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1.
J Assoc Physicians India ; 68(2): 39-42, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009361

RESUMO

Background: Pulmonary complications are one of the most common causes of postoperative morbidity and mortality after coronary artery bypass graft (CABG) surgery. There is paucity of data of CABG in abnormal pulmonary function tests (PFT) in Indian population. Objectives: To study correlation of PFT with clinical outcome in patients undergoing CABG. Methods: Three hundred seventy patients aged 35 to 65 years who underwent CABG between May 2015 and November 2016 and ready to participate were included for this prospective observational study. Each patient was subjected to detailed clinical history, clinical examination and PFT. Primary outcome measures were post CABG ventilator stay, intensive care unit (ICU) stay, and hospital stay. Fisher's exact tests was used to compare qualitative data whereas Mann-Whitney U test was used to find the significant difference between quantitative variables. Results: Higher percentage of patients whose forced expiratory volume in one second (FEV1) was abnormal had longer ventilator stay, ICU stay and hospital stay as compared patients whose FEV1 was normal. Restrictive disease, obstructive disease, and mixed disease patients had longer ventilator stay, ICU stay and hospital stay as compared patients whose spirometry was normal. Conclusion: Abnormal PFT was independent strong predictor of prolonged ventilation, longer length of ICU and hospital stay.


Assuntos
Ponte de Artéria Coronária , Unidades de Terapia Intensiva , Testes de Função Respiratória , Adulto , Idoso , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Espirometria
2.
Praxis (Bern 1994) ; 109(1): 13-17, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31910765

RESUMO

PneumoLaus: Prevalence of Lung Function Abnormalities in a Sample of the General Population of Lausanne Abstract. Reduced lung function predicts increased mortality. The prevalence of spirometric abnormalities depends on their definition, the references values used and the use or not of bronchodilation. In the PneumoLaus study, conducted between 2014 and 2017 in a sample of the general population of Lausanne, prevalence of chronic obstruction was 3,8 %, of reversible obstruction 2,5 % and of possible restriction 2,2 %. These numbers are lower than in other population studies. Men had more abnormal spirometry results than women, and ever-smokers more than never-smokers. Two thirds of participants with chronic obstruction, most of which without respiratory symptoms, were not aware of any lung disease.


Assuntos
Pneumopatias , Feminino , Humanos , Pneumopatias/epidemiologia , Masculino , Prevalência , Valores de Referência , Espirometria
3.
Heart Fail Clin ; 16(1): 33-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735313

RESUMO

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are both common causes of breathlessness and often conspire to confound accurate diagnosis and optimal therapy. Risk factors (such as aging, smoking, and obesity) and clinical presentation (eg, cough and breathlessness on exertion) can be very similar, but the treatment and prognostic implications are very different. This review discusses the diagnostic challenges in individuals with exertional dyspnea. Also highlighted are the prevalence, clinical relevance, and therapeutic implications of a concurrent diagnosis of COPD and HF.


Assuntos
Dispneia/etiologia , Insuficiência Cardíaca/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Comorbidade , Dispneia/diagnóstico , Dispneia/fisiopatologia , Eletrocardiografia , Saúde Global , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Prevalência , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Radiografia Torácica , Fatores de Risco , Espirometria
4.
Pan Afr Med J ; 34: 42, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31762909

RESUMO

Introduction: PLHA who smoke have twice the never-smoker mortality rate and have an increased risk of developing non-AIDS diseases. The prevalence of tobacco smoking is higher among PLHA than in the general population. The purpose of this study was to assess the prevalence of smoking among PLHA, to describe the clinical and spirometric features of smokers and ex-smokers and to assess their knowledge and attitudes toward smoking. Methods: We conducted a cross-sectional, descriptive and analytical study among PLHA followed up in the Outpatient Department of the National University Hospital Center of Fann from 15 July to 15 December 2015. Results: Three hundred (300) PLHA were included in the study. Sex ratio was 0.8. Out of the study population, 15% were smokers and 23.7% were ex-smokers. The average age of patients was 44.38±9.55 years. The quasi-totality of the smokers (91.1%) had already started smoking before the detection of the serological status and 35.6% of them had increased tobacco use after. Respiratory symptoms among smokers were dominated by respiratory distress (64.4%). Smokers who underwent spirometry had obstructive ventilatory impairment not improved by beta-2-mimetic agents (67%) and restrictive disease (28.1%). Out of ex-smokers, 40.8% reported that their serological status was the reason for smoking cessation. Conclusion: People may begin or increase smoking after knowledge of serological status. In PLHA, smoking causes cardiovascular and respiratory diseases as well as complications.


Assuntos
Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Estudos Transversais , Feminino , Seguimentos , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Prevalência , Senegal , Espirometria
5.
Pan Afr Med J ; 33: 295, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692843

RESUMO

Introduction: Spirometric reference values cannot be extrapolated in the populations, being subject to many environmental and human variables; hence the interest of local studies in this field. Methods: This study aims to determine the reference values among healthy adults in Kinshasa. We conducted a cross-sectional study including 7443 subjects (3208 women, 43%). FEV1, FVC, PEF were correlated with anthropometric data. Five age groups were formed and comparisons were made on the basis of sex, age, BMI and of the practice of sporting activity. Results: Differences are evident between the sexes, in terms of FEV1 (3.00 vs 2.21 L), FVC (3.19 vs 2.38) and the PEF (6.8 vs 5.70 L/s); same as for the outer age categories. FEV1 ranged between 2.33 et 4.54 vs 1.93-3.3 L in the age group 20-29 years and 1,76-3,39 vs 1,60 vs 2,53 L in the age group 60-70 years; FVC ranged between 2,44-4,89 vs 1,96-3,56 L and 1,79-3,78 vs 1,66-2,74 L ; PEF ranged between 4,34-12.2 vs 3,62-8.58 L/s and 2.99-6.76 vs 2.99-7.34L/s in the age group 60-70 years. Conclusion: The differences related to gender, age, anthropometric data as well as to the practice of sporting activity are obvious. These results warrant further and more extended investigations and show the relevance of values based on percentiles in the determinantion of a spirometry standard in a given population.


Assuntos
Volume Expiratório Forçado/fisiologia , Fenômenos Fisiológicos Respiratórios , Espirometria , Adulto , Fatores Etários , Idoso , Antropometria , Estudos Transversais , República Democrática do Congo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais , Adulto Jovem
6.
Ther Umsch ; 76(6): 287-292, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31762419

RESUMO

Asthma, COPD or overlap? Symptoms and diagnostic procedures Abstract. Medical history combined with spirometry before and after bronchodilation provides important information, and allows distinguishing between asthma and Chronic obstructive pulmonary disease (COPD) in most of the cases. COPD and asthma are sometimes difficult to discriminate, mainly in older patients with a smoking history and /or history of atopia. Symptoms and the results of diagnostic tests are the basis on which therapeutic decisions are made. Differentiation between asthma and COPD is of great importance because management approaches and goals for these conditions differ. Asthma-COPD-overlap has to be considered if a significant interleave of clinical features of both conditions is identified. If it is not possible to differentiate between the two conditions, ways of additional diagnostic testing are described in this article.


Assuntos
Asma , Doença Pulmonar Obstrutiva Crônica , Idoso , Asma/diagnóstico , Diagnóstico Diferencial , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Espirometria
7.
Am Surg ; 85(9): 1051-1055, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638523

RESUMO

This retrospective chart review demonstrates the relationship between bedside incentive spirometry (ICS) volumes and risk of pulmonary complications. Two hundred patients admitted for rib fractures between April and October 2016 were reviewed. The inclusion criteria were age 18-98 years, diagnosis of rib or sternal fractures, and no procedures requiring postoperative intubation within 48 hours of admission. The exclusion criteria were intubation before arrival, unable to participate in ICS, or previous tracheostomy. ICS volumes recorded in daily progress notes were collected. Of 200 charts reviewed, 154 met the inclusion criteria. In all, 25 endured at least one pulmonary complication. The average ICS on admission was 1355 cc. Patients who did not experience a complication had significantly higher admission ICS volumes than those who did (1441 ± 660 cc vs 920 ± 451 cc, P = 0.0003). They also achieved higher volumes at discharge (1705 ± 662 cc vs 1211 ± 453 cc, P = 0.006). The groups had similar demographics. An admission ICS volume <1 L was associated with 3.3× relative risk of pulmonary complication. Lower volumes were also associated with discharge to nonhome locations. Bedside ICS is a useful tool to identify patients at risk of pulmonary complications from rib fractures. Patients with admission ICS volume <1 L carry a higher risk of complication.


Assuntos
Pneumopatias/diagnóstico , Pneumopatias/etiologia , Testes Imediatos , Fraturas das Costelas/complicações , Espirometria , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco
9.
Afr Health Sci ; 19(2): 1988-1992, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656481

RESUMO

Background: Previous trials have investigated the effect of hepatitis C on lung functions; however, the role of viral load levels is unclear. The aim of this study was to investigate the effect of HCV viremia status on lung functions. Methods: This study was in 60 patients with chronic hepatitis C (CHC). Patients were classified into three groups (non-viremic, low-viremic and high-viremic) based on serum HCV RNA levels. Spirometric parameters (FEV1, FVC, FEV1/FVC) and the proportion of patients with spirometric abnormalities were compared between three groups. Results: High-viremic and low-viremic patients showed a significantly higher prevalance of spirometric abnormality than observed in non-viremic patients (p=0.02). Moreover, there was a significant moderate correlation between viremia level and the percentage of spirometric abnormalities (Cramer's U value=0.452, p=0.002). High-viremic patients were 14.2 times more likely to exhibiting pulmonary dysfunction than non-viremic patients. Additionally, spirometric parameters FEV1 and FVC were significantly reduced in high-viremic and low-viremic patients compared to those in non-viremic patients (p=0.013 and p<0.001 respectively). Conclusion: These results indicate that persistent HCV infection may be associated with reduced pulmonary functions, especially in patients with high viremia levels. Therefore, these patients should be carefully monitored for lung function.


Assuntos
Hepacivirus/isolamento & purificação , Anticorpos Anti-Hepatite C/análise , Hepatite C Crônica/diagnóstico , Pulmão/fisiologia , RNA Viral/sangue , Viremia/diagnóstico , Adulto , Feminino , Hepatite C Crônica/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Testes de Função Respiratória , Espirometria , Carga Viral , Viremia/epidemiologia , Viremia/virologia
10.
Br J Nurs ; 28(18): 1196-1200, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597050

RESUMO

Bronchiolitis obliterans syndrome (BOS) following allogenic haematopoietic stem cell transplant is considered the manifestation of chronic graft versus host disease (cGvHD) in the lung, and affects about 14% of patients with cGvHD, mainly in the first 2 years after transplant. Despite advances in assessment, diagnosis and treatment, the clinical prognosis remains poor for patients with pulmonary manifestations of cGvHD. A pilot study of 50 patients was devised to establish whether a relationship exists between forced expiratory volume in 1 second (FEV1) via pulmonary function test (PFT) and the equivalent peak expiratory flow (PEF) via peak flow handheld spirometry in cGvHD patients receiving extracorporeal photopheresis (ECP). Only PEF observed within 2 days of PFT could be compared with data at month 3, 6, 9 and 12. This pilot study illustrated that monitoring via handheld peak flow readings has the potential to become an acceptable method of monitoring lung function longitudinally in cGvHD patients.


Assuntos
Doença Enxerto-Hospedeiro/fisiopatologia , Pulmão/fisiologia , Testes de Função Respiratória/métodos , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Fluxo Expiratório Forçado , Doença Enxerto-Hospedeiro/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Fotoferese , Projetos Piloto , Reprodutibilidade dos Testes , Espirometria/instrumentação , Espirometria/métodos , Adulto Jovem
11.
Muscle Nerve ; 60(6): 679-686, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31566774

RESUMO

INTRODUCTION: The purpose of this study was to comprehensively evaluate respiratory muscle function in adults with facioscapulohumeral muscular dystrophy (FSHD). METHODS: Fourteen patients with FSHD (9 men, 53 ± 16 years of age) and 14 matched controls underwent spirometry, diaphragm ultrasound, and measurement of twitch gastric and transdiaphragmatic pressures (twPgas and twPdi; n = 10) after magnetic stimulation of the lower thoracic nerve roots and the phrenic nerves. The latter was combined with recording of diaphragm compound muscle action potentials (CMAPs; n = 14). RESULTS: The following parameters were significantly lower in patients vs controls: forced vital capacity (FVC); maximum inspiratory and expiratory pressure; peak cough flow; diaphragm excursion amplitude; and thickening ratio on ultrasound, twPdi (11 ± 5 vs 20 ± 6 cmH2 O) and twPgas (7 ± 3 vs 25 ± 20 cmH2 O). Diaphragm CMAP showed no group differences. FVC correlated inversely with the clinical severity scale score (r = -0.63, P = .02). DISCUSSION: In FSHD, respiratory muscle weakness involves both the diaphragm and the expiratory abdominal muscles.


Assuntos
Diafragma/fisiopatologia , Debilidade Muscular/fisiopatologia , Distrofia Muscular Facioescapuloumeral/fisiopatologia , Músculos Respiratórios/fisiopatologia , Potenciais de Ação/fisiologia , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Diafragma/diagnóstico por imagem , Feminino , Humanos , Masculino , Pressões Respiratórias Máximas , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Distrofia Muscular Facioescapuloumeral/complicações , Condução Nervosa , Nervo Frênico , Raízes Nervosas Espinhais , Espirometria , Vértebras Torácicas , Ultrassonografia , Capacidade Vital
12.
Rev Assoc Med Bras (1992) ; 65(9): 1161-1167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618331

RESUMO

OBJECTIVE: To investigate the use of Bilevel Positive Airway Pressure (BiPAP) in morbidly obese individuals in two moments following bariatric surgery (Roux-en-Y gastric bypass): post-anesthetic recovery (PAR) and first postoperative day (1PO). DESIGN: Randomized and blinded clinical trial. METHODS: We studied 40 morbidly obese individuals aged between 25 and 55 years who underwent pulmonary function test and chest X-ray preoperatively, and on the day of discharge (2nd day after surgery). They were randomly allocated into two groups: PAR-G (BiPAP in PAR for one hour), and 1PO-G (BIPAP for one hour on the 1PO). RESULTS: In the PAR-G and 1PO-G, respectively there were significant reductions in slow vital capacity (SVC) (p=0.0007 vs. p<0.0001), inspiratory reserve volume (IRV) (p=0.0016 vs. p=0.0026), and forced vital capacity (FVC) (p=0.0013 vs. p<0.0001) and expiratory reserve volume (ERV) was maintained only for the PAR-G (p=0.4446 vs. p=0.0191). Comparing the groups, the SVC (p=0.0027) and FVC (p=0.0028) showed a significant difference between the treatments, while the PAR-G showed smaller declines in these capacities. The prevalence of atelectasis was 10% for the PAR-G and 30% for the 1PO-G (p=0.0027). CONCLUSION: Thus, the use of BiPAP in PAR can promote restoration of ERV and contribute to the reduction of atelectasis.


Assuntos
Cirurgia Bariátrica/reabilitação , Pressão Positiva Contínua nas Vias Aéreas , Atelectasia Pulmonar/epidemiologia , Adulto , Volume de Reserva Expiratória , Feminino , Humanos , Pulmão/fisiopatologia , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Período Pós-Operatório , Prevalência , Atelectasia Pulmonar/prevenção & controle , Método Simples-Cego , Espirometria , Capacidade Vital
13.
Adv Exp Med Biol ; 1222: 1-8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31541365

RESUMO

The aim of the study was to assess the need for changes in spirometry reference values in the Polish population with time lapse, as the aftereffect of a radical socioeconomic overturn of the 1990. We retrospectively analyzed data files on forced expiratory volume in 1 s (FEV1), vital capacity (VC), and forced VC (FVC) in healthy, never-smoking Caucasians (731 females and 327 males) obtained in in 1993-1998. We assessed a discrepancy between the then measured values of these variables, on the one side, and the corresponding European Community for Steel and Coal (ECSC) predicted values or the current updated predicted values for the Polish population, on the other side. We found that those old measured values approximately corresponded to the ECSC reference, but they were appreciably lower than the current Polish reference values; the younger the subjects the greater the difference. The current Polish reference values of FVC were much closer to the old measured VC than to the old measured FVC values, which introduces a substantial discrepancy between the past and present FVCs. We conclude that the spirometry reference values may change with time lapse. Thus, accuracy of prediction equations should be periodically updated, which seems to particularly concern the equations elaborated for the nations that undergo rapid economic developments connected with changes in living standards.


Assuntos
Volume Expiratório Forçado/fisiologia , Espirometria/normas , Capacidade Vital , Feminino , Voluntários Saudáveis , Humanos , Pulmão , Masculino , Polônia , Valor Preditivo dos Testes , Valores de Referência , Testes de Função Respiratória , Estudos Retrospectivos , Espirometria/métodos
15.
Fisioter. Pesqui. (Online) ; 26(3): 265-274, jul.-set. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1039882

RESUMO

RESUMO Este trabalho teve como objetivo caracterizar as posturas induzidas por dois sistemas diferentes de cadeira-mesa e analisar seus efeitos na função pulmonar. Trata-se de estudo transversal, descritivo, do tipo sujeito único e intrasséries (A-B, B-A), com coleta em dias consecutivos. Participaram da pesquisa 15 voluntárias e foram utilizados dois sistemas cadeira-mesa: convencional (A) e experimental (B). A postura foi avaliada por meio de fotogrametria em cada um dos sistemas, com imagens analisadas por meio do programa AutoCAD® 2010. Posteriormente, foram calculados os ângulos articulares da postura média das participantes em cada sistema. Os dados posturais e respiratórios foram comparados considerando as diferentes posições adotadas. O sistema cadeira-mesa convencional promoveu dois diferentes padrões posturais: um deles apresentou ângulos articulares similares aos do sistema experimental, com resultados de espirometria semelhantes, e o outro padrão apresentou ângulos corporais de acordo com os padrões esperados com valores de espirometria significativamente inferiores em VEF1, VEF1/CVF e FEFmáx. O sistema experimental diferiu de valores de espirometria da postura ortostática relatados na literatura somente em FEFmáx, sugerindo similaridade de condição postural. Conclui-se que o mobiliário experimental melhorou a função respiratória na postura sentada em comparação com o mobiliário tradicional, podendo beneficiar pessoas em condições especiais, como gestantes, obesos e pessoas com doenças pulmonares crônicas.


RESUMEN Este estudio tuvo como objetivo caracterizar las posturas inducidas por dos sistemas diferentes de silla-mesa y analizar sus efectos sobre la función pulmonar. Se trata de un estudio transversal, descriptivo, de tipo de un solo sujeto e intraseries (A-B, B-A), con recolección en días consecutivos. Quince voluntarios participaron en el estudio, y se utilizaron dos sistemas de silla-mesa: convencional (A) y experimental (B). La evaluación postural se realizó mediante fotogrametría en cada uno de los sistemas, con imágenes analizadas por medio del programa AutoCAD® 2010. Posteriormente, se calcularon los ángulos de articulación de la postura media de las participantes en cada sistema. Los datos posturales y respiratorios se compararon considerando las diferentes posiciones adoptadas. El sistema de silla-mesa convencional promovió dos patrones posturales diferentes: uno presentó ángulos de articulación similares al sistema experimental, con resultados de espirometría similares, y el otro estándar presentó ángulos corporales de acuerdo con los patrones esperados con resultados de espirometría significativamente más bajos en VEF1, VEF1/CVF y FEFmax. El sistema experimental difería de los valores de espirometría de la postura ortostática informados en la literatura solo en FEFmax, lo que sugiere una similitud de la condición postural. Se concluyó que los muebles experimentales pueden mejorar la función respiratoria en la posición sentada cuando se comparaban con los muebles tradicionales, y pueden beneficiar a personas en condiciones especiales, como mujeres embarazadas, personas obesas y personas con enfermedades pulmonares crónicas.


ABSTRACT The objective of this study was to characterize the postures induced by two different chair-desk systems and analyze their effects on lung function. This was a cross-sectional, descriptive study of single subject with intra-series type analysis (A-B, B-A) during consecutive days of data collection. Fifteen volunteers participated using two chair-desk systems: conventional (A) and experimental (B). Postural evaluation was performed in both systems using photogrammetry. These images were analyzed using AutoCAD® 2010, estimating the average position of the joint angles of individuals in each system. These values were analyzed verifying the averages in each posture. Postural and respiratory data were compared by checking whether the different positions adopted by the participants resulted in changes in the spirometry values. Conventional chair-desk system promoted two different postural patterns, considering that one presented joint angles similar to experimental system, with similar spirometry results and the other presented body angles according to the reference of standards and spirometry results significantly lower in FEV1, FEV1/FVC and FEFmax. Experimental system differed from values of literature in standing posture only in FEFmax, suggesting similarity of postural situation. It was concluded that the experimental furniture proved a tool capable of benefiting respiratory function in sitting posture and may be an option to benefit people in special conditions such as pregnant women, obese individuals and people with chronic pulmonary diseases.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Mecânica Respiratória/fisiologia , Espirometria , Fenômenos Biomecânicos/fisiologia , Estudos Transversais , Ergonomia
16.
Med. clín (Ed. impr.) ; 153(5): 191-195, sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183994

RESUMO

Introducción: La enfermedad pulmonar obstructiva crónica y la insuficiencia cardíaca (IC) son 2 enfermedades con una elevada morbimortalidad. La coexistencia de estas 2 enfermedades se estima que es frecuente, pero ha sido escasamente estudiada. Objetivo: Estudiar la prevalencia de limitación al flujo aéreo en una muestra de pacientes diagnosticados de IC en seguimiento en una unidad de IC y valorar las características y comorbilidades de estos pacientes. Métodos: Se trata de un estudio prospectivo observacional. Se incluyeron de forma consecutiva los pacientes visitados en la Unidad de Insuficiencia Cardíaca del Hospital Universitari Germans Trias i Pujol entre enero del 2014 y junio del 2015. Se realizaron pruebas funcionales respiratorias y se obtuvieron datos clínicos. Resultados: Se incluyeron 118 pacientes en el estudio (edad 67,2 años; DE 12,1; el 77,1% hombres). La prevalencia de limitación al flujo aéreo fue del 36,4%, con un porcentaje de infradiagnóstico del 67,4%. Los pacientes con limitación al flujo aéreo presentaban un aumento de las comorbilidades y de la mortalidad. Conclusión: La prevalencia de limitación al flujo aéreo en pacientes con IC es elevada, con un importante grado de infradiagnóstico. Sería recomendable la realización de una espirometría de cribado en estos pacientes


Background: Chronic obstructive pulmonary disease and heart failure (HF) are 2 diseases with high morbidity and mortality. The coexistence of these two diseases is estimated to be frequent, but has been poorly studied. Aim: To study the prevalence of airflow limitation in a sample of patients diagnosed with HF in follow-up in an HF unit and to assess their characteristics and comorbidities. Methods: This is a prospective observational study. The patients who visited the HF Unit of the Hospital Universitari Germans Trias i Pujol between January 2014 and June 2015 were included consecutively. Respiratory functional tests were performed and clinical data were obtained. Results: 118 patients were included in the study (age 67.2 years, 77.1% men). The prevalence of non-reversible airflow obstruction was 36.4%, with an underdiagnosis percentage of 67.4%. Patients with airflow limitation had an increase in comorbidities, but no worse prognosis. Conclusion: The prevalence of airflow limitation in patients with HF is high, with a significant degree of underdiagnosis. It seems reasonable to recommend performing a screening spirometry in these patients


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/complicações , Obstrução das Vias Respiratórias/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Estudos Prospectivos , Testes Respiratórios , Obstrução das Vias Respiratórias/fisiopatologia , Espirometria
17.
Arq Bras Cir Dig ; 32(2): e1439, 2019 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31460599

RESUMO

BACKGROUND: Abdominal disorders can alter respiratory function and increase the morbidity and mortality of patients with chronic obstructive pulmonary disease. AIM: To improve the physiotherapeutic and muscular capacity in chronic obstructive pulmonary muscular inspiration in the preoperative preparation in abdominal surgeries. METHOD: Retrospective and documentary study using SINPE © , clinical database software of patients with chronic obstructive pulmonary disease and candidates to abdominal operation. The sample consisted of 100 men aged 55-70 years, all with chronic obstructive pulmonary disease who underwent preoperative physiotherapeutic treatment. They were divided into two groups of 50 individuals (group A and group B). In group A the patients were treated with modern mobility techniques for bronchial clearance and the strengthening of the respiratory muscles was performed with IMT ® Threshold. In group B the treatment performed for bronchial obstruction was with classic maneuvers and for the strengthening of the respiratory muscles for flow incentive was used Respiron ® . RESULTS: Both groups obtained improvement in the values ​​of the PiMáx after the different treatments. Group A obtained greater change in the intervals and a more significant increase of the values of the PiMax in relation to the average pre and post-treatment. However, when analyzing the variance and the standard deviation of the samples, group B presented the best results showing more homogeneity. CONCLUSIONS: The modern and traditional bronchial clearance techniques associated with inspiratory muscle training were equally effective in gaining inspiratory muscle strength with increased Pmax. In this way, the two can be used in the preoperative preparation of patients with chronic obstructive pulmonary disease and referred to abdominal operations.


Assuntos
Exercícios Respiratórios/métodos , Procedimentos Cirúrgicos do Sistema Digestório , Cuidados Pré-Operatórios/métodos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Músculos Respiratórios/fisiopatologia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/reabilitação , Testes de Função Respiratória , Estudos Retrospectivos , Software , Espirometria
18.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 164-169, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465184

RESUMO

Background: The link between upper and lower airways is recognized clinically as a "unique airway". Subclinical spirometric abnormalities have been observed in patients with rhinitis without asthma, which could be proportional to rhinitis severity. Objectives: To investigate possible subclinical alterations in lung function and bronchodilator reversibility in children and adolescents with allergic (AR) and non-allergic rhinitis (NAR) without asthma, according to the clinical grade of rhinitis classified by ARIA (Allergic Rhinitis and Its Impact on Asthma). Methods: In a cross-sectional analytical study, we included patients aged 5 to 18 years with symptoms of AR and NAR without asthma. Spirometry was performed by flow-volume curve and we analyzed the abnormalities in respiratory function and bronchodilator response in relation to clinical grade of rhinitis by ARIA using an adjusted logistic model. Results: We studied 193 patients; 42 (21.7%) had some spirometric abnormalities. Patients with moderate-severe persistent rhinitis had greater impairment of lung function compared to the other grades of rhinitis (p=0.009). This defect was associated with both frequency (p=0.03) and severity of rhinitis (p=0.04) but not with atopic status (p=0.28). A positive bronchodilator response was more frequent in grades moderate-severe of rhinitis than in mild forms (p=0.04). Conclusion: Abnormalities of lung function was more prevalent in moderate-severe persistent rhinitis and was associated with the frequency and severity of rhinitis but not to atopic status. The bronchodilator reversibility was observed in patients with intermittent and persistent moderate-severe rhinitis.


Assuntos
Albuterol/uso terapêutico , Broncodilatadores/uso terapêutico , Pulmão/fisiopatologia , Rinite/complicações , Rinite/tratamento farmacológico , Adolescente , Alérgenos/administração & dosagem , Alérgenos/classificação , Argentina , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Pulmão/efeitos dos fármacos , Masculino , Rinite/diagnóstico , Rinite Alérgica/complicações , Rinite Alérgica/diagnóstico , Rinite Alérgica/tratamento farmacológico , Índice de Gravidade de Doença , Testes Cutâneos , Espirometria
19.
J Pak Med Assoc ; 69(Suppl 2)(6): S2-S9, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31369528

RESUMO

Objectives: To estimate the economic burden of asthma treatment by quantifying direct medical expenditures at one of Southern Vietnam's public hospitals base on the hospital perspective. Methods: A retrospective, prevalence-based, cost-of-illness analysis was developed using the hospital's electronic medical record data to calculate the economic burden of asthma (ICD-10 code J45, J46) through direct medical costs from January 2014 to December 2017. All costs were converted to US dollars and to the year 2018. Data were analyzed using descriptive statistics. The potential correlations between variables were evaluated using the chisquare test and bootstrap difference. Results: The average direct medical cost of asthma was estimated to range from $34.7 to $55.3 per - outpatient and $45.1 to $107.2 per - inpatient annually. The total economic burdens for 4 years from 2014 to 2017 were $110,387.4 from outpatients and $13,413.8 from inpatients. The most influential component was medication cost. Conclusions: Asthma places a high economic burden on individuals and the healthcare system in Vietnam. The findings of this study provide health administrators with important evidence to enhance surveillance of the disease and to allow suitable drafting of national health policy.


Assuntos
Assistência Ambulatorial/economia , Antiasmáticos/economia , Asma/economia , Efeitos Psicossociais da Doença , Gastos em Saúde , Hospitalização/economia , Adolescente , Adulto , Antiasmáticos/uso terapêutico , Asma/terapia , Criança , Custos de Medicamentos , Feminino , Custos Hospitalares , Hospitais Públicos , Humanos , Seguro Saúde , Masculino , Estudos Retrospectivos , Espirometria/economia , Vietnã , Adulto Jovem
20.
BMC Public Health ; 19(1): 1183, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31462261

RESUMO

BACKGROUND: Early detection of lung disease may help reduce disease development. Detection through preventive health checks may be beneficial. Nevertheless, the knowledge is sparse on how to enhance the participation rate in health checks among citizens at risk of developing lung disease. This study investigates if focused information on spirometry can increase the participation rate in a general health check. METHODS: We conducted an open-label, household cluster-randomised trial with a two-group parallel design including 4407 citizens aged 30-49 years in Denmark and an average cluster size of 1.55 citizens per household. The control group (n = 2213) received a standard invitation describing the content of the general health check and containing practical information. The intervention group (n = 2194) received an extended invitation highlighting the benefits of early detection and prevention of lung disease. The primary outcome was difference in participation rate between the two groups. The secondary outcome was the proportion of participants at risk of lung disease in both groups. Risk profile was defined as current smoking or self-reported lung symptoms. The inclusion period was 25 November 2015-3 February 2017. RESULTS: No major difference in participation rate was seen between the intervention group (53.4%) and the control group (52.0%). Participants had statistically significantly higher education level compared to non-participants. A total of 24.2% of the participants were at risk of developing lung disease, but no difference was found between the intervention group and the control group. CONCLUSION: This study revealed no effect on participation rate of including focused spirometry information in the health check invitation. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02615769 . Registered on 25 November 2015. The trial protocol has been published.


Assuntos
Pneumopatias/diagnóstico , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/estatística & dados numéricos , Espirometria , Adulto , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato
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