken F, Degani-Costa LH, Novaes NP. Breaking bad news in neurology: assessing training, perceptions, and preparedness among residency programs in Brazil. einstein (São Paulo) 2023; 21:eAO0036. [PMID: 37075459 PMCID: PMC10118364 DOI: 10.31744/einstein_journal/2023ao0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 08/30/2022] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVE • Neurology trainees and program directors recognized a lack of structured breaking bad news training. • Program directors reported that many factors hinder the implementation of breaking bad news education. • Trainees felt capable of breaking bad news, but most did not have lectures, simulations, nor feedback. • Trainees acknowledged negative feelings when breaking bad news, including sadness and helplessness. We aimed to evaluate how breaking bad news training was implemented in neurology residency programs in Brazil and to assess the perception and preparedness of trainees and program directors. METHODS We performed a cross-sectional descriptive study. Neurology trainees and program directors were recruited from the Brazilian Academy of Neurology registry through convenience sampling. Participants answered a survey evaluating the breaking bad news training at their institution and their preparedness and perception towards the topic. RESULTS We collected 172 responses from 47 neurology institutions from all five socio-demographic regions of Brazil. More than 77% of trainees were dissatisfied with their breaking bad news training, and around 92% of program directors believed their programs required substantial improvement. Approximately 31% of neurology trainees reported never having a lecture about communicating bad news, 66% reported never having a simulated training, and nearly 61% never received feedback regarding their communication abilities. Moreover, 59% of program directors acknowledged that feedback was not a standard practice and nearly 32% reported the absence of any specific training. CONCLUSION This study suggested that the breaking bad news training in neurology residencies across Brazil is deficient and highlighted challenges to achieve this core competency. Program directors and trainees recognized the importance of the topic, and program directors acknowledged that many factors hinder the ability to implement formal training. Given the relevance of such a skill to patient care, every effort should be made to provide structured training opportunities during residency.
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Gille T, Sivapalan P, Kaltsakas G, Kolekar SB, Armstrong M, Tuffnell R, Evans RA, Vagheggini G, Degani-Costa LH, Vicente C, Das N, Poberezhets V, Rolland-Debord C, Bayat S, Vogiatzis I, Franssen FME, Pinnock H, Vanfleteren LEGW. ERS International Congress 2021: highlights from the Respiratory Clinical Care and Physiology Assembly. ERJ Open Res 2022; 8:00710-2021. [PMID: 35615417 PMCID: PMC9125042 DOI: 10.1183/23120541.00710-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, randomised controlled trials and qualitative research that were presented during the 2021 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 - Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.
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Affiliation(s)
- Thomas Gille
- Service de Physiologie et Explorations Fonctionnelles, Centre Hospitalier Universitaire Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bobigny, France.,Inserm U1272 "Hypoxia and the Lung", UFR Santé - Médecine - Biologie Humaine Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Herlev-Gentofte University Hospital, Hellerup, Denmark
| | - Georgios Kaltsakas
- Lane Fox Respiratory Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre of Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,1st Respiratory Medicine Dept, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Shailesh B Kolekar
- Dept of Internal Medicine, Zealand University Hospital, Roskilde, Denmark.,Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Matthew Armstrong
- Dept of Rehabilitation and Sport Sciences, Bournemouth University, Poole, UK
| | - Rachel Tuffnell
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rachael A Evans
- NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK.,Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Guido Vagheggini
- Dept of Medical Specialties, Chronic Respiratory Failure Care Pathway, Azienda USL Toscana Nordovest, Volterra, Italy.,Fondazione Volterra Ricerche Onlus, Volterra, Italy
| | | | | | - Nilakash Das
- Laboratory of Respiratory Diseases and Thoracic Surgery, Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Vitalii Poberezhets
- Dept of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Camille Rolland-Debord
- Service de Pneumologie, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Sam Bayat
- Service de Pneumologie et de Physiologie, CS10217, CHU Grenoble, Grenoble, France.,Univ. Grenoble Alpes, Inserm UA07 STROBE, Grenoble, France
| | - Ioannis Vogiatzis
- Dept of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Frits M E Franssen
- Dept of Research and Development, Ciro, Horn, the Netherlands.,Dept of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Lowie E G W Vanfleteren
- COPD Center, Dept of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Dept of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Almeida LKR, Avelino-Silva TJ, de Lima E Silva DC, Campos BA, Varela G, Fonseca CMB, Amorim VL, Piza FMDT, Aliberti MJ, Degani-Costa LH. Palliative care in Hospitalized Middle-Aged and Older Adults With COVID-19. J Pain Symptom Manage 2022; 63:680-688. [PMID: 35017017 PMCID: PMC8743276 DOI: 10.1016/j.jpainsymman.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/06/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
CONTEXT As COVID-19 overwhelms health systems worldwide, palliative care strategies may ensure rational use of resources while safeguarding patient comfort and dignity. OBJECTIVE To describe palliative care practices in hospitalized middle-aged and older adults in two of the largest COVID-19 treatment centers in Sao Paulo, Brazil. METHODS Retrospective cohort. Eligible patients were those aged 50 years or older hospitalized between March and May 2020 with a laboratory confirmation of SARS-CoV-2 infection. Palliative care implementation was defined as present if medical notes indicated a decision to limit escalation of life support measures, or when opioids or sedatives were prescribed for palliative management of symptoms. RESULTS We included 1162 participants (57% male, median 65 years). Overall, 21% were frail and 54% were treated in intensive care units, but only 17% received palliative care. Stepwise logistic regression demonstrated that age ≥80 years, dementia, history of stroke or cancer, frailty, having a PaO2/FiO2<200 or a C-reactive protein ≥150mg/dL at admission predicted palliative care implementation. Patients placed under palliative care stayed longer (13 vs.11 days) and were more likely to die in hospital (86 vs.27%). They also spent more days in ICU and received vasoactive drugs, hemodialysis, and invasive ventilation more frequently. CONCLUSIONS One in five middle-aged and older adults hospitalized with COVID-19 received palliative care in our cohort. Patients who were very old, multimorbid, frail, and had severe COVID-19 were more likely to receive palliative care. However, it was often delayed until advanced and invasive life support measures had already been implemented.
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Affiliation(s)
- Lyna Kyria Rodrigues Almeida
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil; Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina (L.K.R.D.A., T.J.A.S., M.J.A.), Universidade de São Paulo, Sao Paulo, Brazil
| | - Thiago J Avelino-Silva
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina (L.K.R.D.A., T.J.A.S., M.J.A.), Universidade de São Paulo, Sao Paulo, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein (T.J.A.S., V.L.A., L.H.D.C.), Sao Paulo, Brazil
| | - Débora Carneiro de Lima E Silva
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil
| | - Bruna A Campos
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil
| | - Gabriela Varela
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil
| | - Cristina Mara Baghelli Fonseca
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil
| | - Victor Lp Amorim
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein (T.J.A.S., V.L.A., L.H.D.C.), Sao Paulo, Brazil
| | - Felipe Maia de Toledo Piza
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil
| | - Marlon Jr Aliberti
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina (L.K.R.D.A., T.J.A.S., M.J.A.), Universidade de São Paulo, Sao Paulo, Brazil
| | - Luiza Helena Degani-Costa
- Hospital Municipal Dr. Moysés Deutsch (L.K.R.D.A, D.C.D.L.S., B.A.C., G.V., C.M.B.F., V.L.A., F.M.D.T.P., L.H.D.C.) Sao Paulo, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein (T.J.A.S., V.L.A., L.H.D.C.), Sao Paulo, Brazil.
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7
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Degani-Costa LH, Assis JPD, Gonçalves PPP, Gushken F, Szarf G, Afonso Junior JE. Accuracy of echocardiography and chest tomography for pulmonary hypertension screening in patients awaiting lung transplantation. Einstein (Sao Paulo) 2021; 19:eAO5710. [PMID: 34932775 PMCID: PMC8687646 DOI: 10.31744/einstein_journal/2021ao5710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 12/01/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To examine the accuracy of a pulmonary hypertension screening strategy based on a combination of echocardiographic data and tomographic measurements (pulmonary artery diameter and pulmonary artery diameter to ascending aorta diameter ratio) in patients with chronic lung disease referred for lung transplantation. METHODS A retrospective observational study with patients with pulmonary emphysema or fibrosis referred for transplantation between 2012 and 2016. Pulmonary hypertension was defined as mean pulmonary artery pressure ≥25mmHg, or between 21 and 24mmHg, with pulmonary vascular resistance >3 Wood units on right heart catheterization. Tomographic measurements were made by two independent radiologists. RESULTS This sample comprised 13 patients with emphysema and 19 patients with pulmonary fibrosis. Of these, 18 had pulmonary hypertension. The level of agreement in tomographic measurements made by radiologists was high (intraclass correlation coefficients 0.936 and 0.940, for pulmonary artery diameter and pulmonary artery diameter to ascending aorta diameter ratio, respectively). Areas under the ROC curves constructed for pulmonary artery diameter, pulmonary artery diameter to ascending aorta diameter ratio, and pulmonary artery systolic pressure as predictors of pulmonary hypertension were 0.540, 0.629 and 0.783, respectively. The sensitivity, specificity and negative predictive value of pulmonary artery systolic pressure ≥40mmHg were 67%, 79% and 65%, respectively. The combined criterion (pulmonary artery diameter to ascending aorta diameter ratio >1 and/or pulmonary artery systolic pressure ≥40mmHg) achieved sensitivity of 72%, specificity of 79%, and a negative predictive value of 69%. CONCLUSION Measurements of pulmonary artery and ascending aorta diameter were highly reproducible. The association of pulmonary artery and aortic diameter >1 and/or pulmonary artery systolic pressure ≥40mmHg improved the sensitivity and the negative predictive value for pulmonary hypertension screening. This strategy demands prospective validation to assess safety and cost-effectiveness.
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Affiliation(s)
| | | | | | | | - Gilberto Szarf
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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8
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Gushken F, Degani-Costa LH, Colognese TCP, Rodrigues MT, Zanetti M, Bonamigo-Filho JL, Matos LDNJD. Barriers to enrollment in pulmonary rehabilitation: medical knowledge analysis. Einstein (Sao Paulo) 2021; 19:eAO6115. [PMID: 34705946 PMCID: PMC8522705 DOI: 10.31744/einstein_journal/2021ao6115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 03/15/2021] [Indexed: 12/01/2022] Open
Abstract
Objective To assess clinicians’ knowledge about pulmonary rehabilitation, and identify the barriers faced when referring patients with health insurance to pulmonary rehabilitation. Methods This was a survey-based cross-sectional study conducted in 2019, at a private reference hospital in São Paulo, Brazil. Eligible participants were physicians registered with the following specialties: internal medicine, geriatrics, cardiology, pulmonology or thoracic surgery. Results We collected 72 responses, and 99% of participants recognized chronic obstructive pulmonary disease as a potential indication for pulmonary rehabilitation; less often (75%), they listed interstitial lung disease, bronchiectasis and pulmonary hypertension. Most participants (67%) incorrectly associated pulmonary rehabilitation with lung function improvement, while 28% of cardiologists and 35% of internists/geriatricians failed to recognize benefits on mood disorders. Notably, 18% of participants recommended pulmonary rehabilitation only to patients on supplemental oxygen and 14% prescribed only home physical therapy, patterns more commonly seen among non-respiratory physicians. The three most perceived barriers to referral and adherence were health insurance coverage (79%), transportation to pulmonary rehabilitation center (63%) and lack of social support (29%). Conclusion Financial, logistic and social constraints pose challenges to pulmonary rehabilitation enrollment, even for patients with premium healthcare insurance. Moreover, physician knowledge gaps may be an additional barrier to pulmonary rehabilitation referral and adherence. Providing continued medical education, incorporating automatic reminders in electronic medical records, and using telerehabilitation tools may improve pulmonary rehabilitation referral, adherence, and ultimately, patient care.
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Affiliation(s)
- Fernanda Gushken
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | | | | | - Mayra Zanetti
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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9
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Todt BC, Szlejf C, Duim E, Linhares AOM, Kogiso D, Varela G, Campos BA, Baghelli Fonseca CM, Polesso LE, Bordon INS, Cabral BT, Amorim VLP, Piza FMT, Degani-Costa LH. Clinical outcomes and quality of life of COVID-19 survivors: A follow-up of 3 months post hospital discharge. Respir Med 2021; 184:106453. [PMID: 34010740 PMCID: PMC8116128 DOI: 10.1016/j.rmed.2021.106453] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Over 66 million people worldwide have been diagnosed with COVID-19. Therefore, understanding their clinical evolution beyond hospital discharge is essential not only from an individual standpoint, but from a populational level. OBJECTIVES Our primary aim was to assess the impact of COVID-19 on health-related quality of life (HRQoL) 3 months after hospital discharge. Additionally, we screened for anxiety and depression and assessed important clinical outcomes. METHODS This was a single-center cohort study performed in Sao Paulo (Brazil), in which participants were contacted by telephone to answer a short survey. EQ-5D-3L was used to assess HRQoL and clinical data from patients' index admission were retrieved from medical records. RESULTS We contacted 251 participants (59.8% males, mean age 53 years old), 69.7% of which had presented with severe COVID-19. At 3 months of follow-up, 6 patients had died, 51 (20.3%) had visited the emergency department again and 17 (6.8%) had been readmitted to hospital. Seventy patients (27.9%) persisted with increased dyspnoea and 81 had a positive screening for anxiety/depression. Similarly, patients reported an overall worsening of EQ-5D-3L single summary index at 3 months compared to before the onset of COVID-19 symptoms (0.8012 (0.7368 - 1.0) vs. 1.0(0.7368 - 1.0), p < 0.001). This affected all 5 domains, but especially pain/discomfort and anxiety/depression. Only female sex and intensive care requirement were independently associated with worsening of HRQoL. CONCLUSION Patients hospitalized for COVID-19 frequently face persistent clinical and mental health problems up to 3 months following hospital discharge, with significant impact on patients' HRQoL.
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Affiliation(s)
- Beatriz Costa Todt
- Internal Medicine Residency Program, Hospital Israelita Albert Einstein, Brazil
| | - Claudia Szlejf
- Department of Big Data, Hospital Israelita Albert Einstein, Brazil
| | - Etienne Duim
- Department of Diagnostic and Ambulatory Medicine, Hospital Israelita Albert Einstein, Brazil
| | | | | | | | | | | | | | | | | | - Victor L P Amorim
- Hospital Municipal Dr. Moysés Deutsch, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, Internal Medicine Department, Hospital Israelita Albert Einstein, Brazil
| | - Felipe M T Piza
- Hospital Municipal Dr. Moysés Deutsch, Brazil; Intensive Care Unit, Hospital Israelita Albert Einstein, Brazil
| | - Luiza Helena Degani-Costa
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Internal Medicine Department, Hospital Israelita Albert Einstein, Brazil.
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10
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Degani-Costa LH, Rolla F, Oliveira RAG, Schettino GDPP, Cordioli RL, Hohmann FB, Campos NS, Alencar RM, Ferraz LJR, Piza FMDT. Emerging from the COVID-19 pandemic: the numbers and lessons that will stay with us forever. Einstein (Sao Paulo) 2021; 19:eED6207. [PMID: 33656058 PMCID: PMC7898589 DOI: 10.31744/einstein_journal/2021ed6207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Luiza Helena Degani-Costa
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil
| | - Fabiana Rolla
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil
| | | | | | | | - Fábio Barlem Hohmann
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil
| | - Niklas Söderberg Campos
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil
| | | | - Leonardo José Rolim Ferraz
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil
| | - Felipe Maia de Toledo Piza
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil
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Almendros I, Baillieul S, Caballero C, Degani-Costa LH, Furian M, Hirotsu C, Louvaris Z, Thiel S, Turnbull CD. Highlights from the 2018 European Respiratory Society International Congress: sleep and clinical physiology. ERJ Open Res 2019; 5:00201-2018. [PMID: 31304175 PMCID: PMC6612603 DOI: 10.1183/23120541.00201-2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/22/2019] [Indexed: 12/13/2022] Open
Abstract
The 2018 European Respiratory Society (ERS) International Congress held in Paris, France, served as a platform to discover the latest research on respiratory diseases, the improvement in their treatments and patient care. Specifically, the scientific sessions organised by ERS Assembly 4 provided novel insights into sleep disordered breathing and fresh knowledge in respiratory physiology, stressing its importance to understanding and treating respiratory diseases. This article, divided by session, will summarise the most relevant studies presented at the ERS International Congress. Each session has been written by early career members specialised in the different fields of this interdisciplinary assembly.
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Affiliation(s)
- Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
- All authors contributed equally and are listed alphabetically
| | - Sébastien Baillieul
- HP2 laboratory, Grenoble Alpes University, Grenoble, France
- U1042, INSERM, Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France
- All authors contributed equally and are listed alphabetically
| | - Candela Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- All authors contributed equally and are listed alphabetically
| | - Luiza Helena Degani-Costa
- Pulmonary Function and Clinical Exercise Physiology Unit, Pulmonary Division, Dept of Medicine, Federal University of São Paulo, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
- All authors contributed equally and are listed alphabetically
| | - Michael Furian
- Dept of Pulmonology and Sleep Disorders Center, University Hospital of Zurich, Zurich, Switzerland
- All authors contributed equally and are listed alphabetically
| | - Camila Hirotsu
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland
- All authors contributed equally and are listed alphabetically
| | - Zafeiris Louvaris
- Faculty of Movement and Rehabilitation Sciences, Division of Respiratory Rehabilitation, Dept of Rehabilitation Sciences, KU Leuven, Research Group for Rehabilitation in Internal Disorders, University Hospitals Leuven, Leuven, Belgium
- All authors contributed equally and are listed alphabetically
| | - Sira Thiel
- Dept of Pulmonology and Sleep Disorders Center, University Hospital of Zurich, Zurich, Switzerland
- All authors contributed equally and are listed alphabetically
| | - Christopher D. Turnbull
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- All authors contributed equally and are listed alphabetically
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Sayegh ALC, Degani-Costa LH. Effects of exercise training on endothelial and diastolic age-related dysfunctions: a new view of an old problem. J Physiol 2017; 595:4591-4592. [PMID: 28466473 DOI: 10.1113/jp274531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ana Luiza Carrari Sayegh
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Paulista School of Medicine, Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil
| | - Luiza Helena Degani-Costa
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Paulista School of Medicine, Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil
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13
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Degani-Costa LH, Faresin SM, dos Reis Falcão LF. Preoperative evaluation of the patient with pulmonary disease. Braz J Anesthesiol 2013; 64:22-34. [PMID: 24565385 DOI: 10.1016/j.bjane.2012.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 11/19/2012] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In daily clinical practice, pulmonary complications related to surgical procedure are common, increasing the morbidity and mortality of patients. Assessment of the risk of pulmonary complications is an important step in the preoperative evaluation. Thus, we review the most relevant aspects of preoperative assessment of the patient with lung disease. CONTENT Pulmonary risk stratification depends on clinical symptoms and patient's physical status. Age, preexisting respiratory diseases, nutritional status, and continued medical treatment are usually more important than additional tests. Pulmonary function tests are of great relevance when high abdominal or thoracic procedures are scheduled, particularly when lung resection are considered. CONCLUSION Understanding the perioperative evaluation of the potential risk for developing pulmonary complication allows the medical team to choose the adequate anesthetic technique and surgical and clinical care required by each patient, thereby reducing adverse respiratory outcomes.
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Affiliation(s)
- Luiza Helena Degani-Costa
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Sonia Maria Faresin
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Luiz Fernando dos Reis Falcão
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Massachusetts General Hospital, Harvard Medical School, MA, USA.
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