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Monteiro KS, Santino TA, Pakhale S, Balfour L, Pereira Pinto de Mendonça KM. Translation, cross-cultural adaptation and psychometric evaluation of the Brazilian version of the Cystic Fibrosis Knowledge Scale (CFKS). PLoS One 2021; 16:e0259232. [PMID: 34784376 PMCID: PMC8594816 DOI: 10.1371/journal.pone.0259232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Information on the level of knowledge about cystic fibrosis (CF) among affected people and their families is still scarce. OBJECTIVE This study aimed to translate, cross-culturally adapt and analyze the psychometric properties of the Brazilian version of Cystic Fibrosis Knowledge Scale (CFKS). MATERIALS AND METHODS The translation and cross-cultural adaptation involved the stages of translation, synthesis of translations, reverse translation, synthesis of reverse translations, review by a multi-professional committee of experts and pre-testing. The reliability, viability, construct, predictive, concurrent and discriminant validity were investigated. RESULTS The sample consisted of 40 individuals with cystic CF, 47 individuals with asthma, 242 healthcare workers and 81 students from the health area. The Brazilian version of the CFKS presented high internal consistency (α = 0.91), moderate floor and ceiling effects, without differences in the test-retest scores. An analysis of factorial exploration identified three dimensions. Confirmatory factor analysis led to an acceptable data-model fit. There was good predictive validity, with a difference in the scores among all the evaluated groups (p <0.001), as well as good discriminant validity since individuals with asthma had greater knowledge of asthma compared to CF (r = 0.401, p = 0.005; r2 = 0.162). However, there was no difference between the diagnosis time and knowledge about CF (r = -0.25, p = 0.11; r2 = 0.06), either between treatment adherence and knowledge about CF (r = -0.04, p = 0.77; r2 = 0.002). CONCLUSION The Brazilian version of the CFKS indicated that the scale is able to provide valid, reliable and reproducible measures for evaluating the knowledge about CF.
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Affiliation(s)
- Karolinne Souza Monteiro
- Faculty of Health Science of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
- * E-mail:
| | - Thayla Amorim Santino
- Graduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Smita Pakhale
- Faculty of Medicine, University of Ottawa, Ottawa, Canadá
| | - Louise Balfour
- Faculty of Medicine, University of Ottawa, Ottawa, Canadá
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Development and Validity Assessment of a Chronic Obstructive Pulmonary Disease Knowledge Questionnaire in Low- and Middle-Income Countries. Ann Am Thorac Soc 2021; 18:1298-1305. [PMID: 33476252 DOI: 10.1513/annalsats.202007-884oc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: The majority of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) occurs in low- and middle-income countries (LMICs). Despite the increasing burden of COPD, disease-specific knowledge among healthcare workers and patients in LMICs remains limited. COPD knowledge questionnaires (COPD-KQ) are valid and reliable tools to assess COPD knowledge and can be employed in settings with limited health literacy. Objectives: To develop and assess the validity and reliability of a COPD-KQ among individuals with COPD in three LMIC settings. Methods: Twelve questions were generated by an expert team of 16 researchers, physicians, and public health professionals to create an LMIC-specific COPD-KQ. The content was based on previous instruments, clinical guidelines, focus-group discussions, and questionnaire piloting. Participants with COPD completed the questionnaire across three diverse LMIC settings before and 3 months after delivery of a standardized COPD-specific education package by a local community health worker trained to deliver the education to an appropriate standard. We used paired t tests to assess improvement in knowledge after intervention. Results: Questionnaire development initially yielded 52 items. On the basis of community feedback and expertise, items were eliminated and added, yielding a final 12-item questionnaire, with a maximum total score of 12. A total of 196 participants with COPD were included in this study in Nepal (n = 86), Peru (n = 35), and Uganda (n = 75). The mean ± standard deviation baseline score was 8.0 ± 2.5, and 3 months after education, the mean score was 10.2 ± 1.7. The community health worker-led COPD educational intervention improved COPD knowledge among community members by 2.2 points (95% confidence interval, 1.8-2.6 points; t = 10.9; P < 0.001). Internal consistency using Cronbach's α was 0.75. Conclusions: The LMIC COPD-KQ demonstrates face and content validity and acceptable internal consistency through development phases, suggesting a reliable and valid COPD education instrument that can be used to assess educational interventions across LMIC settings. Clinical trial registered with www.clinicaltrials.gov (NCT03365713).
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Almeida CSD, Andrade SN, Abreu MNS, Malta DC, Lana FCF. Reprodutibilidade dos módulos bebidas alcoólicas e drogas ilícitas da Pesquisa Nacional de Saúde do Escolar 2015. Rev Esc Enferm USP 2020; 54:e03660. [DOI: 10.1590/s1980-220x2019014903660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 04/23/2020] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Avaliar a reprodutibilidade dos módulos de uso de bebidas alcoólicas e de drogas ilícitas da Pesquisa Nacional de Saúde do Escolar do ano de 2015. Método: Estudo epidemiológico transversal visando avaliar a reprodutibilidade de instrumentos de coleta, realizado na cidade de Divinópolis, Minas Gerais. A amostra foi composta por alunos cursando o 9° ano do Ensino Fundamental em escolas públicas e privadas em 2017. A reprodutibilidade dos módulos de uso de álcool e drogas ilícitas foi aplicada na amostra, e o reteste ocorreu dentro de 15 a 20 dias com os mesmos alunos. Na análise da concordância teste e reteste, foi utilizado o coeficiente Kappa na análise das variáveis categóricas nominais; Kappa com ponderação linear, na análise das variáveis categóricas ordinais; e Coeficiente de Correlação Intraclasse na análise das variáveis numéricas. Resultados: Participaram 303 alunos. A concordância das respostas foi de satisfatória a moderada e não houve nenhum indicador com concordância razoável ou pobre. As frequências também ficaram próximas entre o teste e o reteste. Conclusão: Os módulos analisados foram satisfatórios, considerados reaplicáveis, e são fontes confiáveis para subsidiar Políticas Públicas e programas voltados aos adolescentes.
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Nguyen VN, Huynh TTH, Chavannes NH. Knowledge on self-management and levels of asthma control among adult patients in Ho Chi Minh City, Vietnam. Int J Gen Med 2018. [PMID: 29520161 PMCID: PMC5833772 DOI: 10.2147/ijgm.s157050] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Most asthma patients in Vietnam have poorly controlled asthma. Besides reasons related to the health care system and health care providers, knowledge on the self-management of patients has also contributed to this situation. Purpose To assess knowledge on asthma self-management among adult asthma patients in Ho Chi Minh City. Patients and methods A cross-sectional study with convenience sampling was conducted among 322 ambulatory patients using questionnaires filled in via a face-to-face interview. The questionnaires enquired about: 1) sociodemographic details, 2) the Global Initiative for Asthma 2017 criteria of asthma control, 3) the Asthma Control Test, and 4) the Asthma Self-Management Questionnaire (ASMQ). Knowledge on asthma self-management was determined by the ASMQ score. The relationship between this knowledge and demographic factors and asthma control levels was determined. Results The knowledge on asthma self-management was low, with a mean raw ASMQ score of 4.3 (maximum 14); this is equivalent to 30 in a transformed score (maximum 100). Only 0.3% of these patients had good knowledge, 16.2% had adequate knowledge, and 83.5% had poor knowledge. Of all participants, 52% stated erroneously that asthma can be cured, 30% were confused about control and rescue medications, 68% failed to correctly describe the inhalation technique, and only 15.5% could answer correctly about the management of an exacerbation. Although most participants had poor asthma control, the higher the patient’s level of control, the better the ASMQ score. Conversely, patients with better knowledge of asthma self-management (ASMQ score ≥50) had better asthma control based on the Asthma Control Test score. Also, a higher education level was associated with more knowledge on asthma self-management. Conclusion In these patients, the level of knowledge on asthma self-management was low and significantly correlated with the level of asthma control. There is a clear need to improve knowledge in order to improve asthma control in Vietnam.
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Affiliation(s)
- Vinh Nhu Nguyen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.,Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.,Department of Respiratory Functional Exploration, University Medical Center, Ho Chi Minh City, Vietnam
| | - Thuong Thi Hoai Huynh
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
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Melo J, Moreno A, Ferriani V, Araujo AC, Vianna E, Borges M, Roxo P, Gonçalves M, Mello L, Parreira R, Silva J, Stefanelli P, Panazolo L, Cetlin A, Queiroz L, Araujo R, Dias M, Aragon D, Domingos N, Arruda LK. University and public health system partnership: A real-life intervention to improve asthma management. J Asthma 2016; 54:411-418. [PMID: 27715349 DOI: 10.1080/02770903.2016.1218012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Asthma is under-diagnosed in many parts of the world. We aimed to assess the outcome of a capacitating program on asthma for non-specialist physicians and other healthcare professionals working in the public system in Ribeirão Preto, Brazil. METHODS A group of 16 asthma specialists developed a one-year capacitating program in 11 healthcare clinics in the Northern District of the city, which included lectures on asthma, training on inhalation device use and spirometry, and development of an asthma management protocol. Researchers visited one health unit 2-4 times monthly, working with doctors on patients' care, discussing cases, and delivering lectures. Asthma education was also directed to the general population, focusing on recognition of signs and symptoms and long-term treatment, including production of educational videos available on YouTube. Outcome measures were the records of doctors' prescriptions of individual asthma medications pre- and post-intervention. RESULTS Prior to the program, 3205 units of inhaled albuterol and 2876 units of inhaled beclomethasone were delivered by the Northern District pharmacy. After the one-year program, there was increase to 4850 units (51.3%) for inhaled albuterol and 3526 units (22.6%) for inhaled beclomethasone. The albuterol increase followed the recommendation given to the non-specialist doctors by the asthma experts, that every patient with asthma should have inhaled albuterol as a rescue medication, by protocol. No increase was observed in other districts where no capacitating program was conducted. CONCLUSION A systematic capacitating program was successful in changing asthma prescription profiles among non-specialist doctors, with increased delivery of inhaled albuterol and beclomethasone.
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Affiliation(s)
- Janaina Melo
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Adriana Moreno
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Virginia Ferriani
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Ana Carla Araujo
- c Department of Medicine , University of Ribeirão Preto UNAERP , Ribeirão Preto , Brazil
| | - Elcio Vianna
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Marcos Borges
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Pérsio Roxo
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Marcos Gonçalves
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Luane Mello
- d Department of Social Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Rosa Parreira
- e Department of Pediatrics , Barão de Mauá University Center , Ribeirão Preto , Brazil
| | - Jorgete Silva
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Patricia Stefanelli
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Larissa Panazolo
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Andrea Cetlin
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Luana Queiroz
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Rosângela Araujo
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Marina Dias
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Davi Aragon
- b Department of Pediatrics , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
| | - Nélio Domingos
- f Health Secretariat of Municipal Government of the City of Ribeirão Preto , Ribeirão Preto , Brazil
| | - L Karla Arruda
- a Department of Medicine , Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil
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Olivera CMX, Vianna EO, Bonizio RC, de Menezes MB, Ferraz E, Cetlin AA, Valdevite LM, Almeida GA, Araujo AS, Simoneti CS, de Freitas A, Lizzi EA, Borges MC, de Freitas O. Asthma self-management model: randomized controlled trial. HEALTH EDUCATION RESEARCH 2016; 31:639-652. [PMID: 27473571 DOI: 10.1093/her/cyw035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 06/25/2016] [Indexed: 06/06/2023]
Abstract
Information for patients provided by the pharmacist is reflected in adhesion to treatment, clinical results and patient quality of life. The objective of this study was to assess an asthma self-management model for rational medicine use. This was a randomized controlled trial with 60 asthmatic patients assigned to attend five modules presented by a pharmacist (intervention group) and 59 patients in the control group. Data collection was performed before and after this 4-month intervention and included an evaluation of asthma knowledge, lifestyle, inhaler techniques, adhesion to treatment, pulmonary function and quality of life. An economic viability analysis was also performed. The intervention group obtained an increase in asthma knowledge scores of 58.3-79.5% (P < 0.001). In this group, there was also an increase in the number of individuals who practiced physical exercise (36-43%), in the number of correct replies regarding the use of inhalers, in the percentage of adherent patients, and in quality of life scores for all domains. We concluded that this asthma self-management model was effective in improving the quality of life of asthma patients.
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Affiliation(s)
- Carolina M X Olivera
- Department of Pharmaceutical Sciences, Pharmacy School, Ribeirão Preto 14040-903, Brazil
| | | | - Roni C Bonizio
- Department of Accounting, School of Economy, Administration and Accounting, Ribeirão Preto 14040-905, Brazil
| | | | - Erica Ferraz
- Department of Medicine, Medical School, Ribeirão Preto 14049-900, Brazil
| | - Andrea A Cetlin
- Department of Medicine, Medical School, Ribeirão Preto 14049-900, Brazil
| | | | | | - Ana S Araujo
- Department of Medicine, Medical School, Ribeirão Preto 14049-900, Brazil
| | | | - Amanda de Freitas
- Department of Social Medicine, Medical School, Ribeirão Preto 14049-900, Brazil and
| | - Elisangela A Lizzi
- Department of Mathematics, Federal University of Technology, Curitiba, 80230-901, Brazil
| | - Marcos C Borges
- Department of Medicine, Medical School, Ribeirão Preto 14049-900, Brazil
| | - Osvaldo de Freitas
- Department of Pharmaceutical Sciences, Pharmacy School, Ribeirão Preto 14040-903, Brazil
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Zambelli-Simões L, Martins MC, Possari JCDC, Carvalho GB, Coelho ACC, Cipriano SL, Carvalho-Pinto RMD, Cukier A, Stelmach R. Validation of scores of use of inhalation devices: valoration of errors. J Bras Pneumol 2016; 41:313-22. [PMID: 26398751 PMCID: PMC4635951 DOI: 10.1590/s1806-37132015000004435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: To validate two scores quantifying the ability of patients to use metered dose inhalers (MDIs) or dry powder inhalers (DPIs); to identify the most common errors made during their use; and to identify the patients in need of an educational program for the use of these devices. Methods: This study was conducted in three phases: validation of the reliability of the inhaler technique scores; validation of the contents of the two scores using a convenience sample; and testing for criterion validation and discriminant validation of these instruments in patients who met the inclusion criteria. Results: The convenience sample comprised 16 patients. Interobserver disagreement was found in 19% and 25% of the DPI and MDI scores, respectively. After expert analysis on the subject, the scores were modified and were applied in 72 patients. The most relevant difficulty encountered during the use of both types of devices was the maintenance of total lung capacity after a deep inhalation. The degree of correlation of the scores by observer was 0.97 (p < 0.0001). There was good interobserver agreement in the classification of patients as able/not able to use a DPI (50%/50% and 52%/58%; p < 0.01) and an MDI (49%/51% and 54%/46%; p < 0.05). Conclusions: The validated scores allow the identification and correction of inhaler technique errors during consultations and, as a result, improvement in the management of inhalation devices.
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Affiliation(s)
- Letícia Zambelli-Simões
- Departamento de Fisiopatologia Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
| | - Maria Cleusa Martins
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
| | | | | | | | - Sonia Lucena Cipriano
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
| | | | - Alberto Cukier
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
| | - Rafael Stelmach
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
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Basheti IA, Hamadi SA, Reddel HK. Inter-professional education unveiling significant association between asthma knowledge and inhaler technique. Pharm Pract (Granada) 2016; 14:713. [PMID: 27011779 PMCID: PMC4800018 DOI: 10.18549/pharmpract.2016.01.713] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 03/04/2016] [Indexed: 12/02/2022] Open
Abstract
Objectives: To explore whether an association exists between health care professionals’ (HCPs) asthma knowledge and inhaler technique demonstration skills. Methods: HCPs’ asthma knowledge and inhaler technique demonstration skills were assessed at baseline at an inter-professional educational workshop focusing on asthma medication use. Asthma knowledge was assessed via a published questionnaire. Correct inhaler technique for the three inhalers, the Accuhaler, Turbuhaler and pressurized Metered Dose Inhaler (pMDI) was assessed using published checklists. Results: Two hundred HCPs agreed to participate: 10 specialists (medical doctors specialized in respiratory diseases) (5%), 46 general practitioners (23%), 79 pharmacists (39%), 15 pharmacists’ assistants (8%), 40 nurses (20%) and 10 respiratory therapists (5%). Backwards stepwise multiple regression conducted to determine predictors of HCPs’ inhaler technique, showed that out of many independent variables (asthma knowledge score, profession, age, gender, place of work, years in practice and previous personal use of the study inhaler/s), asthma knowledge score was the only variable showing significant association with inhaler technique (R2=0.162, p<0.001). Conclusion: This study revealed significant associations between asthma knowledge and inhaler technique scores for all HCPs. Providing inter-professional workshops for all HCPs involved integrating education on asthma knowledge and practice of inhaler technique skills are looked-for.
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Affiliation(s)
- Iman A Basheti
- Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science University , Amman ( Jordan ).
| | - Salim A Hamadi
- Department of Pharmacology & Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, Petra University . Amman ( Jordan ).
| | - Helen K Reddel
- Woolcock Institute of Medical Research, University of Sydney . Sydney, NSW ( Australia ).
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Evaluation of structured patient education in occupational skin diseases: a systematic assessment of the disease-specific knowledge. Int Arch Occup Environ Health 2014; 87:861-9. [DOI: 10.1007/s00420-014-0926-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
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Patel KK, Caramelli B, Gomes A. A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press. Clinics (Sao Paulo) 2011; 66:2159-68. [PMID: 22189744 PMCID: PMC3226614 DOI: 10.1590/s1807-59322011001200024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 11/07/2011] [Indexed: 11/21/2022] Open
Abstract
Recent original scientific contributions published in selected Brazilian periodicals and classifiable under cardiovascular and pulmonary subject categories cover a wide range of sub specialties, both clinical and experimental. Because they appear in journals with only recently enhanced visibility, we have decided to highlight a number of specific items appeared in four Brazilian journals, because we understand that this is an important subsidy to keep our readership adequately informed. These papers cover extensive sub-areas in both fields.
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