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Authors
Advisor(s)
Abstract(s)
O Relatório que se segue encontra-se dividido em três capítulos.
O primeiro diz respeito ao projeto de investigação. Trata-se de uma revisão narrativa, onde
serão abordados os vários aspetos da ACOS, nomeadamente fisiopatologia, normas de
diagnóstico, tratamento, qualidade de vida dos doentes e as diferenças entre a síndrome e
as patologias isoladas. A asma e a DPOC são duas patologias do foro respiratório muito
prevalentes em Portugal. Ambas se caracterizam por diversos sinais e sintomas de cariz
respiratório, alguns sobreponíveis, outros distintos. Após análise de alguns doentes,
verificou-se a possibilidade de manifestarem uma panóplia de sintomas da asma, mas
também da DPOC. Deste modo, surge a necessidade de implementar uma condição que
englobasse as duas patologias, tendo surgido a Síndrome de Sobreposição de Asma e DPOC
(ACOS), conhecida por apresentar características de ambas. A ACOS é uma síndrome
relativamente recente e foram várias as tentativas por parte de organismos internacionais
para a definir e caracterizar.
Inicialmente, em 2012, surgiu uma proposta de definição com base em critérios major e
minor, concebida pela Sociedad Española de Neumología y Cirurgía Torácica. Contudo,
com o avanço das investigações e estudos científicos, concluiu-se que estes critérios eram
pouco específicos e sensíveis, sentindo-se necessidade de proceder a algumas alterações.
Os critérios de exclusão dos estudos de Asma e DPOC, constituíam também uma barreira à
evolução e ao conhecimento da síndrome uma vez que definiam a eliminação de
participantes que manifestassem sintomas de ambas as patologias simultaneamente.
Posteriormente, em 2014, após vários momentos de pesquisa, a GINA e a GOLD, iniciativas
internacionais paras a Asma e para a DPOC respetivamente, trabalharam em conjunto para
propor determinados critérios de diagnóstico, com o intuito de auxiliar os clínicos e, de certo
modo, uniformizar o processo.
Apesar de tudo, ainda não foi possível chegar a um consenso amplo e a um conjunto de
critérios que possa ter aplicação fácil na clínica e na investigação epidemiológica.
O segundo capítulo compila toda a minha experiência em Farmácia Comunitária,
descrevendo tudo o que fiz ao longo de 12 semanas. O estágio decorreu na Farmácia
Misericórdia, em Nelas, de 12 de setembro a 2 de dezembro de 2022 e foi aqui que tive o
meu primeiro contacto com o que é a profissão farmacêutica e com o utente. Foram vários
os momentos de aprendizagem e formação. Pude aprofundar várias áreas desde a cosmética
aos medicamentos não sujeitos a receita médica, mas aquilo que constituiu o maior desafio
foi sem dúvida o aconselhamento farmacêutico e a interação com o utente. Para além de
tudo isto, consegui pôr em prática tudo aquilo que me foi transmitido ao longo de 5 anos e
cimentar os conhecimentos. Por último, o terceiro capítulo relata o meu processo de aprendizagem no Hospital Amato
Lusitano, em Castelo Branco. O estágio em Farmácia Hospitalar teve a duração de 8
semanas, tendo decorrido no período de 5 de dezembro de 2022 a 30 de janeiro de 2023.
Um dos conceitos mais prevalentes durante este estágio foi a Farmácia Clínica e a
intervenção farmacêutica. Pude acompanhar o trabalho diário das Farmacêuticas e auxiliar
em certas questões que lhes eram colocadas por parte dos serviços clínicos, o que me
permitiu aprofundar algumas noções e contactar com situações novas.
The following report is divided into 3 chapters. The fisrt one concerns the research project. This is a narrative review, where the very aspects of ACOS will be addressed, namely pathophysiology, diagnostic standards, treatment, patients´quality of life and the diferences between the syndrome and the isolated pathologies. Asthma and COPD are two very prevalent respiratory pathologies in Portugal. Both are characterized by many respiratory signs and symptoms, some overlapping, others distint. After analysis of some patients, it was verified the possibility of manifesting a range of symptoms of asthma, but also of COPD. Thus, arises the need to implement a condition that encompasses both pathologies, resulting in the Asthma- COPD overlap syndrome (ACOS), known to presente features of both. ACOS is a relatively recent syndrome and several attempts have been made by international organizations to define and characterize it. Initially, in 2012, a proposal for a definition based on major and minor criteria emerged, conceived by the Sociedad Española de Neumología e Cirurgía Torácica. However, with the advancements of investigations and scientific studies, was concluded that these criteria were not very specific nor sensitive, feeling the need to make some changes. The exclusion criteria for Asthma and COPD studies also constituted a barrier to the evolution and knowledge of the syndrome, since they defined the elimination of participants who manifested symptoms of both pathologies simultaneously. Later, in 2014, after several moments of research,GINA and GOLD, international initiatives for Asthma and COPD respectively, worked together to propose certain diagnostic criteria, with the aim of helping clinicians and, somehow, standardize the process. Despite everything, it has not yet been possible to reach a broad consensos and a set of criteria that can be easily applied in clinical and epidemiological research. The second chapter compilles all my Community Pharmacy expirience, describing everything I did over 12 weeks. The internship took place at Farmácia Misericórdia, in Nelas, from September 12 to December 2, 2022 and it was here that I had my first contact with what pharmaceutical profession is and with the patient. There were several moments of learning and training. I was able to delve into several areas from cosmetics to nonprescrition medicines, but what constituted the greatest challenge was undoubtedly pharmaceutical advice and interaction with the patient. Beside all that, I was able to put into pratice evetything that was passed on to me over 5 years and cement my knowledge. Finally, the third chapter reports my learning process at Hospital Amato Lusitano, in Castelo Branco. The Hospital Pharmacy internship lasted 8 weeks, from December 5, 2022 to January 30,2023. One of the most prevalente concepts during this internship was Clinical Pharmacy and pharmaceutical intervention. I was able to follow the daily work of the Pharmacists and help with certain questions that were put to them by the clinical services, which allowed me to deepen some notions and get in touch with new situations.
The following report is divided into 3 chapters. The fisrt one concerns the research project. This is a narrative review, where the very aspects of ACOS will be addressed, namely pathophysiology, diagnostic standards, treatment, patients´quality of life and the diferences between the syndrome and the isolated pathologies. Asthma and COPD are two very prevalent respiratory pathologies in Portugal. Both are characterized by many respiratory signs and symptoms, some overlapping, others distint. After analysis of some patients, it was verified the possibility of manifesting a range of symptoms of asthma, but also of COPD. Thus, arises the need to implement a condition that encompasses both pathologies, resulting in the Asthma- COPD overlap syndrome (ACOS), known to presente features of both. ACOS is a relatively recent syndrome and several attempts have been made by international organizations to define and characterize it. Initially, in 2012, a proposal for a definition based on major and minor criteria emerged, conceived by the Sociedad Española de Neumología e Cirurgía Torácica. However, with the advancements of investigations and scientific studies, was concluded that these criteria were not very specific nor sensitive, feeling the need to make some changes. The exclusion criteria for Asthma and COPD studies also constituted a barrier to the evolution and knowledge of the syndrome, since they defined the elimination of participants who manifested symptoms of both pathologies simultaneously. Later, in 2014, after several moments of research,GINA and GOLD, international initiatives for Asthma and COPD respectively, worked together to propose certain diagnostic criteria, with the aim of helping clinicians and, somehow, standardize the process. Despite everything, it has not yet been possible to reach a broad consensos and a set of criteria that can be easily applied in clinical and epidemiological research. The second chapter compilles all my Community Pharmacy expirience, describing everything I did over 12 weeks. The internship took place at Farmácia Misericórdia, in Nelas, from September 12 to December 2, 2022 and it was here that I had my first contact with what pharmaceutical profession is and with the patient. There were several moments of learning and training. I was able to delve into several areas from cosmetics to nonprescrition medicines, but what constituted the greatest challenge was undoubtedly pharmaceutical advice and interaction with the patient. Beside all that, I was able to put into pratice evetything that was passed on to me over 5 years and cement my knowledge. Finally, the third chapter reports my learning process at Hospital Amato Lusitano, in Castelo Branco. The Hospital Pharmacy internship lasted 8 weeks, from December 5, 2022 to January 30,2023. One of the most prevalente concepts during this internship was Clinical Pharmacy and pharmaceutical intervention. I was able to follow the daily work of the Pharmacists and help with certain questions that were put to them by the clinical services, which allowed me to deepen some notions and get in touch with new situations.
Description
Keywords
Acos Asma Doença Pulmonar Obstrutiva Crónica Dpoc Farmácia Comunitária Farmácia Hospitalar Qualidade de Vida