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1.
Heliyon ; 5(11): e02904, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31844762

RESUMEN

The efficacy of Pelargonium sidoides preparation EPs 7630 in the common cold (CC) was assessed by performing meta-analyses of randomized, double-blind, placebo-controlled trials. Mean differences (MD) and risk ratios (RR) with their 95% confidence intervals (CI) were computed. Five trials with a total of 833 patients were included. All trials had a treatment period of ten days with visits at days 3, 5, and 10 after baseline and used a ten-symptom Cold Intensity Score (CIS) as the primary outcome. Significant differences favoring EPs 7630 were observed for total CIS reduction (day 5: MD = -2·30; 95%CI = -4·12,-0·49; day 10: MD = -1·16; 95%CI = -2·22,-0·10), proportion of patients with substantial improvement (day 5: RR = 1·73; day 10: RR = 1·06) and complete remission (day 5: RR = 2·52; day 10: RR = 2·13). Subjects treated with EPs 7630 missed fewer days at work, used less paracetamol and had an improved sleep quality. No serious adverse reactions to EPs 7630 were reported. The results support the efficacy of EPs 7630 in adults with CC.

2.
Arch Intern Med ; 167(1): 60-7, 2007 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-17210879

RESUMEN

BACKGROUND: Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD), but depression's impact on COPD outcomes has not been fully investigated. We evaluated the impact of comorbid depression on mortality, hospital readmission, smoking behavior, respiratory symptom burden, and physical and social functioning in patients with COPD. METHODS: In this prospective cohort study, 376 consecutive patients with COPD hospitalized for acute exacerbation were followed up for 1 year. The independent associations of baseline comorbid depression (designated as a Hospital Anxiety and Depression Scale score of > or =8) with mortality, hospital readmission, length of stay, persistent smoking, and quality of life (determined by responses to the St George Respiratory Questionnaire) were evaluated after adjusting for potential confounders. RESULTS: The prevalence of depression at admission was 44.4%. The median follow-up duration was 369 days, during which 57 patients (15.2%) died, and 202 (53.7%) were readmitted at least once. Multivariate analyses showed that depression was significantly associated with mortality (hazard ratio, 1.93; 95% confidence interval, 1.04-3.58), longer index stay (mean, 1.1 more days; P = .02) and total stay (mean, 3.0 more days; P = .047), persistent smoking at 6 months (odds ratio, 2.30; 95% confidence interval, 1.17-4.52), and 12% to 37% worse symptoms, activities, and impact subscale scores and total score on the St George Respiratory Questionnaire at the index hospitalization and 1 year later, even after controlling for chronicity and severity of COPD, comorbidities, and behavioral, psychosocial, and socioeconomic variables. CONCLUSIONS: Comorbid depressive symptoms in patients with COPD are associated with poorer survival, longer hospitalization stay, persistent smoking, increased symptom burden, and poorer physical and social functioning. Interventions that reduce depressive symptoms may potentially affect COPD outcomes.


Asunto(s)
Trastorno Depresivo/mortalidad , Estado de Salud , Readmisión del Paciente/tendencias , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Calidad de Vida , Anciano , Trastorno Depresivo/psicología , Femenino , Estudios de Seguimiento , Humanos , Tiempo de Internación/tendencias , Masculino , Pronóstico , Estudios Prospectivos , Enfermedad Pulmonar Obstructiva Crónica/psicología , Recurrencia , Singapur/epidemiología , Encuestas y Cuestionarios , Tasa de Supervivencia/tendencias
3.
J Psychosom Res ; 60(5): 513-9, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16650592

RESUMEN

BACKGROUND: Little is known about the long-term consequence of severe acute respiratory syndrome (SARS). We carried out an assessment on SARS patients after their recovery from their acute illness. METHOD: Postal survey comprising Health-Related Quality of Life (HRQoL) questionnaires and anxiety and depression measures was sent to them at 3 months' postdischarge. RESULTS: There was a significant impairment in both the HRQoL and mental functioning. Forty-one percent had scores indicative of a posttraumatic stress disorder (PTSD); about 30% had likely anxiety and depression. CONCLUSION: SARS has significant impact on HRQoL and psychological status at 3 months.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Depresión/epidemiología , Calidad de Vida/psicología , Síndrome Respiratorio Agudo Grave , Trastornos por Estrés Postraumático/epidemiología , Sobrevivientes/psicología , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , China/etnología , Demografía , Depresión/diagnóstico , Depresión/psicología , Femenino , Hospitalización , Humanos , India/etnología , Malasia/etnología , Masculino , Alta del Paciente , Proyectos Piloto , Síndrome Respiratorio Agudo Grave/psicología , Síndrome Respiratorio Agudo Grave/rehabilitación , Índice de Severidad de la Enfermedad , Singapur , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios , Factores de Tiempo
4.
Chest ; 128(6): 3810-6, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16354849

RESUMEN

STUDY OBJECTIVES: We hypothesized that the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index would better predict hospitalization for COPD than FEV1 alone, and the purpose of this study was to test this hypothesis in a cohort of patients with COPD. DESIGN: Historical cohort study. SETTING: University-affiliated hospital. PATIENTS: One hundred twenty-seven patients with COPD recruited from the outpatient clinic of a single institution were followed up for a mean period of 16.2 months. MEASUREMENTS: The BODE index was calculated for each patient using variables obtained within 4 weeks of enrollment. The main outcome measure was the number of hospital admissions for COPD during follow-up. We used the Poisson regression model to quantify and compare the relationship between FEV1 and BODE scores with the number of hospital admissions. RESULTS: During the follow-up period, 47% of patients required at least one hospital admission and 17% died. Using Poisson regression analysis, a significant effect of BODE score on the number of hospital admissions was found (incidence rate ratio, 1.20; 95% confidence interval [CI], 1.15 to 1.25; p < 0.001). In comparison, there was a significant but smaller effect of the FEV1 percentage of predicted on the number of hospital admissions (incidence rate ratio, 0.08; 95% CI, 0.04 to 0.16; p < 0.001). When categorizing the BODE scores into four quartiles, we found that the BODE index is also a better predictor of hospital admissions than the staging system of COPD as defined by the Global Initiative for Chronic Obstructive Lung Disease. The pseudo r2 using quartiles of the BODE index as the predictor was 0.16, as compared to 0.04 for stages of severity based on FEV1. CONCLUSIONS: The BODE staging system, which includes in addition to FEV1 other physiologic and clinical variables, helps to better predict hospitalization for COPD.


Asunto(s)
Obstrucción de las Vías Aéreas/diagnóstico , Índice de Masa Corporal , Disnea/diagnóstico , Hospitalización/estadística & datos numéricos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Anciano , Obstrucción de las Vías Aéreas/epidemiología , Estudios de Cohortes , Intervalos de Confianza , Disnea/epidemiología , Tolerancia al Ejercicio , Femenino , Estudios de Seguimiento , Hospitales Universitarios , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Distribución de Poisson , Valor Predictivo de las Pruebas , Pronóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Pruebas de Función Respiratoria , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Perfil de Impacto de Enfermedad
5.
Chest ; 128(3): 1393-400, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16162734

RESUMEN

STUDY OBJECTIVES: To characterize the long-term pulmonary function and health status in a prospectively identified cohort of patients who survived the severe acute respiratory syndrome (SARS). DESIGN: Prospective follow-up cohort study. SETTING: University-affiliated hospital. PATIENTS: Ninety-four patients who recovered from SARS were assessed at a uniform time point of 1 year after hospital discharge. MEASUREMENTS: The study included the measurement of static and dynamic lung volumes, the determination of the diffusing capacity of the lung for carbon monoxide (D(LCO)), and a health status evaluation using the St. George Respiratory Questionnaire (SGRQ). RESULTS: Eleven patients (12%) had mild impairment of FVC, 20 (21%) had mild impairment of FEV1, 5 (5%) had mild impairment of the FEV1/FVC ratio, and 17 (18%) had mild impairment of the D(LCO). There was one patient (1%) who had moderate impairment of FVC, one patient (1%) who had moderate impairment of the FEV1/FVC ratio, and three patients (3%) who had moderate impairment of the D(LCO). No pulmonary function abnormalities were detected in 59 patients (63%). Mean scores were significantly higher (ie, worse) than the population norms in the activity (p < 0.001), impacts (p < 0.001), and total (p < 0.001) domains of the SGRQ. CONCLUSIONS: One year after recovery from SARS, persistent pulmonary function impairment was found in about one third of patients. The health status of SARS survivors was also significantly worse compared with the healthy population. The main determinants of morbidity in recovered SARS patients need to be further defined.


Asunto(s)
Estado de Salud , Pruebas de Función Respiratoria , Síndrome Respiratorio Agudo Grave , Adulto , Femenino , Estudios de Seguimiento , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Recuperación de la Función , Singapur , Sobrevivientes , Factores de Tiempo
6.
Respir Care ; 49(12): 1498-503, 2004 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-15571640

RESUMEN

INTRODUCTION: Common modalities of clinical exercise testing for outcome measurement after pulmonary rehabilitation (PR) include walk tests, progressive cycle ergometry, and cycle endurance testing. We hypothesized that patients' responses to PR, as measured by those 3 tests, are differentially correlated, and we designed a study to investigate the tests' capacity to detect changes after PR. METHODS: We prospectively tested 37 male patients with stable chronic obstructive pulmonary disease who completed a comprehensive 6-week PR program that included supervised exercise training that emphasized steady-state lower-limb aerobic exercise. Before and after the PR program the patients underwent 6-minute walk test, progressive cycle ergometry, and cycle endurance testing (at 80% of the peak work rate achieved during progressive cycle ergometry). The exercise performance indices of interest were the peak oxygen uptake (VO2max) and maximum work-rate (Wmax) during progressive cycle ergometry, the cycling endurance time, and the 6-minute walk distance (6MWD). RESULTS: After PR there were statistically significant improvements in 6MWD (16%, p <0.001), VO2max (53%, p=0.004), Wmax (30%, p=0.001), and cycling endurance time (144%, p <0.001). The changes in VO2max and Wmax were significantly correlated (r=0.362, p=0.027), as were the changes in endurance time and Wmax (r=0.406, p=0.013). There was no significant correlation between changes in any other exercise index. CONCLUSIONS: Among the frequently used exercise tests in PR, the most responsive index is the endurance time. The correlation between the post-PR changes in the various exercise indices is poor.


Asunto(s)
Prueba de Esfuerzo , Resistencia Física , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Anciano , Ciclismo/fisiología , Ergometría , Prueba de Esfuerzo/estadística & datos numéricos , Terapia por Ejercicio , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Espirometría , Factores de Tiempo , Caminata/fisiología
7.
Clin Nutr ; 31(3): 345-50, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22122869

RESUMEN

BACKGROUND & AIMS: The confounding effect of disease on the outcomes of malnutrition using diagnosis-related groups (DRG) has never been studied in a multidisciplinary setting. This study aims to determine the prevalence of malnutrition in a tertiary hospital in Singapore and its impact on hospitalization outcomes and costs, controlling for DRG. METHODS: This prospective cohort study included a matched case control study. Subjective Global Assessment was used to assess the nutritional status on admission of 818 adults. Hospitalization outcomes over 3 years were adjusted for gender, age, ethnicity, and matched for DRG. RESULTS: Malnourished patients (29%) had longer hospital stays (6.9±7.3 days vs. 4.6±5.6 days, p<0.001) and were more likely to be readmitted within 15 days (adjusted relative risk=1.9, 95% CI 1.1-3.2, p=0.025). Within a DRG, the mean difference between actual cost of hospitalization and the average cost for malnourished patients was greater than well-nourished patients (p=0.014). Mortality was higher in malnourished patients at 1 year (34% vs. 4.1 %), 2 years (42.6% vs. 6.7%) and 3 years (48.5% vs. 9.9%); p<0.001 for all. Overall, malnutrition was a significant predictor of mortality (adjusted hazard ratio=4.4, 95% CI 3.3-6.0, p<0.001). CONCLUSIONS: Malnutrition was evident in up to one third of the inpatients and led to poor hospitalization outcomes and survival as well as increased costs of care, even after matching for DRG. Strategies to prevent and treat malnutrition in the hospital and post-discharge are needed.


Asunto(s)
Costos de la Atención en Salud , Hospitalización/economía , Desnutrición/economía , Desnutrición/epidemiología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Factores de Confusión Epidemiológicos , Costos y Análisis de Costo , Femenino , Hospitales Universitarios , Humanos , Tiempo de Internación/economía , Masculino , Desnutrición/mortalidad , Desnutrición/terapia , Persona de Mediana Edad , Mortalidad , Readmisión del Paciente/economía , Prevalencia , Estudios Prospectivos , Singapur/epidemiología , Adulto Joven
8.
Ann Acad Med Singap ; 38(10): 862-8, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19890577

RESUMEN

INTRODUCTION: This study objectively evaluates the effectiveness of a 6-week Preparatory Training Phase (PTP) programme prior to Basic Military Training (BMT) for less physically conditioned conscripts in the Singapore Armed Forces. MATERIALS AND METHODS: We compared exercise test results of a group of less fi t recruits who underwent a 16-week modified-BMT (mBMT) programme (consisting of a 6-week PTP and 10-week BMT phase) with their 'fitter' counterparts enlisted in the traditional 10-week direct-intake BMT (dBMT) programme in this prospective cohort study consisting of 36 subjects. The main outcome measures included cardiopulmonary responses parameters (VO(2)max and V(O2AT)) with clinical exercise testing and distance run timings. RESULTS: Although starting off at a lower baseline in terms of physical fitness [VO(2)max 1.73 +/- 0.27 L/min (mBMT group) vs 1.97 +/- 0.43 L/min (dBMT), P = 0.032; V(O2AT) 1.02 +/- 0.19 vs 1.14 +/- 0.32 L/min respectively, P = 0.147], the mBMT group had greater improvement in cardiopulmonary indices and physical performance profiles than the dBMT cohort as determined by cardiopulmonary exercise testing [VO(2)max 2.34 +/- 0.24 (mBMT) vs 2.36 +/- 0.36 L/min (dBMT), P = 0.085; V(O2AT) 1.22 +/- 0.17 vs 1.21 +/- 0.24 L/min respectively, P = 0.303] and 2.4 kilometres timed-run [mBMT group 816.1 sec (pre-BMT) vs 611.1 sec (post-BMT), dBMT group 703.8 sec vs 577.7 sec, respectively; overall P value 0.613] at the end of the training period. Initial mean difference in fitness between mBMT and dBMT groups on enlistment was negated upon graduation from BMT. CONCLUSION: Pre-enlistment fitness stratification with training modification in a progressive albeit longer BMT programme for less-conditioned conscripts appears efficacious when measured by resultant physical fitness.


Asunto(s)
Personal Militar/estadística & datos numéricos , Educación y Entrenamiento Físico/métodos , Aptitud Física , Carrera/fisiología , Adolescente , Pueblo Asiatico , Índice de Masa Corporal , Estudios de Cohortes , Prueba de Esfuerzo/estadística & datos numéricos , Humanos , Masculino , Consumo de Oxígeno , Educación y Entrenamiento Físico/normas , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Medición de Riesgo , Singapur , Factores de Tiempo , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-18046907

RESUMEN

STUDY OBJECTIVES: To verify whether and to what extent the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index correlates with a disease-specific index of health status in patients with COPD. DESIGN: Cross-sectional study. SETTING: University-affiliated hospital. PATIENTS: One hundred patients with stable COPD recruited from the outpatient clinic of a single institution. MEASUREMENTS: The BODE index was calculated for each patient using variables obtained within 2 weeks of enrollment. At enrollment, all patients completed the St George's Respiratory Questionnaire (SGRQ). The Kruskal-Wallis test was used to compare health status scores with clinical and functional categories of COPD. The Spearman correlation coefficient (r) was calculated to assess the association between health status scores and clinical or functional variables. RESULTS: Categorizing the BODE scores into 4 quartiles, we found that higher BODE quartiles were associated with higher (worse) SGRQ scores. The differences among the BODE quartiles in health status indexes were significant for total SGRQ as well as all 3 of the SGRQ subscales. In all sections of the SGRQ, scores were moderately to strongly associated with the BODE quartiles (r = 0.27-0.46). In contrast, the association between the SGRQ total, impacts, activity and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were weaker (r = 0.27-0.28). There was no significant association between SGRQ symptoms and GOLD stages. CONCLUSIONS: The BODE scoring system corresponds to important differences in health status of patients with COPD. This grading system is better correlated to the health status indexes of the SGRQ than the GOLD staging criteria.


Asunto(s)
Disnea/etiología , Estado de Salud , Enfermedad Pulmonar Obstructiva Crónica , Calidad de Vida , Índice de Severidad de la Enfermedad , Anciano , Índice de Masa Corporal , Estudios Transversales , Disnea/diagnóstico , Tolerancia al Ejercicio , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Enfermedad Pulmonar Obstructiva Crónica/clasificación , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Pruebas de Función Respiratoria , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Factores de Tiempo , Caminata
10.
Respirology ; 11(2): 188-95, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16548905

RESUMEN

OBJECTIVE: The factors that determine frequent hospital readmissions for acute exacerbations of COPD (AECOPD) are poorly understood. The aim of this study was to ascertain rates of re-hospitalizations for AECOPD patients and evaluate factors associated with frequent readmissions for acute exacerbations. METHODS: We conducted a cross-sectional survey of 186 patients with moderate to severe COPD with one or more admissions for acute exacerbations to two large general hospitals. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including depression and spirometry were ascertained in the stable state both before discharge and at 1-month post discharge. RESULTS: Among them, 67% had one or more previous readmission, 46% had two or more, 9% had 10-20 readmissions in the 1-year period prior to current admission. There was a high prevalence of current or ex-heavy smokers, underweight patients, depression and consumption of psychotropic drugs, and low prevalence of caregiver support, pulmonary rehabilitation and influenza and pneumococcal vaccination. Univariate analysis showed that male sex, duration >5 years, FEV(1) < 50% predicted, use of psychotropic drugs, receipt of pulmonary rehabilitation and vaccination were significantly associated with frequent past readmissions. Multivariate analysis revealed that disease duration >5 years (odds ratio (OR) = 2.32; 95% confidence interval (CI): 1.09-4.92), FEV(1) < 50% predicted (OR = 2.60; 95% CI: 1.18-5.74), use of psychotropic drugs (OR = 13.47; 95% CI: 1.48-122.92) and vaccination status (OR = 3.27; 95% CI: 1.12-9.57) were independently associated with frequent readmissions for AECOPD. CONCLUSION: Frequent past readmission for AECOPD was associated with disease severity and psychosocial distress and increased use of vaccinations.


Asunto(s)
Readmisión del Paciente/tendencias , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Estudios de Seguimiento , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Recurrencia , Factores de Riesgo , Singapur/epidemiología
11.
Clin Endocrinol (Oxf) ; 63(2): 197-202, 2005 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16060914

RESUMEN

OBJECTIVE: Following the severe acute respiratory syndrome (SARS) outbreak, many survivors were observed to suffer from psychosomatic symptoms reminiscent of various endocrine disorders. Hence, we sought to determine the existence of any chronic endocrine sequelae in SARS survivors. DESIGN, PATIENTS, MEASUREMENTS: Sixty-one survivors of SARS prospectively recruited were analysed for hormonal derangements 3 months following recovery. Patients with pre-existing endocrine disorders were excluded. Any endocrine abnormalities diagnosed were investigated and treated where indicated up to a year. Serial evaluation facilitated characterization of trends and prognostication of any endocrinological aberrations. RESULTS: Twenty-four (39.3%) patients had evidence of hypocortisolism. The hypothalamic-pituitary-adrenal (HPA) axis dysfunction of the majority resolved within a year. Two (3.3%) of the hypocortisolic cohort had transient subclinical thyrotoxicosis. Four (6.7%) were biochemically hypothyroid, being comprised of three with central hypothyroidism and one with primary hypothyroidism. Two of the three with central hypothyroidism had concomitant central hypocortisolism. Eight had subnormal DHEAS levels. CONCLUSIONS: These preliminary findings highlight a possible aetiologic role of SARS-associated coronavirus in causing a reversible hypophysitis or direct hypothalamic effect, with the HPA axis affected more frequently than the HPT axis.


Asunto(s)
Hidrocortisona/sangre , Síndrome Respiratorio Agudo Grave/fisiopatología , Hormona Adrenocorticotrópica/sangre , Adulto , Antiinflamatorios/uso terapéutico , Femenino , Humanos , Hidrocortisona/uso terapéutico , Sistema Hipotálamo-Hipofisario/fisiopatología , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Sistema Hipófiso-Suprarrenal/fisiopatología , Prednisolona/uso terapéutico , Estudios Prospectivos , Síndrome Respiratorio Agudo Grave/sangre , Síndrome Respiratorio Agudo Grave/tratamiento farmacológico , Enfermedades de la Tiroides/sangre , Enfermedades de la Tiroides/complicaciones , Enfermedades de la Tiroides/fisiopatología
12.
Respirology ; 8(3): 332-8, 2003 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12911827

RESUMEN

OBJECTIVES: The aim of this study was to explore the relationship between resting pulmonary function indices and the ratio of minute ventilation at peak exercise to the maximal voluntary ventilation (VEmax/MVV) and to determine whether an improvement in breathing capacity during exercise (i.e. VEmax/MVV > 1) is associated with greater exercise capacity in patients with COPD. METHODOLOGY: The results of pulmonary function tests and incremental, symptom-limited cardiopulmonary exercise testing in 84 patients with predominantly moderate to severe COPD were reviewed. Multiple linear regression analysis was applied to determine the relationship of VEmax/MVV with selected independent variables at rest. Multiple logistic regression was used to determine significant predictors of VEmax/MVV 1. RESULTS: FEV1/FVC and inspiratory capacity (IC) were the only variables among resting pulmonary function indices that were significant independent determinants of VEmax/MVV and the stepwise analysis generated the following equation: VEmax/MVV = (-1.05E-02 x FEV1/FVC) + (0.15 x IC) + 1.28; r= 0.701, P < 0.001. Using multiple logistic regression with VEmax/MVV 1 as a dependent categorical variable, FEV1/FVC was the only significant predictor among resting pulmonary indices of a VEmax/MVV ratio of > 1 (Odds ratio 0.93, 95%CI 0.89, 0.97). There was a significant association between VEmax/MVV and peak oxygen uptake (VO2max) after adjusting for FEV1 (r = 0.66, P < 0.001). If the categorical variable of VEmax/MVV ( 1) was used instead of a continuous variable, a significant association with VO2max remained after adjusting for FEV1 (r = 0.60, P < 0.001). CONCLUSIONS: Among resting pulmonary function indices, the FEV1/FVC ratio is the best determinant of an improvement in breathing capacity during exercise in COPD patients. After adjusting for FEV1, an improvement in breathing capacity during exercise is associated with significantly higher exercise capacity.


Asunto(s)
Tolerancia al Ejercicio , Volumen Espiratorio Forzado/fisiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Capacidad Vital/fisiología , Anciano , Anciano de 80 o más Años , Prueba de Esfuerzo , Humanos , Modelos Logísticos , Persona de Mediana Edad , Consumo de Oxígeno , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Fenómenos Fisiológicos Respiratorios , Estudios Retrospectivos
13.
Respirology ; 9(1): 76-80, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-14982606

RESUMEN

OBJECTIVES: The aim of the present study was to investigate the relationship between the FEV(1) and maximal voluntary ventilation (MVV) in healthy adult Chinese subjects, and to determine the validity of existing prediction equations of MVV for use in the Chinese population. METHODOLOGY: Ninety-five healthy subjects (48 male and 47 female) stratified into five age groups (from 20 to 70 years) for both sexes were recruited from the general population. The FEV(1) and MVV of these subjects were measured with a clinical spirometer. The MVV was determined using the closed-circuit technique. The MVV was assessed for 12 s and values were calculated to obtain L/min. Multiple regression analysis was used to develop equations to predict MVV with age, height, FEV(1) as well as with FEV(1) alone as predictor variables. One-sample t-tests were used to compare the actual values of MVV for the subjects with their predicted values using equations from previous studies of MVV in healthy subjects. RESULTS: Using FEV(1) only, the following predictive equation was obtained: MVV = FEV(1) x 45.12 - 15.85 (adjusted r(2) = 0.792). Predicted MVV values using previously cited equations, including MVV = FEV(1) x 35 or 40, were all significantly different from the actual MVV values of these subjects. CONCLUSIONS: The relationship between MVV and FEV(1) among healthy adult Chinese subjects is described. Previously cited equations describing the relationship between FEV(1) and MVV cannot be applied to healthy adult Chinese subjects.


Asunto(s)
Pueblo Asiatico , Ventilación Voluntaria Máxima , Adulto , Anciano , China , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Espirometría
14.
Am J Respir Crit Care Med ; 169(9): 1028-33, 2004 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-14977622

RESUMEN

The aim of this study is to investigate the effects of inhaled furosemide on the sensation of dyspnea produced during exercise in patients with stable chronic obstructive pulmonary disease (COPD). In a double-blind, randomized, crossover study we compared the effect of inhaled furosemide on dyspneic sensation during exercise testing with that of placebo. Spirometry and incremental and constant-load exercise testing were performed after inhalation of placebo or furosemide on 2 separate days in 19 patients with moderate or severe COPD. Subjects were asked to rate their sensation of respiratory discomfort using a 100-mm visual analog scale. There was significant improvement in mean FEV1 and FVC after inhalation of furosemide (p = 0.038 and 0.005, respectively) but not after placebo. At standardized exercise time during constant-load exercise testing but not during incremental exercise, the mean dyspneic visual analog scale score was lower after inhalation of furosemide compared with placebo (33.7 +/- 25.2 vs. 42.4 +/- 24.0 mm, respectively, p = 0.014). We conclude that inhalation of furosemide alleviates the sensation of dyspnea induced by constant-load exercise testing in patients with COPD and that there is significant bronchodilation after inhalation of furosemide compared with placebo in these patients.


Asunto(s)
Diuréticos/uso terapéutico , Disnea/tratamiento farmacológico , Furosemida/uso terapéutico , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Administración por Inhalación , Anciano , Antropometría , Actitud Frente a la Salud , Estudios Cruzados , Diuréticos/farmacología , Método Doble Ciego , Disnea/diagnóstico , Disnea/etiología , Disnea/psicología , Prueba de Esfuerzo/efectos de los fármacos , Prueba de Esfuerzo/métodos , Femenino , Volumen Espiratorio Forzado/efectos de los fármacos , Furosemida/farmacología , Humanos , Masculino , Ventilación Voluntaria Máxima/efectos de los fármacos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Espirometría , Resultado del Tratamiento , Capacidad Vital/efectos de los fármacos
15.
Respirology ; 7(3): 225-31, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12153688

RESUMEN

OBJECTIVE: Normative data for cardiopulmonary exercise testing (CPET) may vary among subjects of different races. The objectives of the present study were to: (i) establish normal standards for cardiopulmonary responses during incremental cycle ergometer testing in order to derive predictive equations for clinically useful variables during CPET of Chinese subjects; and (ii) determine the validity of existing prediction equations of maximal exercise performance for use in our local Chinese population. METHODOLOGY: The maximal and submaximal cardiopulmonary responses were analysed for 95 healthy sedentary adult Chinese subjects (48 men and 47 women; aged 20-70 years) who underwent CPET using a cycle ergometer and an incremental work-rate protocol until symptom limitation. RESULTS: Measurements, at maximal exercise, of oxygen uptake (VO2(max)), power output and heart rate were regressed on age, height, weight and gender. The predictive equations for these exercise parameters performed better than those published previously in out-sample predictive accuracy. Comparison with previous studies also showed that prediction equations of VO2(max) derived from studies based predominantly or exclusively on Caucasian populations overestimated the actual values for our subjects. CONCLUSIONS: Previously established prediction equations for maximal exercise performance during CPET based on non-Chinese populations may not be applicable to Chinese subjects in our population.


Asunto(s)
Pueblo Asiatico , Prueba de Esfuerzo , Adulto , Anciano , Antropometría , China/etnología , Femenino , Humanos , Análisis de los Mínimos Cuadrados , Masculino , Persona de Mediana Edad , Consumo de Oxígeno , Valor Predictivo de las Pruebas , Estándares de Referencia , Mecánica Respiratoria , Singapur
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