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Interrelationship between serum and sputum inflammatory mediators in chronic obstructive pulmonary disease

BIZETO, L.; MAZZOLINI, A.B.; RIBEIRO, M.; STELMACH, R.; CUKIER, A.; NUNES, M.P.T.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
126.12%
Little is known about airway inflammatory markers in chronic obstructive pulmonary disease (COPD). The objective of the present study was to identify and try to correlate pulmonary and peripheral blood inflammatory markers in COPD. In a cross-sectional study on patients with stable COPD, induced sputum and blood samples were collected for the determination of C-reactive protein, eosinophilic cationic protein, serum amyloid A protein, a-1 antitrypsin (a-1AT), and neutrophil elastase. Twenty-two patients were divided into two groups according to post-bronchodilator forced expiratory volume in the first second (%FEV1): group 1 (N = 12, FEV1 <40%) and group 2 (N = 10, FEV1 ³40%). An increase in serum elastase, eosinophilic cationic protein and a-1AT was observed in serum markers in both groups. Cytology revealed the same total number of cells in groups 1 and 2. There was a significantly higher number of neutrophils in group 1 compared to group 2 (P < 0.05). No difference in eosinophils or macrophages was observed between groups. Serum elastase was positively correlated with serum a-1AT (group 1, r = 0.81, P < 0.002 and group 2, r = 0.83, P < 0.17) and negatively correlated with FEV1 (r = -0.85, P < 0.03 and -0.14, P < 0.85, respectively). The results indicate the presence of chronic and persistent pulmonary inflammation in stable patients with COPD. Induced sputum permitted the demonstration of the existence of a subpopulation of cells in which neutrophils predominated. The serum concentration of all inflammatory markers did not correlate with the pulmonary functional impairment.

Experimental Basis and New Insights for Cell Therapy in Chronic Obstructive Pulmonary Disease

de Faria, Carolina Arruda; Kozma, Rodrigo de las Heras; Stessuk, Talita; Ribeiro-Paes, Joao Tadeu
Fonte: HUMANA PRESS INC; TOTOWA Publicador: HUMANA PRESS INC; TOTOWA
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
126.13%
Chronic Obstructive Pulmonary Disease (COPD) can be briefly described as air flow limitation and chronic dyspnea associated to an inflammatory response of the respiratory tract to noxious particles and gases. Its main feature is the obstruction of airflow and consequent chronic dyspnea. Despite recent advances, and the development of new therapeutic, medical and clinical approaches, a curative therapy is yet to be achieved. Therapies involving the use of tissue-specific or donor derived cells present a promising alternative in the treatment of degenerative diseases and injuries. Recent studies demonstrate that mesenchymal stem cells have the capacity to modulate immune responses in acute lung injury and pulmonary fibrosis in animal models, as well as in human patients. Due to these aspects, different groups raised the possibility that the stem cells from different sources, such as those found in bone marrow or adipose tissue, could act preventing the emphysematous lesion progression. In this paper, it is proposed a review of the current state of the art and future perspectives on the use of cell therapy in obstructive lung diseases.; Fundunesp - Fundacao para o desenvolvimento da UNESP; Fundacao para o Desenvolvimento da UNESP (FUNDUNESP); Municipal Government of Assis; Municipal Government of Assis; Capes - Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior; Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease

Caram, Laura Miranda de Oliveira; Ferrari, Renata; Naves, Cristiane Roberta; Tanni, Suzana Erico; Coelho, Liana Sousa; Zanati, Silméia Garcia; Minicucci, Marcos Ferreira; Godoy, Irma
Fonte: Universidade de São Paulo (USP), Faculdade de Medicina Publicador: Universidade de São Paulo (USP), Faculdade de Medicina
Tipo: Artigo de Revista Científica Formato: 772-776
Português
Relevância na Pesquisa
126.34%
OBJECTIVES: ,,,,,The prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease according to disease severity has not yet been established. The aim of this study was to assess the prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease patients according to disease severity. ,,,, ,,,, ,,,,,METHODS: ,,,,,The study included 25 mild/moderate chronic obstructive pulmonary disease patients and 25 severe/very severe chronic obstructive pulmonary disease patients. All participants underwent clinical evaluation, spirometry and electrocardiography/echocardiography. ,,,, ,,,, ,,,,,RESULTS: ,,,,,Electrocardiography and echocardiography showed Q-wave alterations and segmental contractility in five (10%) patients. The most frequent echocardiographic finding was mild left diastolic dysfunction (88%), independent of chronic obstructive pulmonary disease stage. The proportion of right ventricular overload (p<0.05) and blockage of the anterosuperior division of the left bundle branch were higher in patients with greater obstruction. In an echocardiographic analysis, mild/moderate chronic obstructive pulmonary disease patients showed more abnormalities in segmental contractility (p<0.05)...

Experimental Basis and New Insights for Cell Therapy in Chronic Obstructive Pulmonary Disease

de Faria, Carolina Arruda; Kozma, Rodrigo de las Heras; Stessuk, Talita; Ribeiro-Paes, Joao Tadeu
Fonte: Humana Press Inc Publicador: Humana Press Inc
Tipo: Artigo de Revista Científica Formato: 1236-1244
Português
Relevância na Pesquisa
126.13%
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); Chronic Obstructive Pulmonary Disease (COPD) can be briefly described as air flow limitation and chronic dyspnea associated to an inflammatory response of the respiratory tract to noxious particles and gases. Its main feature is the obstruction of airflow and consequent chronic dyspnea. Despite recent advances, and the development of new therapeutic, medical and clinical approaches, a curative therapy is yet to be achieved. Therapies involving the use of tissue-specific or donor derived cells present a promising alternative in the treatment of degenerative diseases and injuries. Recent studies demonstrate that mesenchymal stem cells have the capacity to modulate immune responses in acute lung injury and pulmonary fibrosis in animal models, as well as in human patients. Due to these aspects, different groups raised the possibility that the stem cells from different sources, such as those found in bone marrow or adipose tissue, could act preventing the emphysematous lesion progression. In this paper, it is proposed a review of the current state of the art and future perspectives on the use of cell therapy in obstructive lung diseases.

Unicentric study of cell therapy in chronic obstructive pulmonary disease/pulmonary emphysema

Ribeiro-Paes, Joao Tadeu; Bilaqui, Aldemir; Greco, Oswaldo T.; Ruiz, Milton Artur; Marcelino, Monica Y.; Stessuk, Talita; de Faria, Carolina A.; Lago, Mario R.
Fonte: Dove Medical Press Ltd Publicador: Dove Medical Press Ltd
Tipo: Artigo de Revista Científica Formato: 63-71
Português
Relevância na Pesquisa
126.12%
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); Within the chronic obstructive pulmonary disease (COPD) spectrum, lung emphysema presents, as a primarily histopathologic feature, the destruction of pulmonary parenchyma and, accordingly, an increase in the airflow obstruction distal to the terminal bronchiole. Notwithstanding the significant advances in prevention and treatment of symptoms, no effective or curative therapy has been accomplished. In this context, cellular therapy with stem cells (SCs) arises as a new therapeutic approach, with a wide application potential. The -purpose of this study is to evaluate the safety of SCs infusion procedure in patients with advanced COPD (stage IV dyspnea). After selection, patients underwent clinical examination and received granulocyte colony-stimulating factor, immediately prior to the bone marrow harvest. The bone marrow mononuclear cells (BMMC) were isolated and infused into a peripheral vein. The 12-month follow-up showed a significant improvement in the quality of life, as well as a clinical stable condition, which suggest a change in the natural process of the disease. Therefore, the proposed methodology in this study for BMMC cell therapy in sufferers of advanced COPD was demonstrated to be free of significant adverse effects. Although a larger sample and a greater follow-up period are needed...

Assessment of vitamin A status in chronic obstructive pulmonary disease patients and healthy smokers

Paiva, Sergio A. R.; Godoy, Irma; Vannucchi, Hélio; Fávaro, Rosa M. D.; Geraldo, Rosana R. C.; Campana, Alvaro O.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 928-934
Português
Relevância na Pesquisa
126.19%
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP); The relation between vitamin A status and the degree of lung airway obstruction was examined in a cross-sectional study of 36 male subjects aged 43-74 y who were assigned to five groups as follows: healthy nonsmokers (n = 7), healthy smokers (n = 7), mild chronic obstructive pulmonary disease (COPD-mild) patients (n = 9), COPD-moderate-severe patients (n = 7), and COPD-moderate-severe patients with exacerbation (+ex; n = 6). Smoking habits, pulmonary function tests, and energy-protein status were assessed; serum concentrations of retinyl esters, retinol, retinol binding protein, and transthyretin and relative dose responses were measured. In addition, 12 male smokers aged 45-61 y with mild COPD were randomly assigned to two groups for a longitudinal study: six subjects consumed vitamin A (1000 RE/d; COPD- vitamin A) and six subjects received placebo for 30 d. Lowered serum retinol concentrations were found in the COPD-moderate-severe and COPD-moderate- severe+ex groups. Measurements of vitamin A status in healthy smokers and in COPD-mild patients were not different from those in healthy nonsmokers. The improvement of pulmonary function test results after vitamin A supplementation [mean increase for 1-s forced expiratory volume (FEV1) = 22.9% in the COPD-vitamin A group] may support the assumption of a local (respiratory) vitamin A deficiency in patients with this disease.

Is chronic hypoxemia in patients with chronic obstructive pulmonary disease associated with more marked nutritional deficiency?: A study of the fat-free mass evaluated by anthropometry and bioelectrical impedance methods

Godoy, I.; Castro, M. H.; Silva, E.; Togashi, R. H.; Geraldo, R. R C; Campana, A. O.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 102-108
Português
Relevância na Pesquisa
126.18%
In order to determine wheter blood gases abnormalities, specially hypoxemia, are associated with more marked changes in fat-free mass in patients with chronic obstructive pulmonary disease (CPOD), nutritional assessment was performed on 16 normoxemic (PaO 2 > 55 mm Hg) and 16 hypoxemic (PaO 2 < 55 mm Hg) COPD patients in stable clinical condition. Body weight was expressed as percentage of the ideal body weight. Fat-free mass was estimated by anthropometry (FFM-Anthr) and by bioelectrical impedance (FFM- BI). Handgrip-strength was assessed as a measure of peripheral skeletal muscle strength. Patients were age-matched and presented similar degree of airway obstruction. Malnutrition, defined as body weight less than 90% of the ideal, was observed in 19% of the normoxemic patients and in 25% of the hypoxemic patients (p>0,05). FFM values in hypoxemic patients, estimated by both methods, were not different from those observed in normoxemic patients. No significant difference was observed on handgrip values between the two groups. No correlation was found between nutritional indices and pulmonary function and gases exchange parameters. FFM correlated positively with values of peripheral muscle function in normoxemic and hypoxemic patients. These data add further evidence to the hypothesis that hypoxemia is not a primary cause of the nutritional deficiency observed in COPD patients.

Cytokines and dietary energy restriction in stable chronic obstructive pulmonary disease patients

Godoy, Irma; Campana, A. ́ O; Geraldo, R. R C; Padovani, C. R.; Paiva, S. A R
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 920-925
Português
Relevância na Pesquisa
126.22%
Tumour necrosis factor (TNF)-α has been found to be increased in malnourished chronic obstructive pulmonary disease (COPD) patients; however, the main cause of this phenomenon remains undetermined. In normal subjects, TNF-α production may be induced by dietary energy deprivation. The aim of this study was to investigate if stable COPD patients present alterations of inflammatory mediators after 48 h of dietary energy restriction. Fourteen COPD patients were admitted to the hospital while receiving an experimental diet with an energy content of approximately one-third of their energy needs. Clinical evaluation, nutritional assessment and serum levels of interleukin (IL)-6, TNF-α and C-reactive protein, and secretion of TNF-α by peripheral blood monocytes were assessed on admission and after the experimental diet. For reference values of the laboratory parameters, blood was collected from 10 healthy, elderly subjects. COPD patients showed significantly higher serum concentrations of IL-6 than control subjects, however, the experimental diet was not associated with statistically significant changes in the inflammatory mediators. The findings of this study, although preliminary because of the limited degree and duration of the energy restriction...

The effects of elastic tubing-based resistance training compared with conventional resistance training in patients with moderate chronic obstructive pulmonary disease: a randomized clinical trial

Cipulo Ramos, Ercy Mara; Toledo-Arruda, Alessandra Choqueta de; Fosco, Luciana Cristina; Bonfim, Rafaela; Bertolini, Giovana Navarro; Guarnier, Flavia Alessandra; Cecchini, Rubens; Pastre, Carlos Marcelo; Langer, Daniel; Gosselink, Rik; Ramos, Dionei
Fonte: Sage Publications Ltd Publicador: Sage Publications Ltd
Tipo: Artigo de Revista Científica Formato: 1096-1106
Português
Relevância na Pesquisa
126.16%
Objective: To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity, muscle strength, fat-free mass, and systemic inflammation in patients with chronic obstructive pulmonary disease.Design: A prospective, randomized, eight-week clinical trial.Setting: The study was conducted in a university-based, outpatient, physical therapy clinic.Subjects: A total of 49 patients with moderate chronic obstructive pulmonary disease.Interventions: Participants were randomly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks.Main measures: The primary outcome measure was functional exercise capacity. The secondary outcome measures were peripheral muscle strength, health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire (CRDQ), fat-free mass, and cytokine profile.Results: After eight weeks, the mean distance covered during six minutes increased by 73 meters (69) in the elastic tubing group and by 42 meters (+/- 59) in the conventional group (p < 0.05). The muscle strength and quality of life improved in both groups (P < 0.05), with no significant differences between the groups. There was a trend toward an improved fat-free mass in both groups (P = 0.05). After the first and last sessions...

Chronic obstructive pulmonary disease is underdiagnosed and undertreated in São Paulo (Brazil): results of the PLATINO study

Nascimento,O.A.; Camelier,A.; Rosa,F.W.; Menezes,A.M.B.; Pérez-Padilla,R.; Jardim,J.R.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2007 Português
Relevância na Pesquisa
126.13%
Chronic obstructive pulmonary disease (COPD) is a common disease in adults over 40 years of age and has a great social and economic impact. It remains little recognized and undertreated even in developed countries. However, there are no data about its diagnosis and treatment in Brazil. The objectives of the present study were to evaluate the proportion of COPD patients who had never been diagnosed and to determine if the COPD patients who had been identified were receiving appropriate treatment. The Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO) was a randomized epidemiological study of adults over 40 years living in five metropolitan areas, including São Paulo. The studied sample was randomly selected from the population after a division of the metropolitan area of São Paulo in clusters according to social characteristics. All subjects answered a standardized questionnaire on respiratory symptoms, history of smoking, previous diagnosis of lung disease, and treatments. All subjects performed spirometry. The criterion for the diagnosis of COPD was defined by a post-bronchodilator FEV1/FVC ratio lower than 0.7. A total of 918 subjects were evaluated and 144 (15.8%) met the diagnostic criterion for COPD. However...

Interrelationship between serum and sputum inflammatory mediators in chronic obstructive pulmonary disease

Bizeto,L.; Mazzolini,A.B.; Ribeiro,M.; Stelmach,R.; Cukier,A.; Nunes,M.P.T.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2008 Português
Relevância na Pesquisa
126.12%
Little is known about airway inflammatory markers in chronic obstructive pulmonary disease (COPD). The objective of the present study was to identify and try to correlate pulmonary and peripheral blood inflammatory markers in COPD. In a cross-sectional study on patients with stable COPD, induced sputum and blood samples were collected for the determination of C-reactive protein, eosinophilic cationic protein, serum amyloid A protein, a-1 antitrypsin (a-1AT), and neutrophil elastase. Twenty-two patients were divided into two groups according to post-bronchodilator forced expiratory volume in the first second (%FEV1): group 1 (N = 12, FEV1 <40%) and group 2 (N = 10, FEV1 ³40%). An increase in serum elastase, eosinophilic cationic protein and a-1AT was observed in serum markers in both groups. Cytology revealed the same total number of cells in groups 1 and 2. There was a significantly higher number of neutrophils in group 1 compared to group 2 (P < 0.05). No difference in eosinophils or macrophages was observed between groups. Serum elastase was positively correlated with serum a-1AT (group 1, r = 0.81, P < 0.002 and group 2, r = 0.83, P < 0.17) and negatively correlated with FEV1 (r = -0.85, P < 0.03 and -0.14, P < 0.85, respectively). The results indicate the presence of chronic and persistent pulmonary inflammation in stable patients with COPD. Induced sputum permitted the demonstration of the existence of a subpopulation of cells in which neutrophils predominated. The serum concentration of all inflammatory markers did not correlate with the pulmonary functional impairment.

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Nunes,D.M.; Mota,R.M.S.; Machado,M.O.; Pereira,E.D.B.; de Bruin,V.M.S.; de Bruin,P.F.C.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2008 Português
Relevância na Pesquisa
126.12%
Disturbed sleep is common in chronic obstructive pulmonary disease (COPD). Conventional hypnotics worsen nocturnal hypoxemia and, in severe cases, can lead to respiratory failure. Exogenous melatonin has somnogenic properties in normal subjects and can improve sleep in several clinical conditions. This randomized, double-blind, placebo-controlled study was carried out to determine the effects of melatonin on sleep in COPD. Thirty consecutive patients with moderate to very severe COPD were initially recruited for the study. None of the participants had a history of disease exacerbation 4 weeks prior to the study, obstructive sleep apnea, mental disorders, current use of oral steroids, methylxanthines or hypnotic-sedative medication, nocturnal oxygen therapy, and shift work. Patients received 3 mg melatonin (N = 12) or placebo (N = 13), orally in a single dose, 1 h before bedtime for 21 consecutive days. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness was measured by the Epworth Sleepiness Scale. Pulmonary function and functional exercise level were assessed by spirometry and the 6-min walk test, respectively. Twenty-five patients completed the study protocol and were included in the final analysis. Melatonin treatment significantly improved global PSQI scores (P = 0.012)...

The impact of noninvasive ventilation during the physical training in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD)

Toledo,Andreza; Borghi-Silva,Audrey; Sampaio,Luciana Maria Malosá; Ribeiro,Karla Paiva; Baldissera,Vilmar; Costa,Dirceu
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2007 Português
Relevância na Pesquisa
126.13%
OBJECTIVE: To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways (BiPAP®) in patients with chronic obstructive pulmonary disease. METHODS: Eighteen patients with FEV1 = 34 ± 8% of predicted values, mean age of 68 ± 9 years were randomly distributed into 2 groups, one group performing physical training on a treadmill and the other group performing physical training associated with BiPAP® (physical training+B), for 30 minutes, 3 times a week for 12 weeks. The training velocity was based on a test of cardiopulmonary force performed pre- and postintervention, which registered the values for heart rate, systolic blood pressure, diastolic blood pressure, peripheral oxygen saturation, blood lactate, sensation of dyspnea, respiratory muscle strength, and analysis of gases expired such as oxygen consumption and the production of carbon dioxide. RESULTS: For both groups, there was a significant improvement in dyspnea and peripheral oxygen saturation at identical levels of physical exercise, in distance walked during the physical training, and in respiratory muscle strength (P < 0.05). Only the physical training+B group had a significant improvement in heart rate, systolic blood pressure...

Nutritional status is related to fat-free mass, exercise capacity and inspiratory strength in severe chronic obstructive pulmonary disease patients

Sabino,Pollyane Galinari; Silva,Bruno Moreira; Brunetto,Antonio Fernando
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2010 Português
Relevância na Pesquisa
126.19%
INTRODUCTION: Being overweight or obese is associated with a higher rate of survival in patients with advanced chronic obstructive pulmonary disease (COPD). This paradoxical relationship indicates that the influence of nutritional status on functional parameters should be further investigated. OBJECTIVE: To investigate the impact of nutritional status on body composition, exercise capacity and respiratory muscle strength in severe chronic obstructive pulmonary disease patients. METHODS: Thirty-two patients (nine women) were divided into three groups according to their body mass indices (BMI): overweight/obese (25 < BMI < 34.9 kg/m², n=8), normal weight (18.5 < BMI < 24.9 kg/m², n=17) and underweight (BMI <18.5 kg/m², n=7). Spirometry, bioelectrical impedance, a six-minute walking distance test and maximal inspiratory and expiratory pressures were assessed. RESULTS: Airway obstruction was similar among the groups (p=0.30); however, overweight/obese patients had a higher fat-free mass (FFM) index [FFMI=FFM/body weight² (mean±SEM: 17±0.3 vs. 15±0.3 vs. 14±0.5 m/kg², p<0.01)], exercise capacity (90±8 vs. 79±6 vs. 57±8 m, p=0.02) and maximal inspiratory pressure (63±7 vs. 57±5 vs. 35±8 % predicted, p=0.03) in comparison to normal weight and underweight patients...

Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease

Caram,Laura Miranda de Oliveira; Ferrari,Renata; Naves,Cristiane Roberta; Tanni,Suzana Erico; Coelho,Liana Sousa; Zanati,Silméia Garcia; Minicucci,Marcos Ferreira; Godoy,Irma
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2013 Português
Relevância na Pesquisa
126.34%
OBJECTIVES: The prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease according to disease severity has not yet been established. The aim of this study was to assess the prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease patients according to disease severity. METHODS: The study included 25 mild/moderate chronic obstructive pulmonary disease patients and 25 severe/very severe chronic obstructive pulmonary disease patients. All participants underwent clinical evaluation, spirometry and electrocardiography/echocardiography. RESULTS: Electrocardiography and echocardiography showed Q-wave alterations and segmental contractility in five (10%) patients. The most frequent echocardiographic finding was mild left diastolic dysfunction (88%), independent of chronic obstructive pulmonary disease stage. The proportion of right ventricular overload (p<0.05) and blockage of the anterosuperior division of the left bundle branch were higher in patients with greater obstruction. In an echocardiographic analysis, mild/moderate chronic obstructive pulmonary disease patients showed more abnormalities in segmental contractility (p<0.05)...

Frequency of referral to and attendance at a pulmonary rehabilitation programme amongst patients admitted to a tertiary hospital with chronic obstructive pulmonary disease

Johnston, K.; Young, M.; Grimmer, K.; Antic, R.; Frith, P.
Fonte: Wiley-Blackwell Publicador: Wiley-Blackwell
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
126.12%
BACKGROUND AND OBJECTIVE: Pulmonary rehabilitation (PR) is recommended in the management of people with chronic obstructive pulmonary disease (COPD), but implementation appears to be low. The aim of this study was to determine the frequency of referral to, and attendance at, PR programmes in a sample of patients with COPD. METHODS: A cross-sectional study of patients admitted to a tertiary hospital in South Australia, with a primary diagnosis of COPD between March and November 2011 was conducted. Data were collected from medical records and patient interview. RESULTS: From 235 admissions with preliminary coding as COPD, 88 patients had COPD as the primary reason for admission and were potentially eligible for rehabilitation. While 57% had been referred to rehabilitation during their disease course, only 18% had attended and completed at least half the programme. Seven patients had attended in the previous 2 years. Mean percentage predicted forced expiratory volume in 1 s was 42% at the time of referral. During the index admission, discussion of rehabilitation resulting in a referral occurred in 14 cases (16%). No demographic or disease characteristics were associated with referral/no referral; being reviewed by a COPD nurse coordinator during admission increased the likelihood of referral (odds ratio = 18.7...

Doença obstrutiva grave : similaridades e diferenças em pacientes portadores de doença pulmonar obstrutiva cronica (DPOC) e/ou bronquiectasias; Severe obstructive disease : similarities and differences between patients with chronic obstructive pulmonary disease (COPD) and/or bronchiectasis

Junia Rezende Gonçalves
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 26/02/2010 Português
Relevância na Pesquisa
126.21%
Pacientes com defeito obstrutivo podem responder aos broncodilatadores (BD) na espirometria com aumento do volume expiratório forçado no 1° segundo (VEFi) e/ou da capacidade vital forçada (CVF), sendo chamados respondedores de fluxo e/ou de volume, respectivamente. No entanto, ainda acontece debate considerável na definição de resposta ao BD, com a existência de critérios distintos propostos pelas sociedades de pneumologia. Estudos prévios demonstraram que a doença pulmonar obstrutiva crônica (DPOC) grave caracteriza-se por uma maior resposta de volume (RV) e menor resposta de fluxo (RF). Os objetivos principais deste trabalho foram descrever e comparar pacientes portadores de doença obstrutiva grave, com ou sem história prévia de tabagismo (> 10 anos/maço), por meio da análise de seus parâmetros funcionais, de repercussão sistêmica, e estruturais; testar se os respondedores de volume são pacientes mais graves que os respondedores de fluxo e os não respondedores, de acordo com as definições da SBPT (Sociedade Brasileira de Pneumologia e Tisiologia), da ATS/ERS (American Thoracic Society/European Respiratory Society), e de Paré et al. (AVEF1/ACVF > 1 = RF ou < 1 = RV). Sessenta e oito pacientes (idade 55,9 ± 13...

Nutritional status is related to fat-free mass, exercise capacity and inspiratory strength in severe chronic obstructive pulmonary disease patients

Sabino, Pollyane Galinari; Silva, Bruno Moreira; Brunetto, Antonio Fernando
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2010 Português
Relevância na Pesquisa
126.13%
INTRODUCTION: Being overweight or obese is associated with a higher rate of survival in patients with advanced chronic obstructive pulmonary disease (COPD). This paradoxical relationship indicates that the influence of nutritional status on functional parameters should be further investigated. OBJECTIVE: To investigate the impact of nutritional status on body composition, exercise capacity and respiratory muscle strength in severe chronic obstructive pulmonary disease patients. METHODS: Thirty-two patients (nine women) were divided into three groups according to their body mass indices (BMI): overweight/obese (25 < BMI < 34.9 kg/m², n=8), normal weight (18.5 < BMI < 24.9 kg/m², n=17) and underweight (BMI

O impacto da ventilação não-invasiva no treinamento físico em pacientes com doença pulmonar obstrutiva crônica moderada a grave; The impact of noninvasive ventilation during the physical training in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD)

Toledo, Andreza; Borghi-Silva, Audrey; Sampaio, Luciana Maria Malosá; Ribeiro, Karla Paiva; Baldissera, Vilmar; Costa, Dirceu
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/01/2007 Português
Relevância na Pesquisa
126.13%
OBJETIVO: Avaliar a influência do treinamento físico, com e sem ventilação não invasiva com dois níveis de pressão nas vias aéreas (BiPAP®), em pacientes com doença pulmonar obstrutiva crônica. MÉTODOS: Dezoito pacientes com VEF1=34±8% do previsto, idade média de 68±9 anos, foram randomicamente distribuídos em dois grupos, um grupo realizando treinamento físico em esteira e outro grupo realizando treinamento físico associado ao BiPAP® (treinamento físico+B), durante 30 minutos, 3 vezes por semana, por 12 semanas. A velocidade do treinamento foi baseada no teste cardiopulmonar realizado pré e pós-intervenção, com registro dos valores de freqüência cardíaca, pressão arterial sistólica, pressão arterial diastólica, saturação periférica de oxigênio, lactato sanguíneo, sensação de dispnéia, força muscular respiratória e análise de gases expirados como consumo de oxigênio, produção de dióxido de carbono. RESULTADOS: Em ambos os grupos houve melhora significativa na dispnéia e saturação periférica de oxigênio no mesmo nível de esforço, na distância percorrida no teste cardiopulmonar e na força muscular respiratória (p; OBJECTIVE: To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways (BiPAP®) in patients with chronic obstructive pulmonary disease. METHODS: Eighteen patients with FEV1 = 34 ± 8% of predicted values...

Clinical Epidemiology of Chronic Obstructive Pulmonary Disease

Mascarenhas,Joana; Bettencourt,Paulo; Azevedo,Ana
Fonte: ArquiMed - Edições Científicas AEFMUP Publicador: ArquiMed - Edições Científicas AEFMUP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2011 Português
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Chronic obstructive pulmonary disease (COPD) is responsible for early morbidity and high mortality and significant costs to health systems. Smoking remains the main risk factor for COPD but additional factors, such as indoor and outdoor air pollution, occupational exposure and genetic susceptibility are increasingly recognized. The burden of COPD has been difficult to estimate owing to the multiple definitions applied, with variations between estimates of prevalence exceeding 15%. Definitions based on objective spirometric measurements have yielded higher prevalence estimates than patients’ self-report of a clinical diagnosis of COPD. Th e Global Initiative for Chronic Obstructive Lung Disease (GOLD) proposed a physiologic definition of COPD characterized by airflow limitation that is not fully reversible (post-bronchodilator FEV1/FVC < 0.70). Many authors have argued against this fixed ratio definition and advocate the use of a “lower limit of normal” criterion to define COPD in order to avoid overdiagnosis of the disease in the elderly. Despite controversies, the definition proposed by GOLD is unambiguous, easily remembered by clinicians, reproducible in different settings and suitable for cross-sites comparisons. Recently, two multinational studies adopted the GOLD definition to provide standardized population-based estimates of the prevalence of COPD in adults aged 40 years or over throughout the world. These estimates varied between 11.4 and 26.1% in the international BOLD study and between 2.6% and 7.1% in the five Latin American cities of the PLATINO study. Although debate on COPD definition is ongoing...