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1.
PLoS One ; 13(8): e0202481, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30148839

RESUMO

BACKGROUND: Pleural tuberculosis (PlTB) is the most common extrapulmonary manifestation of this infectious disease which still presents high mortality rates worldwide. Conventional diagnostic tests for PlTB register multiple limitations, including the lack of sensitivity of microbiological methods on pleural specimens and the need of invasive procedures such as pleural biopsy performance. In this scenario, the search for biological markers on pleural fluid (PF) has been the target of several studies as a strategy to overcome the limitations of PlTB diagnosis. This study aims to evaluate the use either isolated or in combination with adenosine deaminase (ADA), interferon-gamma (IFN-γ), interferon-gamma inducible protein of 10-kD (IP-10) levels on PF in order to guide an accurate anti-TB treatment in microbiologically non-confirmed cases. METHODS AND FINDINGS: Eighty patients presenting pleural effusion under investigation were enrolled in a cross-sectional study conducted at Pedro Ernesto University Hospital, Rio de Janeiro, RJ, Brazil. Peripheral blood (PB) and PF samples collected from all patients were applied to the commercial IFN-γ release assay, QuantiFERON-TB Gold In-Tube, and samples were analyzed for IFN-γ and IP-10 by immunoassays. ADA activity was determined on PF by the colorimetric method. Based on microbiological and histological criteria, patients were categorized as follow: confirmed PlTB (n = 16), non-confirmed PlTB (n = 17) and non-PlTB (n = 47). The Mycobacterium tuberculosis antigen-specific production of IFN-γ and IP-10 on PB or PF did not show significant differences. However, the basal levels of these biomarkers, as well as the ADA activity on PF, were significantly increased in confirmed PlTB in comparison to non-PlTB group. Receiver operating characteristics curves were performed and the best cut-off points of these three biomarkers were estimated. Their either isolated or combined performances (sensitivity [Se], specificity [Sp], positive predictive value [PPV], negative predictive value [NPV] and accuracy [Acc]) were determined and applied to Venn's diagrams among the groups. Based on the confirmed PlTB cases, IFN-γ showed the best performance of them at a cut-off point of 2.33 IU/mL (Se = 93.8% and Sp = 97.9%) followed by ADA at a cut-off of 25.80 IU/L (Se = 100% and Sp = 84.8%) and IP-10 (Cut-point = 4,361.90 pg/mL, Se = 75% and Sp = 82.6%). IFN-γ plus ADA (cut-point: 25.80 IU/L) represent the most accurate biomarker combination (98.4%), showing Se = 93.7%, Sp = 100%, PPV = 100% and NPV = 97.9%. When this analysis was applied in non-confirmed PlTB, 15/17 (88.2%) presented at least two positive biomarkers in combination. CONCLUSION: IFN-γ, IP-10, and ADA in PlTB effusions are significantly higher than in non-PlTB cases. IFN-γ is an excellent rule-in and rule-out test compared to IP-10 and ADA. The combination of IFN-γ and ADA, in a reviewed cut-off point, showed to be particularly useful to clinicians as their positive results combined prompts immediate treatment for TB while both negative results suggest further investigation.

2.
J Clin Densitom ; 2018 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-29661687

RESUMO

The historical concept that obesity protects against bone fractures has been questioned. Weight loss appears to reduce bone mineral density (BMD); however, the results in young adults are inconsistent, and data on the effects of weight loss on bone microstructure are limited. This study aimed to evaluate the impact of weight loss using an intragastric balloon (IGB) on bone density and microstructure. Forty obese patients with metabolic syndrome (mean age 35.1 ± 7.3 yr) used an IGB continuously for 6 mo. Laboratory tests, areal BMD, and body composition measurements via dual-energy X-ray absorptiometry, and volumetric BMD and bone microstructure measurements via high-resolution peripheral quantitative computed tomography were conducted before IGB placement and after IGB removal. The mean weight loss was 11.5%. After 6 mo, there were significant increases in vitamin D and carboxyterminal telopeptide of type 1 collagen levels. After IGB use, areal BMD increased in the spine but decreased in the total femur and the 33% radius. Cortical BMD increased in the distal radius but tended to decrease in the distal tibia. The observed trabecular bone loss in the distal tibia contributed to the decline in the total volumetric BMD at this site. There was a negative correlation between the changes in leptin levels and the measures of trabecular quality in the tibia on high-resolution peripheral quantitative computed tomography. Weight loss may negatively impact bone microstructure in young patients, especially for weight-bearing bones, in which obesity has a more prominent effect.

3.
Health Qual Life Outcomes ; 15(1): 211, 2017 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-29065923

RESUMO

BACKGROUND: Obesity is a worldwide public health issue with a negative impact on quality of life. Different weight loss interventions have demonstrated improvements in quality of life. The aim of this study was to investigate the effect of 6 months of treatment with an intragastric balloon (IGB) on health-related quality of life (HRQOL) and its relation to changes in body fat in obese individuals with metabolic syndrome (MS). METHODS: Fifty obese patients with MS aged 18-50 were selected for treatment with IGB for 6 months. Body fat was assessed with anthropometric measures and dual-energy X-ray absorptiometry (DXA) at baseline and after removal of the IGB. HRQOL was evaluated with the short form of the World Health Organization Quality of Life (WHOQOL-BREF) at baseline and soon after removal of the IGB. RESULTS: Thirty-nine patients completed the study. After 6 months, there was a significant improvement in quality of life (p = 0.0009) and health (p < 0.0001) perceptions, and in the Physical (p = 0.001), Psychological (p = 0.031), and Environmental domains (p = 0.0071). Anthropometric measures and total fat determined by DXA were directly and significantly related to an improvement in general aspects of quality of life. The decrease in the percentage of total fat was the parameter that better correlated with improvements in quality of life perception after regression (p = 0.032). CONCLUSIONS: In obese individuals with MS, weight loss parameters were associated with short-term improvements in HRQOL after 6 months of treatment with IGB. However, only total fat was independently related to HRQOL perception. TRIAL REGISTRATION: ClinicalTrials.gov NCT01598233 .


Assuntos
Tecido Adiposo , Balão Gástrico , Síndrome Metabólica/psicologia , Obesidade/psicologia , Qualidade de Vida , Perda de Peso , Adulto , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Obesidade/complicações
4.
Respir Med Case Rep ; 21: 1-6, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28337408

RESUMO

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic disease situated between primary small vessel vasculitides associated with antineutrophil cytoplasmic antibodies (ANCAs) and hypereosinophilic syndromes (HES). Here, we present a case of EGPA in a 38-year-old male, with a previous diagnosis of asthma, who presented with fever, migratory lung infiltrates and systemic eosinophilia that was refractory to previous courses of antibiotics. This case highlights the importance of the primary care physician understanding the differential diagnosis of pulmonary eosinophilic syndromes.

5.
Pulmäo RJ ; 26(1): 51-56, 2017.
Artigo em Português | LILACS | ID: biblio-883609

RESUMO

É bem conhecido o fato de que os principais parâmetros de função pulmonar utilizados na avaliação de gravidade e no seguimento dos pacientes com DPOC não apresentam boa correlação com os sintomas e os principais desfechos da doença, especialmente naqueles pacientes considerados graves. Portanto, torna-se imperativa a busca de novos marcadores funcionais que melhor retratam a gravidade da DPOC. Nesse contexto, tem havido um interesse crescente acerca da técnica de washout do nitrogênio (TWN2), uma vez que é uma ferramenta simples e não invasiva, sendo capaz de detectar heterogeneidade na distribuição da ventilação e doença de pequenas vias aéreas até mesmo quando outros testes de função pulmonar apresentam valores normais. A TWN2 possibilita a busca de pacientes com DPOC cujo fenótipo da doença é basicamente a anormalidade de pequenas vias aéreas e, através desse conhecimento, abre-se o caminho para o desenvolvimento de novas terapias farmacológicas voltadas especificamente para vias aéreas mais periféricas. Além do mais, a avaliação do grau de heterogeneidade na distribuição da ventilação em diferentes graus de gravidade da DPOC juntamente com a evolução importante do seu aparato técnico, justificam a retomada da TWN2 e, ao mesmo tempo, depositam enorme expectativa acerca da sua utilização rotineira na prática clínica.


It is well known that the main pulmonary function parameters used in the assessment of severity and follow-up of patients with COPD do not show a good correlation with the symptoms and the main outcomes of the disease, especially in patients considered to be severe. Therefore, the search for new functional markers that best portray the severity of COPD becomes imperative. In this context, there has been a growing interest in the nitrogen washout technique (N2WT), since it is a simple and non-invasive tool, being able to detect heterogeneity in the distribution of ventilation and small airway disease when other function tests still present normal values. N2WT makes it possible to search for patients with COPD whose phenotype of the disease is basically the small airway abnormality, and through this knowledge, it opens the way for the development of new pharmacological therapies specifically targeted to more peripheral airways. Moreover, the evaluation of the degree of heterogeneity in the distribution of ventilation in different degrees of COPD severity, together with the important evolution of its technical apparatus, justify the resumption of N2WT and, at the same time, put enormous expectations about its use in clinical practice.


Assuntos
Humanos , Testes de Função Respiratória , Mecânica Respiratória , Doença Pulmonar Obstrutiva Crônica/diagnóstico
6.
Multidiscip Respir Med ; 11: 28, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27408717

RESUMO

Obesity is currently one of the major epidemics of this millennium and affects individuals throughout the world. It causes multiple systemic complications, some of which result in severe impairment of organs and tissues. These complications involve mechanical changes caused by the accumulation of adipose tissue and the numerous cytokines produced by adipocytes. Obesity also significantly interferes with respiratory function by decreasing lung volume, particularly the expiratory reserve volume and functional residual capacity. Because of the ineffectiveness of the respiratory muscles, strength and resistance may be reduced. All these factors lead to inspiratory overload, which increases respiratory effort, oxygen consumption, and respiratory energy expenditure. It is noteworthy that patterns of body fat distribution significantly influence the function of the respiratory system, likely via the direct mechanical effect of fat accumulation in the chest and abdominal regions. Weight loss caused by various types of treatment, including low-calorie diet, intragastric balloon, and bariatric surgery, significantly improves lung function and metabolic syndrome and reduces body mass index. Despite advances in the knowledge of pulmonary and systemic complications associated with obesity, longitudinal randomized studies are needed to assess the impact of weight loss on metabolic syndrome and lung function.

7.
J Laparoendosc Adv Surg Tech A ; 26(3): 168-73, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26844373

RESUMO

BACKGROUND: Obesity is a worldwide epidemic that is difficult to control with non-invasive treatments, which usually present poor results. In this context, the intragastric balloon (IGB) is an important tool that presents a mean body weight loss (BWL) estimated at approximately 12%, although individual responses are highly variable. OBJECTIVES: This study assesses whether there are factors that can predict responses to IGB therapy either before or early after placement of the device. MATERIALS AND METHODS: A total of 50 obese patients underwent insertion of IGB placed endoscopically, and patients were monitored for 6 months. The evaluated predictive factors involved general characteristics and psychological, social, and dyspeptic aspects, and the preliminary results obtained in the first month after balloon placement. RESULTS: The mean weight loss was 11.5%, and 48% of the participants presented BWL >10%. Among the factors analyzed before IGB placement, only advanced age (P = .04) and higher scores obtained in the social relationships domain of a shorter version of the World Health Organization's Quality of Life questionnaire (P = .02) were significant. Analysis of the factors evaluated after IGB placement revealed that the BWL amounts observed in week 2 (P = .001) and week 4 (P < .001) and the intensity of dyspeptic symptoms in week 2 (P < .001) were positive predictive factors. CONCLUSIONS: The assessment of predictive factors may help to manage patients with IGB.


Assuntos
Balão Gástrico , Obesidade/terapia , Perda de Peso , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento
8.
Pulmäo RJ ; 25(1): 5-10, 2016. il.
Artigo em Português | LILACS | ID: biblio-848783

RESUMO

A Ultrassonografia tem grande valor na avaliação das doenças da pleura. Trata-se de um método não invasivo e isento de riscos que permite a realização de exame em tempo real e à beira do leito. Ela é útil na análise dos derrames pleurais, inclusive podendo ser utilizada como guia para procedimentos invasivos. Na suspeita de pneumotórax a US também tem grande utilidade assim como na análise das alterações sólidas das superfícies pleurais e das estruturas adjacentes. AU


The ultrasound has great value in the evaluation of diseases of the pleura. This is a non-invasive and risk--free method that allows the realization of examination in real time and at the bedside. It is useful in the analysis of pleural effusions, even can be used as a guide to invasive procedures. In suspected cases of pneumothorax US also has great utility as well as the analysis of the solid changes in pleural surfaces and adjacent structures AU


Assuntos
Humanos , Masculino , Feminino , Derrame Pleural/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Ultrassonografia
9.
Lung ; 192(5): 653-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25047513

RESUMO

BACKGROUND: Interest in using the nitrogen single-breath washout (N2SBW) test to measure ventilation inhomogeneity and small airway function in COPD patients has grown in recent years. Our aim was to assess the correlation of the measures obtained by the N2SBW test and other pulmonary function parameters with the six-minute walk distance (6MWD), the degree of dyspnea score, and health status in COPD patients. METHODS: In this cross-sectional study, 31 patients with COPD were subjected to the N2SBW test, spirometry, whole-body plethysmography, carbon monoxide diffusing capacity measurement, the six-minute walk test, the modified Medical Research Council (mMRC) scale, and the COPD Assessment Test (CAT). RESULTS: We found a strong correlation between the 6MWD and the phase III slope of the nitrogen single-breath washout (Phase III slopeN2SBW) (r = -0.796; p = 0.0001). We found moderate correlations between the 6MWD and the residual volume (RV) (r = -0.651; p = 0.0001) and RV/total lung capacity (RV/TLC) (r = -0.600; p = 0.0004). We also found moderate correlations between the CAT score and Phase III slopeN2SBW(r = 0.728; p = 0.0001), RV (r = 0.646; p = 0.0001) and RV/TLC (r = 0.603; p = 0.0003). There was a significant difference between the mMRC grades for the following variables: Phase III slopeN2SBW (p = 0.0001), RV (p = 0.0001), and smoking history (p = 0.008). Multivariate analysis showed that Phase III slopeN2SBW was the only independent predictor of the 6MWD (R2 = 0.703; p = 0.0001), CAT score (R2 = 0.586; p = 0.0001), and mMRC scale (relative risk = 1.14; p = 0.0001). CONCLUSIONS: In patients with COPD, our findings suggest that the ventilation inhomogeneity impacts the functional exercise capacity, the degree of dyspnea, and health status.


Assuntos
Dispneia/fisiopatologia , Tolerância ao Exercício , Pulmão/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Ventilação Pulmonar , Idoso , Brasil , Testes Respiratórios , Estudos Transversais , Dispneia/diagnóstico , Dispneia/etiologia , Teste de Esforço , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pletismografia Total , Valor Preditivo dos Testes , Capacidade de Difusão Pulmonar , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Fatores de Risco , Índice de Gravidade de Doença , Espirometria
10.
Obes Surg ; 24(2): 232-40, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23949905

RESUMO

BACKGROUND: The purpose of this study is to establish whether the use of an intragastric balloon (IGB) for 6 months improves lung function, metabolic parameters, and body fat distribution in patients with overweight/obesity and metabolic syndrome (MS). METHODS: This is a longitudinal and interventional study on 40 adults, whose anthropometric, laboratory, and lung function parameters were assessed and who underwent dual-energy X-ray absorptiometry (DXA) before implantation and after removal of IGB. RESULTS: The total lung capacity (TLC) (p = 0.0001), functional residual capacity (FRC) (p = 0.0001), residual volume (p = 0.0005), and expiratory reserve volume (ERV) (p = 0.0001) were significantly reduced by IGB. The body mass index (BMI) significantly decreased from a median of 39.1 kg/m(2) at the beginning of the study to 34.5 kg/m(2) at the end of the 6-month period (p = 0.0001). At the end of the study, 31 participants (77.5%) no longer met the diagnostic criteria of MS. The percentage of truncal, android, gynoid, and total fat investigated by DXA exhibited significant reductions (p = 0.0001). Significant correlations were found between delta TLC and delta waist circumference (ρ = -0.34; p = 0.03), delta FRC and delta IMC (ρ = -0.39; p = 0.01), delta ERV and delta BMI (ρ = -0.44; p = 0.005), and delta ERV and delta high-density lipoprotein (HDL) (ρ = -0.37; p = 0.02). Significant correlations were also found between delta ERV and delta truncal (ρ = -0.51; p = 0.004), android (ρ = -0.46; p = 0.01), gynoid (ρ = -0.55; p = 0.001), and total fat (ρ = -0.59; p = 0.0005). CONCLUSIONS: IGB efficiently induced weight loss and promoted the improvement of lung function parameters, with a reduction of the restrictive ventilatory defect. It also promoted improvements of MS and the pattern of body fat distribution.


Assuntos
Balão Gástrico , Síndrome Metabólica/terapia , Obesidade Mórbida/terapia , Perda de Peso , Absorciometria de Fóton , Adulto , Composição Corporal , Distribuição da Gordura Corporal , Índice de Massa Corporal , Volume de Reserva Expiratória , Feminino , Humanos , Estudos Longitudinais , Masculino , Síndrome Metabólica/fisiopatologia , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/cirurgia , Capacidade de Difusão Pulmonar , Indução de Remissão , Capacidade Pulmonar Total
11.
Bone ; 59: 89-92, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24220493

RESUMO

The effects of obesity and metabolic syndrome (MS) on bone health are controversial. Furthermore, the relationship between body composition and bone quality has not yet been determined in this context. The aim of this study was to investigate the correlations between body composition and bone mineral density (BMD) and bone microstructure in obese individuals with MS. This cross-sectional study assessed 50 obese individuals with MS with respect to their body composition and BMD, both assessed using dual X-ray absorptiometry, and bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) of the distal tibia and radius. Several HR-pQCT measurements exhibited statistically significant correlations with lean mass. Lean mass was positively correlated with parameters of better bone quality (r: 0.316-0.470) and negatively correlated with parameters of greater bone fragility (r: -0.460 to -0.310). Positive correlations were also observed between lean mass and BMD of the total femur and radius 33%. Fat mass was not significantly correlated with BMD or any HR-pQCT measurements. Our data suggest that lean mass might be a predictor of bone health in obese individuals with MS.


Assuntos
Tecido Adiposo , Composição Corporal , Densidade Óssea , Osso e Ossos/patologia , Síndrome Metabólica/complicações , Obesidade/complicações , Tecido Adiposo/anatomia & histologia , Adulto , Osso e Ossos/anatomia & histologia , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico por imagem , Síndrome Metabólica/fisiopatologia , Análise Multivariada , Obesidade/diagnóstico por imagem , Obesidade/fisiopatologia , Tamanho do Órgão , Tomografia Computadorizada por Raios X
13.
J Bras Pneumol ; 38(5): 666-71, 2012 Sep-Oct.
Artigo em Inglês, Português | MEDLINE | ID: mdl-23147060

RESUMO

Although hemophagocytic syndrome is a rare clinical condition, it is associated with high mortality and the number of cases described in the literature has progressively increased. The diagnosis of hemophagocytic syndrome is made on the basis of a finding of hemophagocytosis. Sarcoidosis is a highly prevalent disease whose course and prognosis might correlate with the initial clinical presentation and the extent of the disease. We report the case of a patient with long-standing sarcoidosis who presented with intermittent fever and fatigue. The diagnosis of hemophagocytic syndrome was made by bone marrow aspiration, and specific treatment was ineffective. This is the third case of sarcoidosis-related hemophagocytic syndrome reported in the literature and the first reported in Latin America. All three cases had unfavorable outcomes.


Assuntos
Linfo-Histiocitose Hemofagocítica/diagnóstico , Sarcoidose Pulmonar/diagnóstico , Exame de Medula Óssea , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade
14.
J. bras. pneumol ; 38(5): 666-671, set.-out. 2012. ilus, tab
Artigo em Português | LILACS | ID: lil-656018

RESUMO

Embora seja uma condição clínica rara, a síndrome hemofagocítica é associada com alta mortalidade e o número de casos descritos na literatura vem aumentando progressivamente. O diagnóstico de síndrome hemofagocítica depende da presença de hemofagocitose. A sarcoidose é uma doença de alta prevalência cujo curso e prognóstico podem correlacionar-se com a apresentação clínica inicial e a extensão da doença. Relatamos o caso de um paciente com sarcoidose de longa duração que apresentava febre intermitente e fadiga. O diagnóstico de síndrome hemofagocítica foi realizado por aspirado de medula óssea, e o tratamento específico foi ineficaz. Trata-se do terceiro caso de síndrome hemofagocítica relacionada a sarcoidose na literatura mundial e o primeiro na literatura latino-americana. Os três casos tiveram desfecho desfavorável.


Although hemophagocytic syndrome is a rare clinical condition, it is associated with high mortality and the number of cases described in the literature has progressively increased. The diagnosis of hemophagocytic syndrome is made on the basis of a finding of hemophagocytosis. Sarcoidosis is a highly prevalent disease whose course and prognosis might correlate with the initial clinical presentation and the extent of the disease. We report the case of a patient with long-standing sarcoidosis who presented with intermittent fever and fatigue. The diagnosis of hemophagocytic syndrome was made by bone marrow aspiration, and specific treatment was ineffective. This is the third case of sarcoidosis-related hemophagocytic syndrome reported in the literature and the first reported in Latin America. All three cases had unfavorable outcomes.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Linfo-Histiocitose Hemofagocítica/diagnóstico , Sarcoidose Pulmonar/diagnóstico , Exame de Medula Óssea , Evolução Fatal
15.
Lung ; 190(6): 671-6, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22968677

RESUMO

BACKGROUND: Obesity has become a global epidemic in the 21st century, and the placement of an intragastric balloon (IB) is a therapeutic modality used to treat it. Our objectives for this study were to evaluate changes in lung function resulting from IB use and to correlate the pattern of body fat distribution with changes in lung function. METHODS: This was an interventional study with 30 overweight and obese patients with metabolic syndrome. All of the subjects underwent anthropometric measurements, assessment of their body fat distribution pattern by dual-energy X-ray absorptiometry, and pulmonary function testing before implantation of the IB. RESULTS: During the initial evaluations, the main pulmonary function abnormalities observed were decreased expiratory reserve volume (ERV), decreased total lung capacity (TLC), and increased diffusing capacity of carbon monoxide (DL(CO)), which occurred in 56.7, 40, and 23.3 % of patients, respectively. We observed a statistically significant positive correlation between the DL(CO) and the percentage of trunk fat mass (ρ = 0.42; p < 0.01). Three months after placement of the IB, there was a significant reduction in the body mass index (p < 0.0001) and the maximal inspiratory pressure (p < 0.009). We also observed a significant increase in the forced vital capacity (p < 0.0001), TLC (p < 0.001), and ERV (p < 0.0001). CONCLUSIONS: Weight loss as a result of IB causes increased static lung volumes and decreased inspiratory muscle strength. Additionally, being overweight and obese is related to increased DL(CO), especially in individuals with truncal obesity.


Assuntos
Balão Gástrico , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/cirurgia , Testes de Função Respiratória , Adulto , Distribuição da Gordura Corporal , Volume de Reserva Expiratória , Feminino , Humanos , Pessoa de Meia-Idade , Capacidade de Difusão Pulmonar , Capacidade Pulmonar Total , Perda de Peso
16.
Artigo em Português | LILACS | ID: lil-538850

RESUMO

JUSTIFICATIVA E OBJETIVOS: A porfiria intermitente aguda (PIA) é uma doença rara e sua crise pode causar lesões irreversíveis, caso não seja tratada precocemente. O tratamento estabelecido se dá com a administração de hematina, substância não disponível no Brasil. O objetivo deste estudo foi relatar um caso em que a hemodiálise foi usada com sucesso como alternativa para tratar uma crise de PIA. RELATO DO CASO: Paciente do sexo masculino, 28 anos, com crise de PIA, importante comprometimento neurológico e alterações autonômicas. Foi tratado com sucesso com sessões diárias de hemodiálise diante da indisponibilidade no Brasil do fármaco de primeira escolha. CONCLUSÃO: A hemodiálise é uma alternativa eficaz para o tratamento das crises de PIA nos países onde a hematina não está disponível. Se realizada precocemente pode evitar sequelas e melhorar a qualidade de vida dos pacientes.


Assuntos
Humanos , Masculino , Adulto , Diálise Renal/métodos , Porfiria Aguda Intermitente
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