ABSTRACT
Background: Considering millions of people affected by Coronavirus disease 2019 (COVID-19), long-lasting sequelae can significantly impact health worldwide. Data from prospective studies in lower-middle-income countries on persistent lung dysfunction secondary to COVID-19 are lacking. This work aims to determine risk factors and the impact of persistent lung dysfunctions in COVID-19 survivors. Methods: Observational and prospective cohort of patients admitted to a tertiary hospital from June 2020 to November 2020. Persistence of chest CT scan alterations, desaturation in the six-minute walk test (6MWT), forced expiratory volume in one second (FEV1), lung carbon monoxide diffusion (DLCO), and maximum inspiratory pressure (MIP) were measured 6 months after hospital discharge. Additionally, the Barthel index (BI) and the Modified Medical Research Council (mMRC) Dyspnea Scale were used to determine the impact of lung dysfunction in activities of daily living (ADL). Results: It was included 44 patients. Sixty percent had persistent lung CT scan abnormalities. From 18 to 43% of patients had at least one pulmonary function dysfunction, a decrease in FEV1 was the least prevalent (18%), and a reduction in DLCO and MIP was the most frequent (43%). In general, female gender, comorbidity index, and age were associated with worse lung function. Additionally, the presence of lung dysfunction could predict worse BI (r-square 0.28) and mMRC (r-square 0.32). Conclusion: Long-term lung dysfunction is relatively common in survivors from severe COVID-19 and impacts negatively on ADL and the intensity of dyspnea, similar to studies in high-income countries.
ABSTRACT
Objetivo: Correlacionar a sensação de dispneia obtida pela escala Medical Research Council modificada (mMRC) com as variáveis respiratórias e o tempo de internação em portadores de doença pulmonar obstrutiva crônica (DPOC) hospitalizados. Material e Métodos: Estudo transversal de caráter observacional e descritivo; no qual participaram do estudo pacientes interna-dos na Santa Casa de Misericórdia (SCM) de Goiânia-GO e Hospital Geral de Goiânia Dr. Alberto Rassi (HGG), com diag-nóstico de DPOC. Foram coletados sinais vitais, dados antro-pométricos e aplicada a escala de mMRC. Resultados: Foram avaliados 28 participantes, com média de idade de 74,10±12,46 anos; a média de mMRC foi de 3,10±1,19, comprometimento moderado, não ocorrendo diferença de mMRC entre homens e mulheres (p=0,503), além de não ter sido encontrada cor-relação entre o mMRC com a FR (r= -0,035 p=0,864), SpO2 (r=-0,228 p=0,222) e o tempo de internação (r=0,140 p=0,486). No entanto, em relação a necessidade de internação em uni-dade de terapia intensiva e o tempo de internação na unidade houve correlação significativa (r-0,457 p<0,01 e r 0,388 p<0,04, respectivamente). Conclusão: Não se encontrou relação da sensação de dispneia com as variáveis respiratórias e o tempo de internação total, porém foi possível verificar uma correlação entre o mMRC e a necessidade de internação e o tempo de internação em unidade de terapia intensiva. (AU)
Objetive:To correlate the dyspnea syndrome with the modified Medical Research Council scale (mMRC) with the respiratory and temporal variables of hospitalization in patients with hospitalized chronic obstructive pulmonary disease (COPD). Method: Cross-sectional observational and descriptive studyin which participated patients from the Santa Casa de Misericórdia (SCM) of Goiânia-GO and the General Hospital of Goiânia Dr. Alberto Rassi (HGG), with the diagnosis of COPD. Vital signs and anthropometric data were collected and the mMRC scale was applied. Results: Twenty-eight participants were evaluated, with a mean age of 74.10 ± 12.46 years; the mean mMRC was 3.10 ± 1.19, there was moderate impairment, no difference of mMRC between men and women (p = 0.503), nor was it found among mMRC with FR (r = -0.035 p = 0.864), SpO2 (r = -0.228 p = 0.222) and length of stay (r = 0.140 p = 0.486), which means that intensive care unit stay and length of stay in the domestic unit are important (r-0,457 p<0,01 e r 0,388 p<0,04 respectively). Conclusion: No differences between dyspnea syndrome and respiratory variables and total hospitalization time were found, but it was possible that they occurred between the MRC and the need for hospitalization and length of stay in intensive care therapy. There is a moderate influence of the dyspnea syndrome to direct the attention to the individuals under hospitalization, in order to minimize the progression of the disorder and greater impairment in the general state of health. (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Severity of Illness Index , Pulmonary Disease, Chronic Obstructive/physiopathology , Dyspnea/diagnosis , Symptom Assessment/methods , Length of Stay , Cross-Sectional Studies , Dyspnea/physiopathology , Intensive Care UnitsABSTRACT
En este trabajo se reporta el estudio experimental de la alquilación intramolecular de Friedel-Crafts de orto-alilanilinas N-bencilo sustituidas, que explica desde los puntos de vista cinético y termodinâmico la formación de dihidrodibenzo [b,e]azepinas y tetrahidrodibenzo[b, ƒ] azocinas. El seguimiento de los cambios en concentración resultantes del tratamiento en condiciones heterogéneas se llevó a cabo por Cromatografía de Gases-Detector de Ionización en Llama (CG-DILL), mientras que la espectroscopia Ultravioleta-Visible (UV-Vis) y el análisis quimiométrico con el Método Multivariante de Resolución de Curvas-Mínimos Cuadrados Alternados (MMRC-MCA) se usaron para examinar los efectos de las condiciones de reacción en fase homogénea e in situ. Con los resultados obtenidos se puede concluir que la supervisión de parámetros, tales como constantes de velocidad y energías de activación, hizo posible evidenciar los efectos de sustituyen-te, temperatura, velocidad de agitación y concentración, sobre la velocidad y re-gioselectividad de la reacción.
In this work, experimental studies of intramolecular Friedel-Crafts alkylation of N-benzyl sustituted ortho-allylanilines are reported; the results explain the formation of both dihydrodibenz[b,e]azepine and tetrahydrodibenz[b,ƒ]azocine isomers from kinetic and thermodynamic points of view. The concentration changes resulting from treatment under heterogeneous conditions were followed by Gas Chromatography-Flame Ionization Detector (GC-FID), while Ultraviolet-Visible (UV-Vis) spectroscopy with Multivariate Curve Resolution-Alternating Least Squares (MCR-ALS) chemometric analysis were used for analysis of the effects of reaction conditions in homogeneous phase and in-situ. With the obtained results could be conclude that the supervision of parameters such as rate constants and activation energies proved the effects of substituent, temperature, agitation speed and concentration on reaction velocity and regioselectivity.
No trabalho reporta-se o estudo experimental da alquilação intramolecular de Friedel-Crafts de orto-alil-anilines N-bencil substituídas o quais explicam desde a cinética e a termodinâmica, a produção de dihidrodibenzo[b,e]azepinas e tetrahidrodibenzo[b,ƒ]azocinas. O procedimento experimental nas condições erogén foi estabelecida mediante GC-FID e a espectroscopia UV-Vis com análise quimiométrico MCR-ALS foi usada para estabelecer as condições da reação na fase homogênea e in situ. Baseados nos resultados obtidos pode-se concluir como variação dos parâmetros constate de velocidade e energia de ativação fize possível evidenciar os efeitos do substituinte, temperatura, velocidade de agitação e concentração, sobra a velocidade e seletividade da reação.