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1.
Rev. bras. med. fam. comunidade ; 17(44): 3105, 20220304. ilus, tab
Article in Portuguese | LILACS, ColecionaSUS | ID: biblio-1399860

ABSTRACT

Introdução: As doenças respiratórias crônicas estão entre os principais problemas de saúde pública no mundo. Mesmo sendo sensíveis ao tratamento na Atenção Primária à Saúde, são a terceira principal causa de morte no Brasil. Os serviços de telemedicina apresentam-se como aliados importantes dos profissionais de saúde no que tange ao manejo de doenças respiratórias como a asma e a doença pulmonar obstrutiva crônica. Objetivo: Avaliar a adequabilidade de um serviço de telemedicina diagnóstica em espirometria considerando os indicadores de oferta, utilização e cobertura populacional no estado do Rio Grande do Sul. Resultados: No período estudado, o serviço ofertou 27.672 exames de telespirometria aos usuários do Sistema Único de Saúde do Rio Grande do Sul encaminhados por médicos da Atenção Primária à Saúde. A utilização esteve abaixo de 50% da oferta em todas as macrorregiões de saúde do estado. Conclusões: O estudo demonstrou que a capacidade instalada pelo serviço esteve adequada para atender à demanda populacional do Rio Grande do Sul, no entanto a baixa utilização do serviço pode estar associada ao desconhecimento sobre ele e à dificuldade em reconhecer essas doenças por parte dos profissionais de saúde da Atenção Primária à Saúde.


Introduction: Chronic respiratory diseases are among the main public health problems in the world. Despite being sensitive to treatment in Primary Health Care, they are the third leading cause of deaths in Brazil. Telemedicine services present themselves as important allies of health professionals regarding the management of respiratory diseases such as asthma and chronic obstructive pulmonary disease. Objective: to evaluate the adequacy of a telemedicine diagnostic service in spirometry considering the indicators of supply, use and population coverage in the state of Rio Grande do Sul. Results: In the studied period, the service offered 27,672 telespirometry tests to users of the Brazilian Unified Health System referred by Primary Health Care physicians; the use was under 50% in relation to the offer in all health macro-regions of the state. Conclusions: The study demonstrated that the capacity installed by the service was adequate to meet the demand of the population in Rio Grande do Sul. However, the low usage of the service may be associated with lack of knowledge about the service and the difficulty to recognize these diseases by health professionals in Primary Health Care.


Introducción: Las enfermedades respiratorias crónicas están entre los principales problemas de salud pública en el mundo. Aunque son sensibles al tratamiento en la Atención Primaria de Salud, son la tercera principal causa de muerte en Brasil. Los servicios de telemedicina se presentan como aliados importantes de los profesionales de la salud en lo que respecta al manejo de enfermedades respiratorias como asma y Enfermedad Pulmonar Obstructiva Crónica. Objetivo: evaluar la adecuación de un servicio de telemedicina diagnóstica en espirometría considerando los indicadores de oferta, utilización y cobertura poblacional en el estado de Rio Grande do Sul. Resultados: En el período estudiado, el servicio ofertó 27.672 exámenes de telespirometría a los usuarios del Sistema Único de Salud del RS encaminados por médicos de la atención primaria de salud, la utilización estuvo por debajo del 50% de la oferta en todas las macrorregiones de salud del Rio Grande do Sul. Conclusiones: El estudio demostró que la capacidad instalada por el servicio estuvo adecuada para atender la demanda poblacional de Rio Grande do Sul, sin embargo, la baja utilización del servicio puede estar asociada al desconocimiento del servicio y a la dificultad de reconocer estas enfermedades por parte de los profesionales de salud de la atención primaria de salud.


Subject(s)
Asthma , Spirometry , Telemedicine , Pulmonary Disease, Chronic Obstructive
2.
J. health med. sci. (Print) ; 8(1): 21-27, ene.-mar. 2022. graf, tab
Article in Spanish | LILACS | ID: biblio-1391830

ABSTRACT

El estudio de la función pulmonar en los deportistas de alto rendimiento es importante para el correcto manejo del entrenamiento y así evitar la frecuencia de la fatiga muscular respiratoria. Lo anterior reviste mayor importancia en el fútbol, debido al elevado esfuerzo desplegado por los deportistas en sus diferentes posiciones. Determinar el efecto del entrenamiento deportivo sobre la función pulmonar en deportistas de fútbol de la división sub-20 de un equipo deportivo local de la ciudad de Pereira. Se realizó un estudio descriptivo con 40 deportistas del equipo de fútbol de la división sub-20 de la ciudad de Pereira, Colombia. A todos se les realizó la prueba de espirometría, donde se identificó su función pulmonar teniendo relevancia en la relación VEF1/CVF. Los resultados encontrados refieren que la posición más frecuente en la población estudiada es la de volante, los parámetros recolectados de la relación VEF1/CVF muestran normalidad de su función pulmonar. Los deportistas de alto rendimiento realizan la ventilación a grandes volúmenes de aire corriente y menor frecuencia respiratoria, debido, al constante estímulo a que someten el centro respiratorio y al desarrollo de los músculos respiratorios aumentando la elasticidad tóraco-pulmonar mejorando la mecánica ventilatoria, favoreciendo por tanto la ventilación alveolar, por tal razón es importante incluir dentro del entrenamiento físico y de acondicionamiento, los ejercicios respiratorios.


The study of lung function in high-performance athletes is important for the correct management of training and thus avoiding the frequency of respiratory muscle fatigue. This is more important in soccer, due to the high effort deployed by athletes in their different positions. To determine the effect of sports training on lung function in soccer athletes from the U20 division of a local sports team in the city of Pereira. A descriptive study was carried out with 40 athletes from the soccer team of the sub20 division of the city of Pereira, Colombia. All of them underwent the spirometry test, where their lung function was identified, having relevance in the FEV1 / CVF relationship. The results found refer that the most frequent position in the study population is that of a steering wheel, the parameters collected from the FEV1 / FVC ratio show normal lung function. High-performance athletes perform ventilation with large volumes of running air and a lower respiratory rate, due to the constant stimulation of the respiratory center and the development of the respiratory muscles, increasing thoracopulmonary elasticity, improving ventilatory mechanics, favoring Both alveolar ventilation, for this reason it is important to include breathing exercises within physical training and conditioning.


Subject(s)
Humans , Respiratory Function Tests/methods , Athletes/statistics & numerical data , Spirometry , Population Characteristics , Epidemiology, Descriptive , Cross-Sectional Studies , Athletic Performance
3.
Article in Portuguese | LILACS | ID: biblio-1368463

ABSTRACT

RESUMO: Objetivo: avaliar o comportamento de parâmetros do sistema respiratório durante internação para antibioticoterapia intravenosa (AIV) como tratamento da exacerbação pulmonar aguda (EPA) em escolares com fibrose cística (FC). Métodos: estudo do tipo analítico observacional, before-after, realizado no Hospital Infantil Joana de Gusmão, Florianópolis ­ Santa Catarina. Foram incluídas crianças com diagnóstico de FC, entre seis e 15 anos, em internação para tratamento da exacerbação pulmonar aguda, no início (T1), durante (T2) e ao final (T3) da internação foi conduzida avaliação de escores específicos de EPA, dados antropométricos e realizada avaliação dos parâmetros do sistema respiratório pelo sistema de oscilometria de impulso (IOS) e espirometria. Foram obtidos, em prontuário, dados de colonização bacteriana, genótipo, gravidade da doença (Escore de Schwachman-Doershuk-ESD) e espirometria mais recente em estabilidade clínica. Aplicou-se o teste Shapiro-Wilk para análise da distribuição dos dados e os testes ANOVA de medidas repetidas, teste de Friedman, teste T pareado e Wilcoxon, com nível de significância de 5%. Resultados: participaram 16 crianças/adolescentes (68.8% meninas, 12.88±1.67anos). Houve aumento dos parâmetros da espirometria e dados antropométricos (p<0.005) no T3, bem como redução dos escores de EPA e do X5 (p<0.005) no T3. Conclusão: os dados apresentados nesse trabalho mostram melhora dos escores de EPA, dados antropométricos, parâmetros da espirometria e do parâmetro de recolhimento elástico do IOS (X5).RESUMODescritores: Fibrose cística, Exacerbação dos sintomas, Testes de função pulmonar, Mecânica respiratória. (AU)


ABSTRACT: Objective: Evaluate the respiratory system parameters of children with cystic fibrosis (CF) during hospitalization for acute pulmonary exacerbation (APE) treatment. Methods: observational study before-after that occurred at the CF reference center. There were included children with cystic fibrosis (CF) between six to 15 years old hospitalized due to APE. The registration of the APE clinical scores, anthropometric data, and respiratory system (IOS and spirometry) evaluation occurred at the beginning (T1), during (T2), and at the end (T3) of the hospitalization. There were registered pathogens, genetic mutation, disease severity (Schwachman-Doershuk Score), and the most recent spirometry when they were clinically stable. The Shapiro-Wilk test was applied to analyze data distribution, and the repeated measure ANOVA, Friedman test, Tpaired test, and Wilcoxon test were performed to compare data, with a significance level set at 5%. Results: sixteen children/adolescents participated in the study (68.8% girls, 12.88±1.67 years old). The spirometric parameters, X5 parameter, and anthropometric data increased (p<0.005) and the APE scores decreased (p<0.005) at T3. Conclusion: APE scores, anthropometric data, spirometric parameters, and IOS elastic recoil parameter (X5) improved at the end of hospitalization.ABSTRACTKeywords: Cystic fibrosis, Symptom flare up, Respiratory function tests, Respiratory mechanics.1. Universidade do Estado de Santa Catarina ­ UDESC ­ Florianópolis, (SC) ­ Brasil https://doi.org/10.11606/issn.2176-7262.rmrp.2022.183755Tayná Castilho1, Renata Maba Gonçalves Wamosy1, Camila Isabel Santos Schivinski1Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado. (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Oscillometry , Respiratory Function Tests , Spirometry , Respiratory Mechanics , Cystic Fibrosis/therapy , Symptom Flare Up
4.
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.966-973, ilus, tab.
Monography in Portuguese | LILACS | ID: biblio-1353818
5.
Rev. colomb. neumol ; 34(1): 29-38, 2022. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1396791

ABSTRACT

La presencia de sibilantes refractarios y localizados en una sola área de auscultación en los adultos, sobre todo si están acompañados de anormalidades espirométricas y radiológicas, son a menudo la expresión clínica de una condición que requiere un proceso diagnóstico más profundo, más allá del facilista diagnóstico de asma. Entre estas anomalías se encuentran los anillos vasculares como el divertículo de Kommerel, que es una variante con una prevalencia muy baja y se caracteriza por la presencia de un arco aórtico derecho con una salida de la arteria subclavia izquierda aberrante y que provoca síntomas por la compresión de las estructuras adyacentes a estas. Aportamos en este caso clínico, el proceso diagnóstico de uno de estos hallazgos incidentales: la presencia de sibilantes localizados en una paciente joven, asintomática con una espirometría alterada que podría hacernos sospechar la presencia de broncomalacia, una aspiración de cuerpo extraño, un proceso infeccioso, tumoral o un anillo vascular que pasó desapercibido hasta la edad adulta.


The presence of refractory and localized wheezing in a single area of auscultation in adults, especially if they are accompanied by spirometric and radiological abnormalities, are often the clinical expression of a condition that requires a deeper diagnostic process, beyond the easy diagnosis of asthma. Among these abnormalities are vascular rings such as Kommerell¨s diverticulum, which is a very low prevalence variant and it is characterized by the presence of a right aortic arch with an aberrant exit from the left subclavian artery and that causes symptoms due to compression of the adjacent structures. In this clinical case, we provide the diagnosis process of one of these incidental findings, such as the presence of localized wheezing in a young asyntomatic patient with altered spirometry that could lead us to suspect the presence of bronchomalacia, foreign body aspiration, an infection, tumor or vascular ring that went unnoticed until adulthood.


Subject(s)
Humans , Asthma , Spirometry , Respiratory Sounds , Vascular Ring , Infections
6.
Neumol. pediátr. (En línea) ; 17(2): 46-51, 2022. ilus
Article in Spanish | LILACS | ID: biblio-1379483

ABSTRACT

La fibrosis quística (FQ) es una enfermedad hereditaria autosómica recesiva, causada por la mutación del gen que codifica la proteína CFTR (cystic fibrosis transmembrane conductance regulator), afecta varios órganos, pero la enfermedad pulmonar es la primera causa de morbimortalidad. El diagnóstico a través del screening neonatal (SNN) y los nuevos tratamientos moduladores del CFTR han aumentado el interés por pesquisar y monitorizar la función pulmonar antes del inicio de los síntomas para lograr un tratamiento adecuado y oportuno con una mejor calidad de vida. Existen numerosas formas de medir la función pulmonar según la edad, colaboración y recursos disponibles. En este artículo se resumen las pruebas clásicas y las más novedosas, como técnicas de imágenes, en la búsqueda de marcadores precoces de daño pulmonar, herramientas con los que cada centro de fibrosis quística debiera contar en la era de tratamientos moduladores del CFTR, que están cambiando el pronóstico de los pacientes con esta enfermedad.


Cystic fibrosis (CF) is an autosomal recessive inherited disease, caused by mutation of the gene encoding the CFTR protein (cystic fibrosis transmembrane conductance regulator), affects several organs, but lung disease is the first cause of morbidity and mortality. Diagnosis through neonatal screening (NNS) and new CFTR modulating treatments have increased interest in screening and monitoring lung function before the onset of symptoms to achieve adequate and timely treatment with a better quality of life. There are numerous ways to measure lung function based on age, collaboration, and available resources. This article summarizes the classic and the most innovative tests, which have emerged from imaging techniques in the search for early markers of lung damage, tools that each cystic fibrosis center should have in the era of CFTR modulating treatments, which are changing the prognosis of patients with this disease.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Respiratory Function Tests/methods , Cystic Fibrosis/physiopathology , Cystic Fibrosis/diagnostic imaging , Oscillometry , Plethysmography , Spirometry , Magnetic Resonance Imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Respiratory System Agents/therapeutic use , Cystic Fibrosis Transmembrane Conductance Regulator , Cystic Fibrosis/drug therapy
8.
Rev. chil. enferm. respir ; 37(4): 285-292, dic. 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388163

ABSTRACT

INTRODUCCIÓN: El incremento del índice de masa corporal afecta la función pulmonar en el asma. Objetivo: determinar si existen diferencias entre asmáticos con estado nutricional normal, sobrepeso y obesidad en cuanto a alteraciones de la oscilometría de impulso (IOS) y espirometría. MÉTODO: Estudio realizado en niños y adolescentes con asma persistente. Se practicó sucesivamente IOS y Espirometría pre y post- broncodilatador según criterios ATS/ERS/SER. Los pacientes se clasificaron en: eutróficos (AE), con sobrepeso (ASP) y obesos (AO). Se compararon promedios de valores basales y con respuesta broncodilatadora (RB) en espirometría e IOS, con análisis de varianzas ANOVA y test de Tukey post hoc. Se consideró un poder de 80% y error α de 5%. RESULTADOS: Se analizaron 559 pacientes, promedio de edad 9,2 años, 50,9% varones. AE 52,4%, ASP 31,3% y AO 16,3%. Se encontraron diferencias significativas entre AO vs AE (X5, AX, D5-20, VEF1/CVF, FEF25-75/CVF, RB VEF1), y entre ASP vs AE (AX, D5-20, VEF1/CVF). También se encontraron diferencias significativas en varones, no encontradas en las mujeres (X5, D5-20, VEF1/CVF, RB CVF, RB VEF1). CONCLUSIONES: Los niños asmáticos con sobrepeso y obesidad, tienen un mayor compromiso de los índices de función pulmonar medida por espirometría e IOS que los asmáticos con estado nutricional normal. Existen diferencias de género en las alteraciones espirometría e IOS.


INTRODUCTION: Increased body mass index asthma affects lung function in asthma. Objective: to determine if asthmatics with overweight or obesity have alterations in Impulse oscillometry (IOS) and spirometry compared to eutrophic METHOD: Study carried out in children and adolescents with persistent asthma. IOS-Spirometry pre and post bronchodilator were performed successively according to ATS/ERS/SER criteria. The patients were classified as: eutrophic (AE), overweight (ASP) and obese (OA). Baseline and bronchodilator response (BR) averages were compared in spirometry and IOS with ANOVA and Tukey's post hoc analysis of variance. A power of 80% and α error of 5% were considered. RESULTS: 559 patients were analyzed, mean age 9.2 years, 50.9% male. AE 52.4%, ASP 31.3% and OA 16.3%. Significant differences were found between OA vs AE (X5, AX, D5-20, FEV1/FVC, FEF25-75 / FVC, RB FEV1), and between ASP vs AE (AX, D5-20, FEV1/FVC). Significant differences were also found in men, not women (X5, D5-20, FEV1/FVC, BR FVC, BR FEV1). CONCLUSIONS: Asthmatic children with overweight and obesity have a greater compromise of pulmonary function parameters measured by spirometry and IOS than asthmatics with normal nutritional status. There are gender differences in spirometry and IOS alterations.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Respiratory Function Tests/methods , Asthma/physiopathology , Lung/physiopathology , Obesity/physiopathology , Oscillometry , Spirometry , Vital Capacity , Forced Expiratory Volume , Nutritional Status , Cross-Sectional Studies , Analysis of Variance , Overweight/physiopathology
9.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(4): 01022105, OUT-DEZ 2021.
Article in Portuguese | LILACS | ID: biblio-1377669

ABSTRACT

RESUMO Introdução: A espirometria é um exame que avalia a função pulmonar,complementando a análise clínica.O objetivo do estudo foi avaliar a associação entre os valores do limite inferior de normalidade (LIN) e ponto de corte fixo na interpretação do distúrbio ventilatório obstrutivo (DVO), utilizando o volume expiratório forçado no 1º segundo (VEF1)/capacidade vital(CV) e VEF1/capacidade vital forçada (CVF) de crianças e adolescentes com doença pulmonar. Métodos: Estudo transversal com 358 testes espirométricos de crianças e adolescentes com doença pulmonar entre 7 e 18 anos de idade foram encaminhados ao Laboratório de Prova de Função Respiratória (LPFR) entre novembro de 2016 e dezembro de 2017. As espirometrias seguiram normas estabelecidas pela American Thoracic Society/European Respiratory Society Task Force (ATS/ERS, 2005). Na classificação do DVO foi utilizado dois critérios de interpretação da relação VEF1/CVF: ponto de corte fixos e o LIN do 50 percentil, considerado padrão ouro. Analisada a concordância através do índice Kappa de Cohen. Resultados: 316 espirometrias,mediana de idade de 12 anos(7-18) e 51,9% do sexo masculino. Observada fraca concordância entre os dois critérios (Kappa igual a 0,30). Pelo LIN do 50 percentil foi possível identificar mais casos de DVO em comparação ao ponto de corte fixo, com p<0,001. Conclusão: Identificamos fraca concordância entre os dois métodos e o LIN foi capaz de classificar mais casos de DVO quando comparados ao ponto de corte fixo. Novos estudos devem ser realizados para conclusão do assunto na faixa etária pediátrica. PALAVRA-CHAVE: Espirometria, obstrução das vias respiratórias, criança, adolescente, diagnóstico


ABSTRACT Introduction: Spirometry is a test that assesses lung function, complementing the clinical analysis. The aim of the study was to evaluate the association between the values of lower limit of normality (LLN) and fixed cut-off point in the interpretation of obstructive ventilatory disorder (OVD), using the forced expiratory volume in the 1st second (FEV1)/vital capacity (VC) and FEV1/forced vital capacity (FVC) of children and adolescents with lung disease. Methods: A cross-sectional study with 358 spirometric tests in children and adolescents with pulmonary disease between 7 and 18 years of age were referred to the Respiratory Function Test Laboratory (LPFR) between November 2016 and December 2017. Spirometry followed the standards established by the American Thoracic Society/European Respiratory Society Task Force (ATS/ERS, 2005). In the classification of OVD, two criteria were used for interpreting the FEV1/FVC ratio: fixed cutoff point and the LLN of the 50th percentile, considered the gold standard. Concordance analysis was through the Cohen's Kappa index. Through the LLN of the 50th percentile, it was possible to identify more cases of OVD compared to the fixed cutoff point, with p<0.001. Conclusion: We found a weak concordance between the two methods, and LLN was able to classify more cases of OVD as compared to the fixed cutoff point. New studies must be carried out to conclude the subject in the pediatric age group. KEYWORDS: Spirometry, airway obstruction, child, adolescent, diagnosis


Subject(s)
Humans , Child , Adolescent , Spirometry , Diagnosis , Airway Obstruction
10.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 473-481, dic. 2021. tab
Article in Spanish | LILACS | ID: biblio-1354772

ABSTRACT

Introducción: en las grandes altitudes, el intercambio gaseoso suele estar deteriorado; en la altitud moderada de la Ciudad de México esto no está aún plenamente definido. Objetivo: caracterizar el intercambio gaseoso en la altitud moderada de la Ciudad de México. Material y métodos: mediante un estudio transversal analítico se estudiaron sujetos nacidos y habitantes de la Ciudad de México, de ambos géneros, con edades de 20 a 59 años sin enfermedad cardiopulmonar. Se registraron sus variables demográficas, espirometría simple y de gasometría arterial. Las diferencias en las variables se calcularon con ANOVA de una vía para grupos independientes y ajuste de Bonferroni. Una p < 0.05 se aceptó como significativa. Resultados: se estudiaron 335 sujetos, de los cuales 168 (50.15%) fueron hombres, la edad grupal fue de 45 ± 11 años, con índice de masa corporal 22.97 ± 1.54 Kg/m2. La relación volumen espiratorio forzado en el primer segundo/Capacidad vital forzada (VEF1/CVF) de 91.58 ± 12.86%. La presión arterial de oxígeno fue de 66 ± 5.02 mmHg, el bióxido de carbono: 32.07 ± 2.66 mmHg, la saturación arterial de oxígeno: 93.03 ± 1.80% y la hemoglobina: 14.07 ± 1.52 gr/dL. Conclusiones: la presión arterial de oxígeno y del bióxido de carbono están disminuidos a la altura de la Ciudad de México.


Background: At high altitude the gas exchange is impaired, in the moderate altitude of Mexico City they are not yet defined. Objective: To characterize the gas exchange in the moderate altitude of Mexico City. Material and methods: Through an analytical cross-sectional study, subjects born and inhabitants of Mexico City, both genders, aged 20 to 59 years without cardiopulmonary disease, were studied. Their demographic variables, simple spirometry and arterial blood gas were recorded. Differences in variables were calculated with one-way ANOVA for independent groups and Bonferroni adjustment. p < 0.05 was accepted as significant. Results: 335 subjects were studied, 168 (50.15%) men. Group age 45 ± 11 years old, body mass index 22.97 ± 1.54 Kg/m2. Forced expiratory volume ratio in the first second / Forced vital capacity (FEV1/FVC) 91.58 ± 12.86%. The arterial oxygen pressure was: 66 ± 5.02 mmHg, carbon dioxide: 32.07 ± 2.66 mmHg, arterial oxygen saturation: 93.0 3 ± 1.80%, and hemoglobin: 14.07 ± 1.52 gr/dL. Conclusions: The arterial oxygen pressure and carbon dioxide are lowered at the Mexico City altitude.


Subject(s)
Humans , Male , Female , Pulmonary Heart Disease , Blood Gas Analysis , Arterial Pressure , Respiratory Function Tests , Spirometry , Forced Expiratory Volume , Pulmonary Circulation , Cross-Sectional Studies , Circulatory and Respiratory Physiological Phenomena
11.
Biomédica (Bogotá) ; 41(3): 481-492, jul.-set. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1345398

ABSTRACT

Resumen Introducción. El asma es una enfermedad crónica y potencialmente grave. El 80 % de los casos es de origen alérgico, por lo cual la inmunoterapia específica con alérgenos es una alternativa terapéutica que modula el curso natural de la enfermedad. Objetivo. Evaluar el impacto de la inmunoterapia en pacientes pediátricos con asma atendidos en una institución de salud de Colombia. Materiales y métodos. Se hizo un estudio observacional descriptivo con componente analítico de corte transversal. Se incluyeron 62 pacientes con diagnóstico de asma alérgica sensibilizados a ácaros del polvo y en tratamiento, mínimo, con seis dosis de inmunoterapia contra ácaros. El efecto del tratamiento se evaluó mediante la escala de puntuación del ACT (Asthma Control Test), la escala de tratamiento de la GINA (Global Initiative for Asthma) y la espirometría. Resultados. La puntuación de la prueba ACT antes del inicio de la inmunoterapia, correspondía a 30 % de pacientes con asma no controlada, 28 % con buen control y 4 % con asma totalmente controlada. Entre los pacientes con asma no controlada, el 46,7 % logró un buen control y el 23,3 % alcanzó un control total. En cuanto a la percepción de los pacientes sobre la mejoría con la inmunoterapia, el 9,75 % percibió una mejoría menor del 50 %, el 45,2 %, una entre el 50 y el 90 %, en tanto que el 41,9 % refirió una igual o mayor del 90 %. No se encontraron cambios significativos en los valores del volumen espiratorio forzado en un segundo (VEF1) en las espirometrías. Conclusiones. Se observaron cambios significativos en los puntajes del ACT y en la percepción de mejoría de la enfermedad en la población tratada con inmunoterapia específica para ácaros, es decir, que esta tendría un efecto beneficioso en el curso natural de la enfermedad


Abstract Introduction: Asthma is a chronic and potentially serious disease and 80% of the cases have an allergic etiology. In this sense, allergen-specific immunotherapy is an alternative that modulates the natural course of the disease. Objective: To evaluate the impact of immunotherapy in pediatric asthma patients treated at a health institution in Colombia. Materials and methods: We conducted an observational descriptive study with an analytical cross-sectional component. Sixty-two patients diagnosed with allergic asthma sensitized to dust mites and treated with at least 6 doses of mite immunotherapy were included. We assessed the impact of immunotherapy using the Asthma Control Test (ACT), the Global Initiative for Asthma (GINA) treatment scale, and spirometry values. Results: The ACT score before the start reported 30% of patients with uncontrolled asthma, 28% with good control, and 4% with totally controlled asthma. Of the patients with uncontrolled asthma, 46.7% achieved good control and 23.3% total control. Regarding patients' perception of improvement with the immunotherapy, 9.75% perceived a response of less than 50%, 45.2% one between 50% -90%, and 41.9% reported response equal to or greater than 90%. No significant changes in FEV1 values were found in spirometry. Conclusions: Significant changes in the ACT scores and the perception of disease improvement were observed in the population evaluated with specific mite immunotherapy, i.e., it had a positive impact on the natural course of the disease.


Subject(s)
Asthma , Immunotherapy , Pediatrics , Spirometry , Rhinitis , Mites
12.
Arch. argent. pediatr ; 119(4): e340-e344, agosto 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281780

ABSTRACT

La acrodisostosis es una displasia esquelética rara, de herencia autosómica dominante, que se caracteriza por la presencia de disostosis facial y periférica, talla baja y diferentes grados de obesidad. La acrodisostosis de tipo 1, secundaria a la mutación heterocigota en el gen PRKAR1A (17q24.2), se caracteriza por la asociación de resistencia hormonal múltiple con anomalías esqueléticas. Su incidencia está infradiagnosticada debido a que comparte rasgos clínicos y de laboratorio con otras entidades como el seudohipoparatiroidismo. Presentamos el caso de una niña de 8 años, con acrodisostosis tipo 1, confirmada mediante estudio genético. Además del fenotipo característico descrito, la talla baja y la resistencia hormonal, la paciente presentó una afectación progresiva de la función pulmonar: un patrón pulmonar obstructivo no reversible. En la literatura revisada, no se han encontrado otros casos que describan esta asociación entre acrodisostosis y afectación respiratoria.


Acrodysostosis is a rare skeletal displasia, of autosomal dominant inheritance, characterized by the presence of facial and peripheral dysostosis, short stature and obesity. Type 1 acrodysostosis is secondary to a mutation in the PRKAR1A (17q24.2) gene, which results in multi hormonal resistance and skeletal anomalities. This syndrome is under-diagnosed as it shares analytical and clinical characteristics with other entities, such as pseudohypoparathyroidism. We report the case of an eight-year-old girl with genetically confirmed type 1 acrodysostosis. In addition to the characteristic phenotype described, the short stature and the hormonal resistance, the patient suffered a progressive lung function deterioration: an irreversible pulmonary obstructive pattern. We have not found in previous literature cases reporting an association between acrodysostosis and lung function impairement.


Subject(s)
Humans , Female , Child , Osteochondrodysplasias/complications , Dysostoses/complications , Lung Diseases, Obstructive/complications , Osteochondrodysplasias/genetics , Osteochondrodysplasias/diagnostic imaging , Spirometry , Diagnosis, Differential , Dysostoses/genetics , Dysostoses/diagnostic imaging , Dyspnea/complications , Mutation/genetics
13.
Rev. cuba. med ; 60(2): e1476, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280343

ABSTRACT

Introducción: La enfermedad pulmonar obstructiva crónica es un problema sanitario mundial por su elevada prevalencia, morbilidad y cuantioso costo económico. Objetivo: Caracterizar mediante la pletismografía a los pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica que presentaron una discrepancia clínica espirométrica. Métodos: Se realizó un estudio descriptivo y transversal en 33 pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica que acudieron a consulta externa del Hospital Neumológico Benéfico Jurídico y el Centro de Investigaciones Clínicas. Se les realizaron volúmenes pulmonares por pletismografía corporal y espirometría en el período comprendido de noviembre 2016 a marzo 2018. Resultados: El sexo masculino (69,7 por ciento) resultó el más frecuente y el grupo de edad predominante fue mayor de 65 años (60,6 por ciento). El 41,2 por ciento de los pacientes presentaron grado de obstrucción moderadamente severo. La capacidad pulmonar total y el volumen residual fueron normales (72,7 por ciento y 42,5 por ciento) respectivamente. El 43,8 por ciento de los pacientes presentaron hiperinsuflación leve. El grado 3 de disnea fue el que predominó en los pacientes. El 12,1 por ciento de los pacientes presentaron aumento del volumen residual dado por atrapamiento aéreo grave con la disminución del volumen espiratorio forzado en el primer segundo. Conclusiones: El comportamiento de los volúmenes pulmonares por pletismografía corporal en la enfermedad pulmonar obstructiva crónica con disociación clínico-espirométrica, evidenció la disminución del volumen espiratorio forzado en el primer segundo y el aumento del volumen residual relacionándose con el grado de disnea(AU)


Introduction: Chronic obstructive pulmonary disease is a global health problem due to its high prevalence, morbidity and high economic cost. Objective: By using plethysmography, to describe patients with diagnosis of chronic obstructive pulmonary disease that had spirometric clinical discrepancy. Methods: A descriptive and cross-sectional study was carried out in 33 patients with diagnosis of chronic obstructive pulmonary disease who attended the outpatient clinic at Benéfico Jurídico Pneumologic Hospital and the Clinical Research Centre. Lung volumes were performed by body plethysmography and spirometry from November 2016 to March 2018. Results: The male sex (69.7 percent) was the most frequent and the predominant age group was older than 65 years (60.6 percent). 41.2 percent of the patients had moderately severe degree of obstruction. Total lung capacity and residual volume were normal, 72.7 percent and 42.5 percent, respectively. 43.8 percent of the patients had mild hyperinflation. Grade 3 dyspnea was the one that predominated in the patients. 12.1 percent of the patients showed increased residual volume due to severe air trapping with decreased forced expiratory volume in the first second. Conclusions: The behavior of lung volumes by body plethysmography in chronic obstructive pulmonary disease with clinical-spirometric dissociation, evidenced decrease in forced expiratory volume in the first second and increased in residual volume related to the degree of dyspnea(AU)


Subject(s)
Humans , Plethysmography, Whole Body/methods , Spirometry/methods , Pulmonary Disease, Chronic Obstructive/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies
14.
Cuad. Hosp. Clín ; 62(1): 38-45, jun. 2021. ilus.
Article in Spanish | LILACS | ID: biblio-1284260

ABSTRACT

OBJETIVOS: determinar las principales características demográficas, clínicas, radiológicas y de función pulmonar de los pacientes con bronquiectasias en la Clínica del Pulmón. MATERIAL Y MÉTODOS: estudio observacional, retrospectivo. Se revisaron las historias clínicas de 23 pacientes con diagnóstico de dilataciones bronquiales. RESULTADOS: de los 23 pacientes, con una edad media de 49,4 ± 3,87 años, 13 corresponden al sexo femenino y 10 al sexo masculino, el tiempo de evolución de la enfermedad desde el diagnóstico de la patología inicial es de 17,3 ± 2,92 años. La tuberculosis es la etiología principal en 15 pacientes (65,2%). Las manifestaciones clínicas más frecuentes son la tos y expectoración mucopurulenta por varios años en la mayoría de los pacientes, al que añadimos la disnea y hemoptisis, la auscultación pulmonar revela la presencia de crépitos en 17 pacientes (73,9%). La Tomografía de Tórax de Alta Resolución distingue dos tipos de bronquiectasias: La sacular o quística y la cilíndrica, de localización unilobar, bilobar y multilobar (difuso). La Espirometría Forzada fue indicada en 10 pacientes (43,5%) 7 mujeres y 3 varones, el Síndrome Bronquial Obstructivo fue el hallazgo más frecuente. La asociación de Tetraciclina con Metronidazol indicado en 9 pacientes (39,1%) mejoró el cuadro clínico. La fisiopatología de esta entidad clínica está sujeta a una constante actualización. CONCLUSIONES: en pacientes tosedores crónicos, las bronquiectasias deben tener prioridad diagnóstica, se trata de una patología antigua, pero de actualidad permanente.


The purpose of this document is to determine the main epidemiological and clinical characteristics of patients with bronchiectasis at the Lung Clinic. METHOD: observational, retrospective study. The medical records of 23 patients diagnosed with bronchial dilation were reviewed. RESULTS: the results of the 23 patients studied, with a mean age of 49,4 ± 3,87 years, 13 correspond to the female sex and 10 to the male sex, indicate that the time of evolution of the disease from the diagnosis of the initial pathology is: 17,3 ± 2,92 years. Tuberculosis is the main etiology in 15 patients (65,2%). The most frequent clinical manifestations were cough and mucopurulent expectoration of several years in most of the patients, to which we must add dyspnea and hemoptysis, pulmonary auscultation reveals the presence of crepitus in 17 patients (73,9%). High Resolution Chest Tomography distinguishes two types of bronchiectasis: the saccular or cystic and the cylindrical, the localization is unilobar, bilobar and multilobar (diffuse). Forced spirometry was indicated in 10 patients (43,5%), 7 women and 3 men, Chronic Obstructive Pulmonary Disease is the main diagnosis. The association of Tetracycline with Metronidazole indicated in 9 patients (39,1%) had positive results. The pathophysiology of this clinical entity is subject to constant updating. CONCLUSIONS: in chronic coughing patients, bronchiectasis must have diagnostic priority, it is an old pathology, but it is permanently current


Subject(s)
Humans , Male , Female , Middle Aged , Bronchiectasis , Pulmonary Disease, Chronic Obstructive , Auscultation , Spirometry , Tuberculosis , Dyspnea , Hemoptysis , Metronidazole
15.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 67-76, 20210000.
Article in Spanish | LILACS | ID: biblio-1178627

ABSTRACT

Introducción: La Enfermedades Neuromusculares se caracterizan por la pérdida progresiva de la fuerza muscular, la morbi-mortalidad aumenta con la exageración de la debilidad muscular determinando mayor riesgo de complicaciones respiratorias. Es de suma importancia evaluar e interpretar adecuadamente la función pulmonar y ventilatoria para poder realizar intervenciones que pueda prevenir dichas complicaciones. Objetivos: El objetivo del estudio fue reportar el estado funcional respiratorio de un grupo de pacientes con ENM en control ambulatorio y relacionar estos hallazgos con umbrales clínicamente relevantes de complicaciones respiratorias, reforzando intervenciones basadas en opiniones de expertos. Materiales y métodos: Se realizó un estudio Descriptivo-Observacional de corte transversal, donde fueron evaluados en forma ambulatoria, de marzo del 2017 a agosto del 2018, 30 niños y adolescentes con enfermedades neuromusculares. Resultados: El 46% del total de pacientes presenta capacidad tusígena no funcional con alto riesgo de complicaciones. No obstante, sólo el 10% del total de pacientes fueron aptos para realizar adecuadamente estudios de espirometría. Durante las pruebas espirométricas, sólo el 50% de los pacientes logró mantener 6 segundos la espiración. Conclusión: Si bien la espirometría es la principal prueba de función pulmonar y una alta proporción de pacientes presentó alteraciones en su morfología, su realización en estados avanzados de enfermedad fue poco factible. Para detectar umbrales de complicaciones respiratorias graves, la medición del flujo generado durante la tos resultó mejor. Conclusión: Si bien la espirometría es la principal prueba de función pulmonar y una alta proporción de pacientes presentó alteraciones en su morfología, su realización en estados avanzados de enfermedad fue poco factible. Para detectar umbrales de complicaciones respiratorias graves, la medición del flujo generado durante la tos resultó mejor.


Introduction: Neuromuscular Diseases are characterized by the progressive loss of muscle mass, morbidity and mortality increases with the progress of muscle weakness due to the increased risk of respiratory complications, so it is very important to properly evaluate and interpret the measurements of lung functions and ventilation to be able to carry out a specific treatment that can reduce respiratory complications. Objectives: The purpose of this work is to present the results of the measurements of flows, volumes, respiratory capacities and spirometric patterns in outpatients with neuromuscular diseases and to verify their usefulness to detect vital risks. Materials and methods: A cross-sectional Descriptive-Observational study was carried out, where 30 children and adolescents with neuromuscular diseases were evaluated on an outpatient basis, from March 2017 to August 2018. Results: 46% of all patients presented a non-functional cough with a high risk of complications and only 10% of all patients were eligible for spirometry studies. During the spirometric tests, 50% of the patients managed to maintain expiration for 6 seconds. In 70% of the patients, abnormalities in the Flow-Volume curve could be detected. Conclusion: Although spirometry is the main pulmonary function test, its usefulness and efficacy in neuromuscular diseases depends on the findings of specific alterations in the morphology of the flow-volume curve, which in many cases are not possible to distinguish.


Subject(s)
Spirometry , Cough , Lung , Neuromuscular Diseases , Respiratory Function Tests
16.
Rev. bras. ter. intensiva ; 33(2): 243-250, abr.-jun. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1289081

ABSTRACT

RESUMO Objetivo: Relatar a independência funcional e o grau de comprometimento pulmonar em pacientes adultos 3 meses após a alta da unidade de terapia intensiva. Métodos: Este foi um estudo de coorte retrospectiva conduzido em uma unidade de terapia intensiva multiprofissional para pacientes adultos em um único centro. Incluíram-se pacientes admitidos à unidade de terapia intensiva entre janeiro de 2012 e dezembro de 2013 que, 3 meses mais tarde, foram submetidos à espirometria e responderam ao questionário Medida de Independência Funcional. Resultados: Os pacientes foram divididos em grupos segundo sua classificação de independência funcional e espirometria. O estudo incluiu 197 pacientes, que foram divididos entre os grupos maior dependência (n = 4), menor dependência (n = 12) e independente (n = 181). Na comparação dos três grupos com relação à classificação pela Medida de Independência Funcional, pacientes com maior dependência tinham escores Acute Physiology and Chronic Health Evaluation II e Sequential Organ Failure Assessment mais altos quando da admissão à unidade de terapia intensiva, idade mais avançada, mais dias sob ventilação mecânica e tempo mais longo de permanência na unidade de terapia intensiva e no hospital. A maioria dos pacientes apresentava comprometimento pulmonar, sendo o padrão obstrutivo o mais frequentemente observado. Na comparação da independência funcional com a função pulmonar, observou-se que, quanto pior a condição funcional, pior a função pulmonar, observando-se diferenças significantes em relação ao pico de fluxo expiratório (p = 0,030). Conclusão: Em sua maioria, os pacientes que retornaram ao ambulatório 3 meses após a alta tinham boa condição funcional, porém apresentavam comprometimento pulmonar relacionado com o grau de dependência funcional.


ABSTRACT Objective: To relate functional independence to the degree of pulmonary impairment in adult patients 3 months after discharge from the intensive care unit. Methods: This was a retrospective cohort study conducted in one adult intensive care unit and a multi-professional post-intensive care unit outpatient clinic of a single center. Patients admitted to the intensive care unit from January 2012 to December 2013 who underwent (3 months later) spirometry and answered the Functional Independence Measure Questionnaire were included. Results: Patients were divided into groups according to the classification of functional independence and spirometry. The study included 197 patients who were divided into greater dependence (n = 4), lower dependence (n = 12) and independent (n = 181) groups. Comparing the three groups, regarding the classification of the Functional Independence Measure, patients with greater dependence had higher Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment values at intensive care unit admission with more advanced age, more days on mechanical ventilation, and longer stay in the intensive care unit and hospital. The majority of patients presented with pulmonary impairment, which was the obstructive pattern observed most frequently. When comparing functional independence with pulmonary function, it was observed that the lower the functional status, the worse the pulmonary function, with a significant difference being observed in peak expiratory flow (p = 0.030). Conclusion: The majority of patients who returned to the outpatient clinic 3 months after discharge had good functional status but did present with pulmonary impairment, which is related to the degree of functional dependence.


Subject(s)
Humans , Adult , Functional Status , Intensive Care Units , Spirometry , Retrospective Studies , APACHE
17.
Prensa méd. argent ; 107(1): 1-12, 20210000. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1362053

ABSTRACT

Introduction: The walking test of 6 minutes (6MW) is a test that merges the answer of different systems (respiratory, cardiovascular, metabolic, skeletal muscle and neurosensorial) and offers an useful objective result to lead therapeutic measurements and stablish a prognosis, it's possible that the comorbid patient lowers their functional reserve and alters the result of the test not only because of the presence of pathologies cardiorespiratory, nevertheless, information about the correlation between the scores of comorbidity and the traveled distance in the 6MW is limited. Objective: Determine the correlation between the traveled distance in the 6MW and the scores of comorbidities of Charlson and Elixhauser. Methods: A cross-sectional study was made, in patients taken to the 6MW made between 2006 until March 2020, in a hospital of high complexity; there were included patients older than 18 years old, whose clinic history record and walk of 6 minutes were available. The index of Charlson and Elixhauser were calculated in the 6MW, a bivariate analysis was made between the antecedents of pathologies and the traveled distance, independently and adjusted, the spearman correlation coefficient was calculated for the different scores and the distance in meters of the 6MW, was considerate a significative p: <0,05. Results: to the final analysis 491 subjects entered, the average age was of 69 years old (sd: 14,9), 54% male, the 15,3% had an abnormal walk less than the 80% of the expected, the diseases that were considered had a statistically significant relation with the decrease of the distance in the 6MW were arterial hypertension (p: <0,001), chronic heart failure (p=0,037), heart arrhythmia (p=0,003), smoking (p=0,022), chronic pulmonary obstruction disease (p: <0,001), dementia (p=0,03diabetes mellitus with target organ damage (p=0,01), moderate to severe chronic kidney disease (p=0,012), obesity (p=0,036) y lymphoma (p=0,038 the spearman correlation coefficient between the traveled distances and Charlson was of -0,343 (IC95%:-0,420 -0,264)(p: < 0,001) and -0,213(IC95%:-0,285 -0,116)(p: <0,001) with the Elixhauser index. Conclusion: The distances walked in meters in the 6MW has a reverse low correlation with the comorbidity index, the diseases that were not cardiopulmonary and that related independently with changes in the traveled dist ance are smoking, dementia, diabetes mellitus, chronic kidney disease, obesity, and lymphoma. Key words: Comorbidities, Walk, Test, Cardiopulmonary, Charlson, Elixhauser


Subject(s)
Humans , Adult , Middle Aged , Pulmonary Heart Disease/pathology , Spirometry , Comorbidity , Surveys and Questionnaires , Exercise Test , Walk Test
18.
Rev. argent. salud publica ; 13: 1-8, 5/02/2021.
Article in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1283061

ABSTRACT

INTRODUCCIÓN: En los estudios espirométricos se recomienda que cada población cuente con sus propios valores de referencia debido a condiciones regionales y a características de tipo étnico, etario, social, geográfico y climático. Estudios previos muestran elevados niveles de material particulado, hidrocarburos policíclicos y compuestos volátiles en el aire de La Plata y alrededores, con correlación entre exposición crónica a contaminantes y efectos adversos sobre desarrollo y función pulmonar. El objetivo fue establecer valores de referencia regionales para parámetros espirométricos en jóvenes de La Plata, siguiendo las recomendaciones de la American Thoracic Society (ATS) y la European Respiratory Society (ERS). MÉTODOS: Estudio transversal, observacional y descriptivo. Se realizaron y analizaron 171 espirometrías a jóvenes sanos de 13-17 años. Se llevaron a cabo medidas de correlación, identificando las variables predictoras. Para las ecuaciones de predicción se ajustaron modelos de regresión en función del sexo. RESULTADOS: La mayor correlación se encontró con talla y peso. Se desarrollaron ecuaciones para capacidad vital forzada (FVC) y volumen espiratorio forzado en el primer segundo (FEV1) según género. DISCUSIÓN: El cálculo de nuevos parámetros con valores menores a los propuestos por un estudio en Barcelona y adaptados por la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) confirmó la importancia de contar con valores de referencia regionales.


Subject(s)
Spirometry , Air Pollution , Particulate Matter , Volatile Organic Compounds
19.
Chinese Medical Journal ; (24): 1552-1560, 2021.
Article in English | WPRIM | ID: wpr-887612

ABSTRACT

BACKGROUND@#Chronic obstructive pulmonary disease (COPD) is a common public health problem worldwide. Recent studies have reported that socioeconomic status (SES) is related to the incidence of COPD. This study aimed to investigate the association between SES and COPD among adults in Jiangsu province, China, and to determine the possible direct and indirect effects of SES on the morbidity of COPD.@*METHODS@#A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province, China. Participants were selected using a multistage sampling approach. COPD, the outcome variable, was diagnosed by physicians based on spirometry, respiratory symptoms, and risk factors. Education, occupation, and monthly family average income (FAI) were used to separately indicate SES as the explanatory variable. Mixed-effects logistic regression models were introduced to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for examining the SES-COPD relationship. A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES.@*RESULTS@#The mean age of the 2421 participants was 56.63 ± 9.62 years. The prevalence of COPD was 11.8% (95% CI: 10.5%-13.1%) among the overall sample population. After adjustment for age, gender, residence, outdoor and indoor air pollution, body weight status, cigarette smoking, and potential study area-level clustering effects, educational attainment was negatively associated with COPD prevalence in men; white collars were at lower risk (OR: 0.60, 95% CI: 0.43-0.83) of experiencing COPD than blue collars; compared with those within the lower FAI subgroup, participants in the upper (OR: 0.68, 95% CI: 0.49-0.97) tertiles were less likely to experience COPD. Such negative associations between all these three SES indicators and COPD were significant among men only. Education, FAI, and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC), FEV1, FVC, and FEV1 percentage of predicted. Education, FAI, and occupation had indirect effects on pulmonary function indices of all participants mainly through smoking status, indoor air pollution, and outdoor air pollution. We also found that occupation could affect post-bronchodilator FEV1/FVC through body mass index.@*CONCLUSIONS@#Education, occupation, and FAI had an adverse relationship with COPD prevalence in Jiangsu province, China. SES has both direct and indirect associations with pulmonary function impairment. SES is of great significance for COPD morbidity. It is important that population-based COPD prevention strategies should be tailored for people with different SES.


Subject(s)
Adult , Aged , China/epidemiology , Cross-Sectional Studies , Forced Expiratory Volume , Humans , Male , Middle Aged , Prevalence , Pulmonary Disease, Chronic Obstructive/epidemiology , Risk Factors , Social Class , Spirometry , Vital Capacity
20.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 39: e2019326, 2021. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136780

ABSTRACT

ABSTRACT Objective: To verify the reproducibility of the six-minute walk test (6MWT) performance and its physiological variables in healthy students. Methods: This is as prospective cross-sectional study. The sample consisted of healthy students aged 6-12 years old from public and private schools in the region of Florianópolis City, Santa Catarina State, (Southern Brazil). The medical state was considered according to the health records and scores on the International Study of Asthma and Allergies in Childhood (ISAAC) and the spirometric values of forced expiratory volume in the first second and forced vital capacity above 80% of what was predicted. Two 6MWTs were conducted with a 30-minute interval between them, following the recommendations from the American Thoracic Society. Physiologic variables were recorded using the portable telemetric gas analyzer K4b2 (Cosmed®, Italy). For analysis, the dyspnea index, the perception of effort and performance variables identified in both 6MWT were considered. Data distribution was verified with the Shapiro-Wilk test and statistical analysis included paired t-test or Wilcoxon test, and intraclass correlation coefficient (ICC). The significance level adopted was 5%. Results: A total of 22 students with a mean age of 10.2±1.5 years participated in the study. The covered distance and the variation of oxygen consumption reproducibility between the two 6MWTs presented ICC=0.76 and ICC=0.86, respectively. There was also similar behavior of the physiological variables when comparing the two tests (p=0.001), especially the minute volume (MV), the oxygen consumption (VO2), and the carbon dioxide production (VCO2). Conclusions: The 6MWT showed reproducible values, both in performance and physiological parameters, in the healthy students analyzed.


RESUMO Objetivo: Verificar a reprodutibilidade do desempenho e das variáveis fisiológicas do teste de caminhada de seis minutos (TC6) realizado por escolares saudáveis. Métodos: Estudo transversal prospectivo. A amostra foi composta de escolares saudáveis, entre 6 e 12 anos, provenientes de escolas públicas e privadas da Grande Florianópolis, SC, Brasil. A higidez foi controlada por meio do recordatório de saúde, do questionário International Study of Asthma and Allergies in Childhood (ISAAC) e dos valores espirométricos de volume expiratório forçado no primeiro segundo (VEF1) e capacidade vital forçada (CVF) acima de 80% do predito. Foram registradas as variáveis fisiológicas utilizando-se o analisador de gases telemétrico portátil K4b2 (Cosmed®, Itália), e, para análise, consideraram-se o índice de dispneia, a percepção de esforço e as variáveis de desempenho identificadas nos dois TC6. Verificou-se a distribuição dos dados pelo teste de Shapiro-Wilk, e a análise estatística incluiu: teste t de Student pareado, ou teste de Wilcoxon, e o coeficiente de correlação intraclasse (ICC). O nível de significância adotado foi de 5%. Resultados: Participaram 22 escolares com idade média de 10,2±1,5 anos. Identificou-se reprodutibilidade da distância percorrida e da variação do consumo de oxigênio entre os dois TC6, com ICC=0,76 e ICC=0,87, respectivamente. Houve similaridade no comportamento das variáveis fisiológicas na comparação entre os dois testes (p=0,001), destacando-se o volume minuto (VE), o consumo de oxigênio (VO2) e a produção de dióxido de carbono (VCO2). Conclusões: O TC6 apresentou valores reprodutíveis tanto no desempenho como nos parâmetros fisiológicos nos escolares saudáveis estudados.


Subject(s)
Walk Test , Physical Functional Performance , Oxygen Consumption/physiology , Spirometry , Vital Capacity/physiology , Forced Expiratory Volume , Cross-Sectional Studies , Prospective Studies , Surveys and Questionnaires , Reproducibility of Results
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