Alpha 1-acid glycoprotein is upregulated in severe COVID-19 patients and decreases neutrophil NETs in SARS-CoV-2 infection.

Orosomucoid, or alpha-1 acid glycoprotein (AGP), is a major acute-phase protein expressed in response to systemic injury and inflammation. AGP has been described as an inhibitor of neutrophil migration on sepsis, particularly its immunomodulation effects. AGP's biological functions in coronavirus disease 2019 (COVID-19) are not understood. We sought to investigate the role of AGP in severe COVID-19 infection patients and neutrophils infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Epidemiological data, AGP levels, and other laboratory parameters were measured in blood samples from 56 subjects hospitalized in the ICU with SARS-CoV-2 infection. To evaluate the role of AGP in NETosis in neutrophils, blood samples from health patients were collected, and neutrophils were separated and infected with SARS-CoV-2. Those neutrophils were treated with AGP or vehicle, and NETosis was analyzed by flow cytometry. AGP was upregulated in severe COVID-19 patients (p<0.05). AGP level was positively correlated with IL-6 and C-reactive protein (respectively, p=0.005, p=0.002) and negatively correlated with lactate (p=0.004). AGP treatment downregulated early and late NETosis (respectively, 35.7% and 43.5%) in neutrophils infected with SARS-CoV-2 and up-regulated IL-6 supernatant culture expression (p<0.0001). Our data showed increased AGP in COVID-19 infection and contributed to NETosis regulation and increased IL-6 production, possibly related to the Cytokine storm in COVID-19.

Dysgeusia increases the risk for death and other side effects during antineoplastic systemic treatment for solid tumors: a cross-sectional study.

BACKGROUND: Chemotherapy (CT) is a systemic treatment using a combination of antineoplastic drugs, orally or intravenously, that inhibit tumor growth and fast-growing normal cells. Due to its nonspecificity, chemotherapy can cause a series of adverse effects, such as altered taste (dysgeusia), associated with malnutrition and, consequently, other adverse effects in the gastrointestinal tract and increased mortality risk. This study aimed to evaluate the influence of dysgeusia on the incidence of other adverse effects and overall survival during antineoplastic chemotherapy. MATERIAL AND METHODS: An observational, retrospective, cross-sectional study was conducted using data from the Electronic Health Record system of the Cancer Institute of Ceará over two years. Before the CT session, the multi-professional team evaluated the patient for the presence and severity of adverse effects (AE), using scores from the CTCAE v5.0 scale. Dysgeusia scores were collected and associated with clinical pathological data, with other adverse effects (nausea, vomiting, diarrhea, oral mucositis, anorexia, constipation), and with overall survival. Chi-square and Mantel-Cox log-rank tests were used. RESULTS: Of 5744 patients evaluated, dysgeusia presented a frequency of 50.6%, being directly associated with female gender (p=0.001), overweight (p=0.022), high tumor stages (p=0.009), a combination of adjuvant and neoadjuvant (p=0.010) and four-year survival (p=0.030). Dysgeusia frequency was directly associated with diarrhea (p<0.001), anorexia (p<0.001), oral mucositis (p<0.001), nausea (p<0.001), constipation (p<0.001) and vomiting (p<0.001), and inversely associated with fatigue (p=0.035). CONCLUSIONS: Dysgeusia during CT increases the risk of other adverse effects and negatively impacts prognosis.

Performance assessment of spatio-temporal regression kriging with GAMLSS models as trends.

The main objective of this study is to propose different probabilistic models for adjusting the trend component, since it significantly influences the quality of the spatio-temporal interpolation of rainfalls. We used the monthly total precipitation data of the São Francisco River Basin (SFRB) for the period of 31 years, 1989-2019. The SFRB occupies 8% of the whole Brazilian territory, mostly located in the Northeast Brazilian region. For the trend component, we propose the fitted GAMLSS models by comparing different probability distribution families, which in most cases include the characteristics of these data. The results indicate the existence of a spatio-temporal pattern of the residues obtained from the adjustment of the trend with zero adjusted Gamma distribution for the accumulated monthly precipitation. The adjustment revealed a spatial dependence of up to 873 km between the pluviometric stations and temporal autocorrelation of approximately 1.6 months. The methodology used in this study enabled us to create rainfall maps, interpolating unobserved locations in differences years. The projection of these maps to the SFRB is considered extremely important for planning and implementing activities related to water resources across the river basin.

A Method for Statistical Processing of Magnetic Field Sensor Signals for Non-Invasive Condition Monitoring of Synchronous Generators.

Condition monitoring of synchronous generators through non-invasive methods is widely requested by maintenance teams for not interfering the machine operation. Among the techniques used, external magnetic field monitoring is a recent strategy with great potential for detecting incipient faults. In this context, this paper proposes the application of a simple strategy with low computational cost to process data of external magnetic field time derivative signals for the purposes of condition monitoring and fault detection in synchronous machines. The information of interest is extracted from changes in the magnetic signature of the synchronous generator, obtained from frequency spectra of monitored signals using induction magnetic field sensors. The process forms a set of time series that reflects constructive and operational characteristics of the machine. The Shewhart control chart method is applied for anomaly detection in these time series, allowing the detection of changes in the machine magnetic signature. This method is employed in an algorithm for continuous condition monitoring of synchronous generators, presenting as output a global change indicator for the multivariable problem associated with magnetic signature monitoring. Correlation matrices are used to improve the algorithm response, filtering series with similar variation patterns associated with detected events. The proposed method is validated through tests on an experimental bench that allows the controlled imposition of faults in a synchronous generator. The proposed global change indicator allows the automatic detection of stator and rotor faults with the machine synchronized with the commercial power grid. The proposed methodology is also applied on data obtained from an equipment installed in a 305 MVA synchronous generator of a hydroelectric power plant where the evolution of an incipient fault, i.e., a mechanical vibration fault, has been detected.

Risk factors for oral mucositis during chemotherapy treatment for solid tumors: a retrospective STROBE-guided study.

BACKGROUND: This study retrospectively analyzed the risk factors for transchemotherapy oral mucositis (OM). MATERIAL AND METHODS: Before each chemotherapy cycle, patients were routinely evaluated for the presence/severity of OM based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale for adverse effects and graded as follows: However, specific conditions such as mucositis are graded on a five-point scale: 0, absence of mucositis, grade 1 (Asymptomatic or mild), 2 (Presence of pain and moderate ulceration, without interference with food intake), 3 (severe pain with interference with food intake) or 4 (Life-threatening with the need for urgent intervention). Information from 2 years of evaluations was collected and patient medical records were reviewed to obtain data on chemotherapy cycle, sex, age, body mass index, body surface area, primary tumor, chemotherapy protocol, and history of head and neck radiotherapy. The X² test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p<0.05). RESULTS: Among 19,000 total evaluations of 3,529 patients during 5.32±4.7 chemotherapy cycles (CT) the prevalence of OM was 6.3% (n=1,195). Chemotherapy duration (p<0.001), female sex (p=0.001), adjuvant intention (p=0.008) and the use of carboplatin (p=0.001), cisplatin (p=0.029), docetaxel (p<0.001) and bevacizumab (p=0.026) independently increased the risk of mucositis. In head and neck tumors, 2018 year (p=0.017), chemotherapy duration (p=0.018), BMI>30 (p=0.008), radiotherapy (p=0.037) and use of carboplatin (p=0.046) and cyclophosphamide (p=0.010) increased this prevalence. CONCLUSIONS: Cycles of chemotherapy, sex, cytotoxicity drugs, bevacizumab and head and neck radiotherapy increase the risk of OM in solid tumors.

Development of a Real-Time Surface Solar Radiation Measurement System Based on the Internet of Things (IoT).

The determination of the levels of solar radiation incident on the terrestrial surface (W·m-2) is essential for several areas such as architecture, agriculture, health, power generation, telecommunications, and climate forecasting models. The high cost of acquiring and maintaining radiometric equipment makes it difficult to create and expand monitoring networks. It contributes to the limited Brazilian radiometric network and affects the understanding and availability of this variable. This paper presents the development of a new surface solar radiation measurement system based on silicon photodiodes (Si) with a spectral range between 300 nm and 1400 nm incorporating Internet of Things (IoT) technology with an estimated cost of USD 200. The proposed system can provide instantaneous surface solar radiation levels, connectivity to wireless networks and an exclusive web system for monitoring data. For the sake of comparison, the results were compared with those provided by a government meteorology station (INMet). The prototype validation resulted in determination coefficients (R2) greater than 0.95 while the statistical analysis referred to the results and uncertainties for the range of ±500 kJ·m-2, less than 4.0% for the developed prototypes. The proposed system operates similarly to pyranometers based on thermopiles providing reliable readings, a low acquisition and maintenance cost, autonomous operation, and applicability in the most varied climatological and energy research types. The developed system is pending a patent at the National Institute of Industrial Property under registration BR1020200199846.

Uncovering the mechanisms of exertional dyspnoea in combined pulmonary fibrosis and emphysema.

The prevailing view is that exertional dyspnoea in patients with combined idiopathic pulmonary fibrosis (IPF) and emphysema (CPFE) can be largely explained by severe hypoxaemia. However, there is little evidence to support these assumptions.We prospectively contrasted the sensory and physiological responses to exercise in 42 CPFE and 16 IPF patients matched by the severity of exertional hypoxaemia. Emphysema and pulmonary fibrosis were quantified using computed tomography. Inspiratory constraints were assessed in a constant work rate test: capillary blood gases were obtained in a subset of patients.CPFE patients had lower exercise capacity despite less extensive fibrosis compared to IPF (p=0.004 and 0.02, respectively). Exertional dyspnoea was the key limiting symptom in 24 CPFE patients who showed significantly lower transfer factor, arterial carbon dioxide tension and ventilatory efficiency (higher minute ventilation (V'E)/carbon dioxide output (V'CO2 ) ratio) compared to those with less dyspnoea. However, there were no between-group differences in the likelihood of pulmonary hypertension by echocardiography (p=0.44). High dead space/tidal volume ratio, low capillary carbon dioxide tension emphysema severity (including admixed emphysema) and traction bronchiectasis were related to a high V'E/V'CO2 ratio in the more dyspnoeic group. V'E/V'CO2 nadir >50 (OR 9.43, 95% CI 5.28-13.6; p=0.0001) and total emphysema extent >15% (2.25, 1.28-3.54; p=0.01) predicted a high dyspnoea burden associated with severely reduced exercise capacity in CPFEContrary to current understanding, hypoxaemia per se is not the main determinant of exertional dyspnoea in CPFE. Poor ventilatory efficiency due to increased "wasted" ventilation in emphysematous areas and hyperventilation holds a key mechanistic role that deserves therapeutic attention.

Modulation of lipase B from Candida antarctica properties via covalent immobilization on eco-friendly support for enzymatic kinetic resolution of rac-indanyl acetate.

In this study, the modulation of enzymatic biocatalysts were developed by the use of lipase B from Candida antarctica covalently immobilized on an eco-friendly support, cashew apple bagasse, activated with 10% glycidol-ethylenediamine-glutaraldehyde (GEG) under different immobilization strategies (5 mM or 100 mM ionic strength and in absence or presence of 0.5% (v/v) Triton X-100). The biocatalysts were characterized for thermal and organic solvents stabilities and compared with the soluble enzyme. The biocatalysts were then applied to the hydrolysis of the rac-indanyl acetate (2:1 ratio enzyme/substrate) at pH 7.0 and 30 °C for 24 h. For all the strategies evaluated, GEG promoted kinetic resolution of rac-indanyl acetate with maximum conversion (50%) and led to (R)-indanol with excellent enantiomeric excess (97%), maintaining the maximum conversion for five consecutive cycles of hydrolysis. Therefore, the use of cashew apple bagasse has proved to be a promising eco-friendly support for enzyme immobilization, since it resulted in stable biocatalysts for enzymatic kinetic resolution.

Development and Validation of an Autonomous System for Measurement of Sunshine Duration.

This paper presented an autonomous electronic system for sunshine duration (SD) monitoring based on the contrast method and developed to operate on a horizontal surface. The prototype uses four photoresistors arranged at 90° in a 20 mm diameter circumference separated by a shading structure used to create a shadow pattern on the detection element. Photoresistors are inserted in individual signal conditioning circuits based on the association between Wheatstone bridges and operational amplifiers to provide an analog signal to the microcontroller unit. The determination of SD occurs through the implementation of fuzzy logic with numerical calculation methods to estimate the probability (f) of solar disk obstruction and estimate SD values. The system does not require additional adjustments after installation or use of energy sources for operation due to the use of an internal battery with charge recovery by solar panels. Experimental results of the proposed system were validated with the ones provided by a government meteorology station. Statistical analysis of the results showed a confidence index (c) greater than 90%, with a precision of 94.26%. The proposed system is a feasible low-cost solution to the available commercial systems for the measurement of sunshine duration.

Seasonal variation of surface radiation and energy balances over two contrasting areas of the seasonally dry tropical forest (Caatinga) in the Brazilian semi-arid.

Arid and semi-arid environments correspond to one-third of the Earth's terrestrial surface. In these environments, precipitation is an essential and limiting element for vegetation growth and ecosystem biomass productivity. The semi-arid region of Brazil comprises around 11.5% of the national territory, where the Caatinga biome originally composed ~ 76% of this area, with water deficit as a prominent feature, annual rainfall lower than 800 mm, temperatures ranging between 25 and 30 °C, and potential evapotranspiration higher than 2000 mm/year. Research on the dynamics of mass and heat fluxes through techniques such as eddy covariance (EC) has contributed to estimate the magnitude and seasonal patterns of turbulent exchanges between ecosystems and the atmosphere. This study was conducted in an area of dense Caatinga (DC) and another of sparse Caatinga (SC) from 2013 to 2014. It was observed that albedo (α) and net radiation (Rn) were higher in the SC compared with DC since the magnitude of incoming shortwave radiation was higher in this area. It was found that most of the Rn is converted to sensible heat flux (H), mainly during the dry period in the SC, about 50% for H and 20% for λE. The energy balance closure showed that the turbulent fluxes (H + λE) were underestimated in comparison to the available energy at the surface (Rn - G). We also observed that this discrepancy was higher in the DC area, corresponding to ~ 30%.

White sand vegetation in an Amazonian lowland under the perspective of a young geological history.

What controls the formation of patchy substrates of white sand vegetation in the Amazonian lowlands is still unclear. This research integrated the geological history and plant inventories of a white sand vegetation patch confined to one large fan-shaped sandy substrate of northern Amazonia, which is related to a megafan environment. We examined floristic patterns to determine whether abundant species are more often generalists than the rarer one, by comparing the megafan environments and older basement rocks. We also investigated the pattern of species accumulation as a function of increasing sampling effort. All plant groups recorded a high proportion of generalist species on the megafan sediments compared to older basement rocks. The vegetation structure is controlled by topographic gradients resulting from the smooth slope of the megafan morphology and microreliefs imposed by various megafan subenvironments. Late Pleistocene-Holocene environmental disturbances caused by megafan sedimentary processes controlled the distribution of white sand vegetation over a large area of the Amazonian lowlands, and may have also been an important factor in species diversification during this period. The integration of geological and biological data may shed new light on the existence of many patches of white sand vegetation from the plains of northern Amazonia.

Change in FVC and survival in chronic fibrotic hypersensitivity pneumonitis.

The predictive value of the decline in FVC by ≥10% on survival in patients with fibrotic hypersensitivity pneumonitis is unknown. Of 112 patients included, 66 (59%) had surgical lung biopsies. Patients with ≥10% decline in predicted FVC after 6-12 months had a significantly increased risk of all-cause mortality (median survival 53 months, 95% CI 37 to 69 vs 139 months, 95% CI 66 to 212 months, p=0.007). On multivariate analysis remained associated with increasing mortality: decline in FVC by ≥10% (HR 4.13, 95% CI 1.96 to 8.70, p=0.005), lower FVC% (HR 1.03, 95% CI 1.01 to 1.05, p=0.003) and with decreasing mortality improvement with antigen avoidance (HR 0.18, 95% CI 0.04 to 0.77, p=0.021).

E12 sheet plastination: Techniques and applications.

Plastination is an anatomical technique that consists of replacing the liquids and fat of specimens by reactive polymers through forced impregnation in a vacuum. These are then polymerized to achieve the final result. E12 sheet plastination involves epoxy resin impregnation of thin (2-4 mm) and ultra-thin (<2 mm) tissue sheets, producing dry, transparent, odorless, non-toxic and long-lasting sheets. E12 sheet plastination techniques were reviewed using MEDLINE, EMBASE and SciELO databases, and manual searches. After searching, 616 records were found using the online and manual searches (MEDLINE, n: 207; EMBASE, n: 346; SciELO, n: 44; Manual search: 23). Finally, 96 records were included in this review (after duplicates and articles unrelated to the subject were excluded). The aim of this work was to review the E12 sheet plastination technique, searching for articles concerning views of it, identifying the different variants implemented by researchers since its creation by Gunther von Hagens, and to identify its applications from teaching and research in anatomy to morphological sciences. Clin. Anat. 31:742-756, 2018. © 2017 Wiley Periodicals, Inc.

Surgical management of long bone fractures in cats using cortical bone allografts preserved in honey.

This report describes comminuted fractures in 2 cats repaired by stabilization with cortical bone allografts that had been preserved in honey. Both cats exhibited appropriate post-operative weight-bearing. Preservation of bone in honey is a simple and widely available alternative for bone banking. This is the first report of a bone defect in cats repaired with bone preserved in honey.

Gestion chirurgicale de fractures osseuses longues chez les chats à l'aide d'une allogreffe de la corticale préservée dans du miel. Ce rapport décrit deux fractures comminutives réparées par la stabilisation à l'aide de l'allogreffe de la corticale qui avait été préservée dans du miel. Les deux chats ont manifesté une mise en charge postopératoire appropriée. La préservation de l'os dans du miel est une méthode de remplacement simple et facilement disponible comme ostéothèque. Il s'agit du premier rapport d'un défaut osseux chez des chats qui a été réparé à l'aide d'un os préservé dans du miel.(Traduit par Isabelle Vallières).

Characterisation and cryopreservation of the ovarian preantral follicle population from Spix's yellow-toothed cavies (Galea spixii Wagler, 1831).

The aim of the present study was to characterise the ovarian preantral follicle (PF) population and to establish a solid surface vitrification (SSV) process using dimethyl sulfoxide (DMSO) as a cryoprotectant for preservation of ovarian tissue from yellow-toothed cavies (Galea spixii). Ovaries were fixed for PF population analysis or were subjected to the SSV process. The mean (± s.e.m.) PF population per ovarian pair was estimated to be 416.0±342.8. There were 140.0±56.0 (63.4%) and 125.0±58.0 (64.0%) primary follicles on the right and left ovaries, respectively. The proportion of this follicle category was significantly greater than that of other follicle categories (P<0.05). The diameter of follicles (123.7±18.3µm), oocytes (50.1±5.0µm) and nuclei (14.27±2.01µm) was larger for secondary ones when compared with other PFs categories. Most PFs were morphologically normal (94.6%), with light microscopy identifying only a few atretic follicles (5.4%). After SSV, there was a reduction in the proportion of morphologically normal PFs compared with the non-vitrified group (69.5% vs 91.2%, respectively). Transmission electron microscopy revealed preservation of oocytes and granulosa cell membranes and the morphological aspect of follicles; the primary change observed in some vitrified PFs was the presence of vacuoles in the oocytes and granulosa cells cytoplasm and turgid mitochondria. In conclusion, the present study provides an estimative and characterization for the PF population in ovaries of G. spixii. Moreover, we report its PFs cryopreservation using an SSV process.

The exceptional genomic word symmetry along DNA sequences.

BACKGROUND: The second Chargaff's parity rule and its extensions are recognized as universal phenomena in DNA sequences. However, parity of the frequencies of reverse complementary oligonucleotides could be a mere consequence of the single nucleotide parity rule, if nucleotide independence is assumed. Exceptional symmetry (symmetry beyond that expected under an independent nucleotide assumption) was proposed previously as a meaningful measure of the extension of the second parity rule to oligonucleotides. The global exceptional symmetry was detected in long and short genomes. RESULTS: To explore the exceptional genomic word symmetry along the genome sequences, we propose a sliding window method to extract the values of exceptional symmetry (for all words or by word groups). We compare the exceptional symmetry effect size distribution in all human chromosomes against control scenarios (positive and negative controls), testing the differences and performing a residual analysis. We explore local exceptional symmetry in equivalent composition word groups, and find that the behaviour of the local exceptional symmetry depends on the word group. CONCLUSIONS: We conclude that the exceptional symmetry is a local phenomenon in genome sequences, with distinct characteristics along the sequence of each chromosome. The local exceptional symmetry along the genomic sequences shows outlying segments, and those segments have high biological annotation density.

Analysis of single-strand exceptional word symmetry in the human genome: new measures.

Some previous studies suggest the extension of Chargaff's second rule (the phenomenon of symmetry in a single DNA strand) to long DNA words. However, in random sequences generated under an independent symbol model where complementary nucleotides have equal occurrence probabilities, we expect the phenomenon of symmetry to hold for any word length. In this work, we develop new statistical methods to measure the exceptional symmetry. Exceptional symmetry is a refinement of Chargaff's second parity rule that highlights the words whose frequency of occurrence is similar to that of its reversed complement but dissimilar to the frequencies of occurrence of other words which contain the same number of nucleotides A or T. We analyze words of lengths up to 12 in the complete human genome and in each chromosome separately. We assess exceptional symmetry globally, by word group, and by word. We conclude that the global symmetry present in the human genome is clearly exceptional and significant. The chromosomes present distinct exceptional symmetry profiles. There are several exceptional word groups and exceptional words with a strong exceptional symmetry.

CRISP: Catheterization RISk score for Pediatrics: A Report from the Congenital Cardiac Interventional Study Consortium (CCISC).

OBJECTIVES: We sought to develop a scoring system that predicts the risk of serious adverse events (SAE's) for individual pediatric patients undergoing cardiac catheterization procedures. BACKGROUND: Systematic assessment of risk of SAE in pediatric catheterization can be challenging in view of a wide variation in procedure and patient complexity as well as rapidly evolving technology. METHODS: A 10 component scoring system was originally developed based on expert consensus and review of the existing literature. Data from an international multi-institutional catheterization registry (CCISC) between 2008 and 2013 were used to validate this scoring system. In addition we used multivariate methods to further refine the original risk score to improve its predictive power of SAE's. RESULTS: Univariate analysis confirmed the strong correlation of each of the 10 components of the original risk score with SAE attributed to a pediatric cardiac catheterization (P < 0.001 for all variables). Multivariate analysis resulted in a modified risk score (CRISP) that corresponds to an increase in value of area under a receiver operating characteristic curve (AUC) from 0.715 to 0.741. CONCLUSION: The CRISP score predicts risk of occurrence of an SAE for individual patients undergoing pediatric cardiac catheterization procedures.

Mid-Term Outcomes after Percutaneous Closure of the Secundum Atrial Septal Defect with the Figulla-Occlutech Device.

OBJECTIVES: To evaluate the mid-term outcomes after percutaneous closure of the secundum atrial septal defects (ASD) using the Figulla-Occlutech device (FOD). BACKGROUND: Transcatheter closure has become the method of choice for most patients with ASD. Although the FOD may have some advantageous characteristics there is a paucity of data on later outcomes after the use of this relatively new device. METHODS: Observational, single arm study including 200 non-consecutive patients who underwent ASD closure between 04/09 and 07/15 in 2 centers. Device performance, deployment technique, and immediate and mid-term outcomes were assessed. RESULTS: Median age and weight were 24 years (4-72) and 58 kg (15-92), respectively. Single defects were observed in 171 patients (median size of 19 mm). The remainder had multiple or multifenestrated defects. Implantation of FOD (median size of 24 mm) was successful in all (99%), but 2 patients (1 with deficient postero-inferior rim; 1 with a large ASD for the size of the child). Embolization with device retrieval occurred in 2 (1%). Median follow-up of 36 months was obtained in 172 patients. Serial echocardiographic assessment showed complete closure in all but 2 patients, in whom an additional small non-significant posterior defect was purposely left untouched. There have been no episodes of late arrhythmias, device embolization, cardiac erosion, endocarditis, thromboembolism, wire fracture, or death. CONCLUSIONS: Transcatheter closure of ASDs in older children, adolescents, and adults using the FOD was highly successful in a wide range of anatomical scenarios with high closure rates and no complications in mid-term follow-up.

A haemodynamic study of pulmonary hypertension in chronic hypersensitivity pneumonitis.

Chronic hypersensitivity pneumonitis is a common fibrotic interstitial lung disease. The prevalence of pulmonary hypertension diagnosed by right heart catheterisation and its cardiopulmonary function findings in patients with chronic hypersensitivity pneumonitis are unknown. Consecutive symptomatic patients with chronic hypersensitivity pneumonitis were prospectively evaluated. All patients were submitted to right heart catheterisation, pulmonary function testing, a 6-min walk test, echocardiography, blood gas determination and N-terminal pro-brain natriuretic peptide analyses. Nonhypoxaemic patients also underwent incremental cardiopulmonary exercise testing. 50 patients underwent right heart catheterisation; 25 (50%) of these had pulmonary hypertension and 22 (44%) had a pre-capillary haemodynamic pattern. The patients with pre-capillary pulmonary hypertension had lower forced vital capacity (mean ± sd 50 ± 17% versus 69 ± 22% predicted, p<0.01), carbon monoxide diffusing capacity (37 ± 12% versus 47 ± 14% predicted, p<0.01), arterial oxygen tension (median (interquartile range) 59.0 (47.8-69.3) versus 73.0 (62.2-78.5) mmHg, p<0.01) and saturation after the 6-min walk test (78 ± 8% versus 86 ± 7%, p<0.01). In pre-capillary pulmonary hypertension, oxygen uptake was also lower at the anaerobic threshold (41 ± 11% versus 50 ± 8% predicted, p=0.04) and at peak exercise (12.8 ± 1.6 versus 15.0 ± 2.5 mL · kg(-1) · min(-1), p=0.02). Pre-capillary pulmonary hypertension is common in symptomatic chronic hypersensitivity pneumonitis and is related to interstitial lung disease severity. Additionally, pulmonary hypertension is more prevalent in hypoxaemic patients with impaired lung function and exercise capacity.