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Resumen Introducción : Hay información escasa sobre evolución a largo plazo de pacientes hospitalizados por neumo nía COVID-19 moderada (NM) y grave (NG). El objetivo del estudio fue determinar impacto clínico, funcional respiratorio y tomográfico (TACAR) luego del alta a 12 meses del diagnóstico. Métodos : análisis según grupos NM y NG, desatura dores (PD) en prueba de caminata 6 min (PC6M) y patrón tomográfico símil fibrótico (SF). Comparamos resultados a 3 y 12 meses de seguimiento. Resultados : 194 pacientes enrolados, evaluados al año: 103 (53% ): masculinos (62.4%), edad 57.7 ± 10.9 años, comorbilidades (hipertensión arterial 38.8%, dia betes 29.6%, antecedentes respiratorios-AR- 18.4%). Com paramos variables a los 3 y 12 meses (media/DE): CVF 84%(19) a 88(19) (p = 0.01); 27% tuvo CVF<80% al año. En PC6M: 426 metros (108) a 447(92) (p = < 0.01). El 12.8% fue PD al año. NG tuvo mayor SF (40% vs. 27.9% p = 0.021). SF se relacionó con CVF <80% (p = 0.004) en toda la co horte, y NG (p < 0.001). Al año en análisis multivariado se asoció a CVF <80%, AR (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) y patrón SF (OR 3.51, 1.25-9.88). PD se asoció a AR (OR 12.2, 2.41-61.85). Discusión : Se observó mejoría en todas las variables al año. Pero al año persisten alteraciones funcionales y tomográficas en <50% de los pacientes. El subgrupo de PD se relacionó a AR. Es importante el seguimiento protocolizado de los pacientes hospitalizados, especial mente los grupos NG, PD y SF.
Abstract Introduction : There is scarce information on longterm evolution of hospitalized patients with moderate (MP) and severe (SP) COVID-19 pneumonia. Objective: to de termine clinical, respiratory function, and tomographic (HRCT) impact after being discharged 12 months after diagnosis. Methods : Analysis according to MP and SP, desatura tor patients (DP) in 6-minute walking test (6MWT) and HRCT fibrotic-like pattern (FLP). Results compared at 3 and 12 months of follow-up. Results : 194 patients enrolled and one year later 103 (53%) were evaluated: gender male (62.4%), age 57.7 ± 10.9 years, comorbidities (arterial hypertension 38.8%, diabetes 29.6%, and respiratory diseases-RD-18.4%). Variables compared 3 months to 12 months (mean/SD): FVC: 84%( 19) to 88%( 19) (p= 0.01). A 27% of patients had FVC<80% at one year. In 6MWT:426 (108) to 447 (92) (p = <0.01). 12.8% are DP in one year. SP had a greater FLP than MP (40% vs. 27.9%, p = 0.021). The FLP group was related to FVC < 80% (p = 0.004) in all patients but only in SP (p < 0.001). After one year, in multivariate analysis, FVC < 80% was associated with RD (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) and FLP (OR 3.51, 1.25-9.88). DP were associated with RD (OR 12.2, 2.41-61.85). Discussion : Improvement was observed in all vari ables when comparing 3 to 12 months. However, after one year, functional and tomographic alterations persist in less than 50% of patients. DP subgroup was related to RD. Protocolled follow-up of hospitalized patients is important, especially in SP, DP, and FLP groups.
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@#ObjectiveTo investigate the relation between body mass index(BMI) and postoperative complications after coronary artery bypass grafting (CABG).MethodsThe clinical data of 99 patients who underwent CABG at Fujian Provincial Hospital were analyzed. The patients were divided into three groups according to their preoperative BMI: normal group(n=21), overweight group(n=33), and obese group(n=45). And the related observation indexes were compared among the 3 groups.ResultsThe hospital mortality of normal, overweight and obese groups were 0%, 3.03% and 4.44% respectively (P>0.05). The rate of pulmonary infection (24.44%) or wound infection (24.39%) in the obese group was significantly higher than those in the normal group(4.76% or 0%) (P<0.05). The time stay ICU or hospital in the obese group were significantly greater than those in the normal and overweight groups (P<0.05). 6-minute walking test (6MWT) in the obese group was significantly less than that in the normal and overweight groups 3 months after the operation(P<0.001).ConclusionHigh preoperative BMI can take a negative effect on patients after CABG following postoperative complications.
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OBJECTIVE: We sought to evaluate the neurohormonal activity in heart transplant recipients and compare it with that in heart failure patients and healthy subjects during rest and just after a 6-minute walking test. INTRODUCTION: Despite the improvements in quality of life and survival provided by heart transplantation, the neurohormonal profile is poorly described. METHODS: Twenty heart transplantation (18 men, 49±11 years and 8.5±3.3 years after transplantation), 11 heart failure (8 men, 43±10 years), and 7 healthy subjects (5 men 39±8 years) were included in this study. Blood samples were collected immediately before and during the last minute of the exercise. RESULTS: During rest, patients' norepinephrine plasma level (659±225 pg/mL) was higher in heart transplant recipients (463±167 pg/mL) and heathy subjects (512±132), p<0.05. Heart transplant recipient's norepinephrine plasma level was not different than that of healthy subjects. Just after the 6-minute walking test, the heart transplant recipient's norepinephrine plasma level (1248±692 pg/mL) was not different from that of heart failure patients (1174±653 pg/mL). Both these groups had a higher level than healthy subjects had (545±95 pg/mL), p<0.05. CONCLUSION: Neurohormonal activity remains increased after the 6-minute walking test after heart transplantation.
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Adult , Female , Humans , Male , Middle Aged , Exercise Test , Heart Failure/blood , Heart Transplantation/physiology , Norepinephrine/blood , Walking/physiology , Case-Control Studies , Heart Failure/surgeryABSTRACT
A Síndrome de Prader-Willi é uma desordem genética que afeta o cromossomo 15. É caracterizada por baixa estatura, hipotonia muscular, retardo mental, anormalidades no comportamento, características dismórficas, distúrbios respiratórios e apetite excessivo, com obesidade progressiva. Estes pacientes também apresentam desenvolvimento sexual incompleto e podem ter distúrbios visuais e hipopigmentação. A maioria tem redução na capacidade de secreção do hormônio GH e hipogonadismo hipogonadotrópico, sugerindo uma disfunção hipotalâmica-pituitária. O tratamento fisioterapêutico é indicado com embasamento nas disfunções ocasionadas. Entretanto, evidências sugerem melhora da função respiratória e do condicionamento físico, promovendo inclusive uma redução do peso corporal. Sendo assim, foram selecionadas 3 crianças em tratamento em uma clínica de fisioterapia da cidade de Maringá, Pr, de ambos os sexos, idade entre 4 e 5 anos, com diagnóstico clínico definido de Síndrome de Prader-Willi. Inicialmente, os pacientes foram avaliados através do teste de caminhada dos 6 minutos, coletados dados como FC, FR, PA, SaO2 e IMC. Durante 3 meses foram submetidos a um tratamento fisioterapêutico, através de técnicas de reabilitação cardiorrespiratória, duas vezes semanais, com duração de 45 minutos. Após a totalização de 28 sessões, os pacientes foram reavaliados, possibilitando a comprovação dos efeitos das técnicas terapêuticas utilizadas, que, embora estatisticamente não tenham modificado os dados, sugeriram uma melhora geral.
Prader-Willi Syndrome is a disorder which affects the 15 chromosome. Is characterized by short height, muscular hipotony, mental disability, behavior abnormality, dismorphic characteristics, respiratory disturbs and obsessive appetite with progressive obesity. These patients also present incomplete sexual development and may have visual disturbs. Most of them have reduction and hypopigmentation in GH hormone secretion and hypogonadotropic hypogonadism, suggesting a hypothalamic pituitary dysfunction. The physiotherapy treatment is recommended based on occasioned dysfunctions, on the other hand, evidences show improvement in the respiratory function and physical conditionament which causes a body weight reduction. Three children from both sex, age 4-5, were singled out in a physiotherapy clinic in the city of Maringá-Pr, with Prader Willi Syndrome diagnose. First, these patients were evaluated by a 6-minute walking test, being collected data such as: FC FR PA SaO2 and IMC. For three months, they went through a physiotherapeutic treatment, by cardiorrespiratory techniques, twice a week with a 45-minute duration. After 28 sections, they were reevaluated, making it possible to proof of the effects of therapeutic techniques used, although statistically that did not change the data suggested an overall improvement.
Subject(s)
Humans , Child , Prader-Willi Syndrome , Rehabilitation , Respiration , Walking , Physical Therapy Modalities , Cardiovascular AbnormalitiesABSTRACT
Objective To evaluate the therapeutic effect of spironolactone on schistosomal pulmonary arterial hypertension(SPAH). Methods A total of 62 patients suffered from hepatosplenic schistosomiasis with pulmonary arterial hypertension were divided into the spironolactone group(n=31) and control group (n=31). All the patients underwent serial echocardiography and the clinical effect before and after the treatment was evaluated by assessing the mean pulmonary arterial pressure (mPAP) and pulmonary arterial diameter (PAD). At the same time, the varieties of the clinical symptoms, signs and the distance of the 6-minute walking test (6-MWT) were investigated. Results In spironolactone group, mPAP(-x±s) decreased from (31.8±7.1) mmHg to (21.2±2.1) mmHg, PAD(-x±s) decreased from (28.0±5.0) mm to (20.0±3.5) mm before and after the treatment respectively(P<0.01). There were significant differences in mPAP, PAD, the distance of 6-MWT and the heart function before and after the treatment in the spironolactone group. However, the data did not show the significant difference in the control group. Conclusion The therapeutic effect of spironolactone in the treatment of SPAH is satisfactory.