Can 1st and 6th month pulmonary function test follow-ups give an idea about the long-term respiratory effects of COVID-19 pneumonia?

SUMMARY OBJECTIVE: The aim of this study was to ascertain the long-term respiratory effects of COVID-19 pneumonia through pulmonary function tests in follow-ups at 1 and 6 months. METHODS: Our study was conducted between August 1, 2020 and April 30, 2021. At 1 month after discharge, follow-up evaluations, PFTs, and lung imaging were performed on patients aged above 18 years who had been diagnosed with COVID-19 pneumonia. In the 6th month, the PFTs were repeated for those with pulmonary dysfunction. RESULTS: A total of 219 patients (mean age, 49±11.9 years) were included. Pathological PFT results were noted in the 1st month for 80 patients and in the 6th month for 46 (7 had obstructive disorder, 15 had restrictive disorder, and 28 had small airway obstruction) patients. A significant difference was found between abnormal PFT results and patient-described dyspnea in the 1st month of follow-up. The 6-month PFT values (especially those for forced vital capacity) were statistically significantly lower in the patients for whom imaging did not indicate complete radiological improvement at the 1-month follow-up. No statistically significant difference was found between the severity of the first computed tomography findings or clinical condition on emergency admission and pulmonary dysfunction (Pearson's chi-square test, P=0.904; Fisher's exact test, P=0.727). CONCLUSION: It is important that patients with COVID-19 pneumonia be followed up for at least 1 month after discharge to be monitored for potential long-term lung damage. PFTs should be administered to those in whom ongoing dyspnea, which started with COVID-19, and/or full recovery were not identified in pulmonary imaging.

Influence of expiratory positive airway pressure on cardiac autonomic modulation at rest and in submaximal exercise in COPD patients

The aim of this study was to evaluate the effect of expiratory positive airway pressure (EPAP) on heart rate variability (HRV) indices at rest and during 6-min walk test (6MWT) in chronic obstructive pulmonary disease (COPD) patients. Fifteen moderate to severe COPD patients were randomized and evaluated with and without (Non-EPAP) a 5 cmH2O EPAP device. Respiratory rate (RR) was collected at rest (5 min), during the 6MWT (5 min), and at recovery (5 min). Indices of HRV were computed in the time domain, in the frequency domain, and nonlinear analysis. For EPAP and Non-EPAP during the 6MWT, we found an increased mean heart rate (HR) (P=0.001; P=0.001) while mean RR (P=0.001; P=0.015) and RR tri index decreased (P=0.006; P=0.028). Peripheral oxygen saturation (P=0.019) increased at rest only in the EPAP group. In EPAP, correlations were found between forced expiratory volume in 1 s (FEV1) and low frequency (LF) sympathetic tonus (P=0.05; r=-0.49), FEV1 and high frequency (HF) parasympathetic tonus at rest (P=0.05; r=0.49), lactate at rest and LF during the 6MWT (P=0.02; r=-0.57), and lactate at rest and HF during 6MWT (P=0.02; r=0.56). Through a linear regression model, we found that lactate at rest explained 27% of the alterations of LF during 6MWT. The use of 5 cmH2O EPAP improved autonomic cardiac modulation and its complexity at rest in COPD patients. Although it did not influence the performance of the 6MWT, the EPAP device caused alterations in resting lactate concentration with an effect on sympatho-vagal control during the test.

Plasma rico em plaquetas no tratamento de lesões condrais articulares induzidas experimentalmente em equinos: avaliação clínica, macroscópica, histológica e histoquímica / Platelet-rich plasma in the treatment of articular chondral defects experimentally induced in horses: clinical, macroscopic, histopathological and histochemical evaluation

Estudou-se a eficácia do plasma rico em plaquetas (PRP) no tratamento de lesões condrais articulares, experimentalmente induzidas em equinos. Para isso, foi induzida uma lesão condral, na tróclea medial femoral dos dois membros pélvicos de quatro animais. Após 30 dias da indução, as oito articulações foram divididas em dois grupos. Os animais do grupo 1 receberam o tratamento intralesional e intra-articular com PRP, e os do grupo 2 foram tratados apenas com solução fisiológica. As avaliações clínicas, constituídas de exames de claudicação e análises do líquido sinovial, foram realizadas antes da indução da lesão - tempo zero -, quinzenalmente, até 120 dias e aos 150 dias. Avaliações macroscópicas, histológicas e histoquímicas foram realizadas no tempo zero e aos 150 dias. Os equinos do grupo 1 apresentaram melhora do grau de claudicação em relação aos do grupo 2. Os exames macroscópicos, histológicos e histoquímicos revelaram melhor tecido de reparação igualmente no grupo 1. Concluiu-se que a administração de PRP apresentou efeitos benéficos no tratamento de lesões condrais experimentais de equinos.

The use of platelet-rich plasma (PRP) in the treatment of articular cartilage defects induced experimentally in horses was studied. For this purpose, both patellofemoral joints of four animals were approached through arthroscopic surgery to perform a cartilage defect on the medial femoral trochlea. After 30 days of induction the eight joints were divided into two groups. Group 1 animals received intralesional and intra-articular treatment with PRP and Group 2 animals were treated only with saline solution. The clinical assessments, constituted by lameness signs and synovial fluid analysis, were performed before induction of injury (time zero) and every 15 days in 120 days, with last analysis on day 150. The macroscopic and morphologic analysis were performed at 0 and 150 days. During the experiment Group 1 animals showed improvement in lameness when compared to Group 2 animals. The macroscopic and morphological analysis showed a better tissue repair in the treated horses. Thus, the implantation of autologous PRP showed beneficial effects in the treatment of chondral lesions, experimentally induced in horses.

Standard electrocardiographic values in Holstein calves

This paper presents electrocardiographic values in 25 Holstein calves using the standard bipolar limbs leads (I, II and III), augmented unipolar limb leads (avL, avR and avF) and a bipolar chest lead (V10). Two groups with different ages were compared (newborn - 18 to 72 hours and calves - 27 to 33 days old). It was concluded that no differences between age groups in P, Q, R, S and T waves, in the PR, QRS, QT and ST intervals and in axis orientation were observed.

Este artigo apresenta valores eletrocardiográficos de 25 bezerros da raça Holandesesa, utilizando-se as derivações bipolares de membro (I, II, III), unipolares aumentadas de membro (avL, avR e avF) e uma derivação bipolar de torax (V10). Dois grupos com animais de diferentes idades foram comparados (18 a 72 horas e 27 a 33 dias de idade). Conclui-se que não houve diferença significativa entre os grupos nas ondas P, Q, R, S e T, nos intervalos PR, QRS, QT e ST e no eixo cardíaco.