Comparison of face-to-face interview and telephone interview administration of COPD assessment test: a randomized study.

OBJECTIVE: To assess the measurement properties of the COPD assessment test (CAT) in a randomized trial comparing a face-to-face interview (FFI) with a telephone interview (TI). METHODS: A randomized study was conducted at two teaching hospitals in Fortaleza, Brazil. Patients were randomly assigned to answer the CAT questionnaire either in a FFI or by TI. The two groups were assessed for internal consistency reliability, cross-sectional validity and test-retest reliability. All patients performed spirometry and answered the modified medical research council dyspnea scale and the St. George's respiratory questionnaire (SGRQ). RESULTS: The total scores of the CAT questionnaire were similar for face-to-face and TI groups, 20.71 (95 % CI 18-23.4) versus 20.81 (95 % CI 19.31-21.7), respectively. For both mode of administration, we found good internal consistency reliability, the Cronbach's alpha ranged from 0.74 (95 % CI 0.61-0.84) to 0.89 (95 % CI 0.84-0.93) for the TI and FFI, respectively. In general, moderate-to-high correlations of CAT with SGRQ were observed, independent of the administration format. For the test-retest reliability, the intraclass correlation coefficients were very similar for both FFI and TI group 0.96 (95 % CI 0.93-0.97) versus 0.98 (95 % CI 0.96-0.98), respectively. CONCLUSION: This study demonstrated that the CAT questionnaire administration either in a FFI or by TI presents moderate-to-high measurement properties. This provides support for the use of both modes of questionnaire administration.

Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: a pilot randomized controlled trial.

OBJECTIVE: To evaluate the effect of 4 weeks of pulmonary rehabilitation (PR) versus chest physical therapy (CPT) on the preoperative functional capacity and postoperative respiratory morbidity of patients undergoing lung cancer resection. DESIGN: Randomized single-blinded study. SETTING: A teaching hospital. PARTICIPANTS: Patients undergoing lung cancer resection (N=24). INTERVENTIONS: Patients were randomly assigned to receive PR (strength and endurance training) versus CPT (breathing exercises for lung expansion). Both groups received educational classes. MAIN OUTCOME MEASURES: Functional parameters assessed before and after 4 weeks of PR or CPT (phase 1), and pulmonary complications assessed after lung cancer resection (phase 2). RESULTS: Twelve patients were randomly assigned to the PR arm and 12 to the CPT arm. Three patients in the CPT arm were not submitted to lung resection because of inoperable cancer. During phase 1 evaluation, most functional parameters in the PR group improved from baseline to 1 month: forced vital capacity (FVC) (1.47L [1.27-2.33L] vs 1.71L [1.65-2.80L], respectively; P=.02); percentage of predicted FVC (FVC%; 62.5% [49%-71%] vs 76% [65%-79.7%], respectively; P<.05); 6-minute walk test (425.5±85.3m vs 475±86.5m, respectively; P<.05); maximal inspiratory pressure (90±45.9cmH(2)O vs 117.5±36.5cmH(2)O, respectively; P<.05); and maximal expiratory pressure (79.7±17.1cmH(2)O vs 92.9±21.4cmH(2)O, respectively; P<.05). During phase 2 evaluation, the PR group had a lower incidence of postoperative respiratory morbidity (P=.01), a shorter length of postoperative stay (12.2±3.6d vs 7.8±4.8d, respectively; P=.04), and required a chest tube for fewer days (7.4±2.6d vs 4.5±2.9d, respectively; P=.03) compared with the CPT arm. CONCLUSIONS: These findings suggest that 4 weeks of PR before lung cancer resection improves preoperative functional capacity and decreases the postoperative respiratory morbidity.

Evaluation of in vitro Antifungal Activity of Xylosma prockia (Turcz.) Turcz. (Salicaceae) Leaves Against Cryptococcus spp.

Cryptococcus species are responsible for important systemic mycosis and are estimated to cause millions of new cases annually. The available therapy is limited due to the high toxicity and the increasing rates of yeast resistance to antifungal drugs. Popularly known as "sucará," Xylosma prockia (Turcz.) Turcz. (Salicaceae) is a native plant from Brazil with little information on its pharmacological potential. In this work, we evaluated in vitro anticryptococcal effects of the leaf ethanolic extract of X. prockia and its fractions against Cryptococcus gattii and Cryptococcus neoformans. We also evaluated phenotypic alterations caused by ethyl acetate fraction (EAF) (chosen according to its biological results). The liquid chromatography-mass spectrometry (LC-MS) analysis of EAF demonstrated the presence of phenolic metabolites that belong to three structurally related groups as majority compounds: caffeoylquinic acid, coumaroyl-glucoside, and caffeoyl-glucoside/deoxyhexosyl-caffeoyl glucoside derivatives. The minimum inhibitory concentration (MIC) values against C. gattii and C. neoformans ranged from 8 to 64 mg/L and from 0.5 to 8 mg/L, for ethanolic extract and EAF, respectively. The EAF triggered an oxidative burst and promoted lipid peroxidation. EAF also induced a reduction of ergosterol content in the pathogen cell membrane. These effects were not associated with alterations in the cell surface charge or in the thermodynamic fingerprint of the molecular interaction between EAF and the yeasts evaluated. Cytotoxic experiments with peripheral blood mononuclear cells (PBMCs) demonstrated that EAF was more selective for yeasts than was PBMCs. The results may provide evidence that X. prockia leaf extract might indeed be a potential source of antifungal agents.

Influence of different sized files on the accuracy of two electronic apex locators.

The aim of this study was to evaluate the impact of different file sizes on the accuracy of two electronic apex locators (EALs). Thirty extracted human single-rooted permanent mandibular incisors were used. A #10 K-file was inserted in the root canal until its end could be observed (using a light microscope) through the apical foramen. One millimetre was subtracted to establish working length (WL). Electronic readings were performed using MiniApex Locator or Root ZX II, from #10 K-file to #130 K-file. Statistical analysis was performed by two-way anova and Tukey test (P ≤ 0.05). From #60 to #130 K-file, observed differences were noted between the values obtained with both EALs and WL (P ≤ 0.05). The MiniApex Locator showed increased means when measurements were made with #50 to #70 and with #120 (P = 0.008) and #130 (P = 0.005) K-files. File sizes influenced the accuracy of EALs - the greater the instrumentation size, the higher mean differences compared to WL.

Compressive Strength and Setting Time of MTA and Portland Cement Associated with Different Radiopacifying Agents.

Objective. The aim of this study was to evaluate the compressive strength and setting time of MTA and Portland cement (PC) associated with bismuth oxide (BO), zirconium oxide (ZO), calcium tungstate (CT), and strontium carbonate (SC). Methods. For the compressive strength test, specimens were evaluated in an EMIC DL 2000 apparatus at 0.5 mm/min speed. For evaluation of setting time, each material was analyzed using Gilmore-type needles. The statistical analysis was performed with ANOVA and the Tukey tests, at 5% significance. Results. After 24 hours, the highest values were found for PC and PC + ZO. At 21 days, PC + BO showed the lowest compressive strength among all the groups. The initial setting time was greater for PC. The final setting time was greater for PC and PC + CT, and MTA had the lowest among the evaluated materials (P < 0.05). Conclusion. The results showed that all radiopacifying agents tested may potentially be used in association with PC to replace BO.