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2.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 473-481, 01-dic-2021. tab
Article in Spanish | LILACS | ID: biblio-1354772

ABSTRACT

Introducción: en las grandes altitudes, el intercambio gaseoso suele estar deteriorado; en la altitud moderada de la Ciudad de México esto no está aún plenamente definido. Objetivo: caracterizar el intercambio gaseoso en la altitud moderada de la Ciudad de México. Material y métodos: mediante un estudio transversal analítico se estudiaron sujetos nacidos y habitantes de la Ciudad de México, de ambos géneros, con edades de 20 a 59 años sin enfermedad cardiopulmonar. Se registraron sus variables demográficas, espirometría simple y de gasometría arterial. Las diferencias en las variables se calcularon con ANOVA de una vía para grupos independientes y ajuste de Bonferroni. Una p < 0.05 se aceptó como significativa. Resultados: se estudiaron 335 sujetos, de los cuales 168 (50.15%) fueron hombres, la edad grupal fue de 45 ± 11 años, con índice de masa corporal 22.97 ± 1.54 Kg/m2. La relación volumen espiratorio forzado en el primer segundo/Capacidad vital forzada (VEF1/CVF) de 91.58 ± 12.86%. La presión arterial de oxígeno fue de 66 ± 5.02 mmHg, el bióxido de carbono: 32.07 ± 2.66 mmHg, la saturación arterial de oxígeno: 93.03 ± 1.80% y la hemoglobina: 14.07 ± 1.52 gr/dL. Conclusiones: la presión arterial de oxígeno y del bióxido de carbono están disminuidos a la altura de la Ciudad de México.


Background: At high altitude the gas exchange is impaired, in the moderate altitude of Mexico City they are not yet defined. Objective: To characterize the gas exchange in the moderate altitude of Mexico City. Material and methods: Through an analytical cross-sectional study, subjects born and inhabitants of Mexico City, both genders, aged 20 to 59 years without cardiopulmonary disease, were studied. Their demographic variables, simple spirometry and arterial blood gas were recorded. Differences in variables were calculated with one-way ANOVA for independent groups and Bonferroni adjustment. p < 0.05 was accepted as significant. Results: 335 subjects were studied, 168 (50.15%) men. Group age 45 ± 11 years old, body mass index 22.97 ± 1.54 Kg/m2. Forced expiratory volume ratio in the first second / Forced vital capacity (FEV1/FVC) 91.58 ± 12.86%. The arterial oxygen pressure was: 66 ± 5.02 mmHg, carbon dioxide: 32.07 ± 2.66 mmHg, arterial oxygen saturation: 93.0 3 ± 1.80%, and hemoglobin: 14.07 ± 1.52 gr/dL. Conclusions: The arterial oxygen pressure and carbon dioxide are lowered at the Mexico City altitude.


Subject(s)
Humans , Male , Female , Pulmonary Heart Disease , Blood Gas Analysis , Arterial Pressure , Respiratory Function Tests , Spirometry , Forced Expiratory Volume , Pulmonary Circulation , Cross-Sectional Studies , Circulatory and Respiratory Physiological Phenomena , Reference Parameters
3.
Medicina (B.Aires) ; 81(5): 715-721, oct. 2021. graf
Article in English | LILACS | ID: biblio-1351042

ABSTRACT

Abstract There are few data regarding the repercussion in the pulmonary function of patients who had severe or critical COVID-19 pneumonia. The objective was to describe these patients´ pulmonary function and establish an association with the severity of the disease (patients with severe or critical pneumonia), the presence of comorbidities, the tomographic involvement and the persistence of dyspnoea. Fifty-five patients were included, 40 (73%) male, media of age 54.9 (11.6) years old and body mass index (BMI) 33.1 (6.09) kg/m2. Fifty (90%) had 1 comorbidity, obesity 67%, arterial hypertension 36%, and diabetes mellitus 35%. Twenty-five (45%) had critical pneumonia. Fifteen (27%) had a spirometric alteration that suggested restriction and 32 (58%) had gas exchange defect. The latter had forced volume capacity (FVC), forced expiratory volume in the first second (FEV1) and carbon monoxide diffusion capacity (DLCO) values significantly lower. Ninety percent presented some degree of involvement in the chest CT scan, ground glass-opacities the most frequent finding. A moderate negative correlation was found between the severity of the tomographic involvement and the DLCO levels. Thirty patients (55%) referred some degree of dyspnoea. Patients with this symptom had DLCO and KCO values below those who did not have dyspnoea: 70.5 vs. 85.1 p = 0.02 and 88 vs. 104 p = 0.02. The presence of abnormal gas exchange is the main characteristic of patients with pulmonary sequelae due to COVID-19. Our study does not show either predictor of evolution towards pulmonary sequelae or an association with the severity of the disease.


Resumen Se conocen pocos datos acerca de la repercusión en la función pulmonar de pacientes que cursaron una neumonía grave o crítica por COVID-19. El objetivo fue describir la función pulmonar de estos pacientes y establecer si existe asociación con la gravedad (neumonía grave o crítica), comorbilidades, compromiso tomográfico y persistencia de disnea. Se incluyeron 55 pacientes, 40 (73%) varones, media de edad 54.9 (11.6) años e índice de masa corporal (IMC) 33.1 (6.09) kg/m2. Cincuenta (90%) tenían una comorbilidad, obesidad 67%, hipertensión arterial 36% y diabetes mellitus 35%. Veinticinco (45%) presentaron neumonía crítica. Se hallaron 15 (27%) con una alteración que sugiere restricción y 32 (58%) presentaron trastorno del intercambio gaseoso. Aquellos con trastorno del intercambio gaseoso, tenían valores de capacidad vital forzada (FVC), volumen espiratorio forzado en el primer segundo (FEV1) y difusión de monóxido de carbono (DLCO) significativamente menores. El 90% tenía algún grado de compromiso en TAC de tórax siendo vidrio esmerilado el hallazgo más frecuente. Se encontró moderada correlación negativa entre gravedad del compromiso tomográfico y nivel de DLCO. A la consulta, 30 (55%) referían algún grado de disnea. Los pacientes con disnea presentaban valores de DLCO y KCO inferiores respecto a los que no referían disnea 70.5 vs. 85.1 p = 0.02 y 88 vs. 104 p = 0.02. La presencia de intercambio anormal de gases es la característica principal de los pacientes con secuelas pulmonares por COVID-19. De nuestro trabajo no surgen predictores para evolución hacia secuela pulmonar ni pudimos asociarlo a la gravedad de la enfermedad.


Subject(s)
Humans , Male , Child , Middle Aged , COVID-19 , Respiratory Function Tests , Forced Expiratory Volume , SARS-CoV-2 , Lung
4.
J. pediatr. (Rio J.) ; 97(1): 37-43, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154715

ABSTRACT

Abstract Objective: To compare quantitative CT parameters between children with severe asthma and healthy subjects, correlating to their clinical features. Methods: We retrospectively analyzed CT data from 19 school-aged children (5-17 years) with severe asthma and 19 control school-aged children with pectus excavatum. The following CT parameters were evaluated: total lung volume (TLV), mean lung density (MLD), CT air trapping index (AT%) (attenuation ≤856 HU), airway wall thickness (AWT), and percentage of airway wall thickness (AWT%). Multi-detector computed tomography (MDCT) data were correlated to the following clinical parameters: forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), FEV1/FVC ratio, sputum and bronchoalveolar lavage analysis, serum IgE levels, and previous hospitalizations due to asthma. Results: Asthma patients presented higher mean values of AT% (23.8 ± 6.7% vs. controls, 9.7 ± 3.2%), AWT (1.46 ± 0.22 mm vs. controls, 0.47 ± −735 ± 28 HU vs. controls, −666 ± 19 HU). Mean AT% was 29.0 ± 4.7% in subjects with previous hospitalization against 19.2 ± 5.0% in those with no prior hospitalization (p < 0.001). AT% presented very strong negative correlations with FVC (r = −0.933, p < 0.001) and FEV1 (r = −0.841, p < 0.001) and a moderate correlation with FEF 25-75% (r = −0.608, p = 0.007). AT% correlation with FEV1/FVC ratio and serum IgE was weak (r = −0.184, p = 0.452, and r = −0.363, p = 0.202) Conclusion: Children with severe asthma present differences in quantitative chest CT scans compared to healthy controls with strong correlations with pulmonary function tests and previous hospitalizations due to asthma.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Aged , Asthma/diagnostic imaging , Respiratory Function Tests , Tomography, X-Ray Computed , Vital Capacity , Forced Expiratory Volume , Retrospective Studies , Lung/diagnostic imaging
5.
Clinics ; 76: e1713, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153987

ABSTRACT

OBJECTIVES: The chemokine ligand (CCL) 21 regulates the maturation, migration, and function of dendritic cells, and has been implicated in the pathogenesis of asthma. This study aimed to investigate the association between serum CCL21 levels and asthma control. METHODS: The serum levels of CCL21 and other inflammatory cytokines were analyzed in patients with asthma (n=44) and healthy controls (n=35) by enzyme-linked immunosorbent assay. IgE levels and eosinophil counts were determined by turbidimetric inhibition immunoassay and fully automatic blood analysis, respectively. The Asthma Control Test (ACT) questionnaire was used, and spirometry and fractional exhaled nitric oxide (FENO) measurements were performed. A multiple unpaired Student's t-test was performed to analyze the differences in CCL21 and interleukin levels between patients with asthma and healthy controls. The correlation of CCL21 levels with disease severity was evaluated using the Pearson's rank correlation test. RESULTS: Serum CCL21 levels were lower in patients with asthma (254.78±95.66 pg/mL) than in healthy controls (382.95±87.77 pg/mL) (p<0.001). Patients with asthma had significantly higher levels of IL-1β (19.74±16.77 vs. 2.63±5.22 pg/mL), IL-6 (7.55±8.65 vs. 2.37±2.47 pg/mL), and tumor necrosis factor-α (12.70±12.03 vs. 4.82±3.97 pg/mL) compared with the controls. CCL21 levels were positively correlated with the ACT score (rs=0.1653, p=0.0062), forced expiratory volume in 1s (FEV1)/forced vital capacity (rs=0.3607, p<0.0001), and FEV1 (rs=0.2753, p=0.0003), and negatively correlated with FENO (rs=0.1060, p=0.0310). CCL21 levels were negatively correlated with serum IgE levels (rs=0.1114, p=0.0268) and eosinophil counts (rs=0.3476, p<0.0001). CONCLUSIONS: Serum CCL21 levels may be a new biomarker for assessing asthma control.


Subject(s)
Humans , Adult , Asthma , Chemokine CCL21/blood , Forced Expiratory Volume , Chemokines , Exhalation , Ligands , Nitric Oxide
6.
J. bras. pneumol ; 47(2): e20200134, 2021. tab, graf
Article in English | LILACS | ID: biblio-1154699

ABSTRACT

ABSTRACT Objective: To investigate the validity of field walking tests to identify exercise-induced hypoxemia and to compare cardiorespiratory responses and perceived effort between laboratory-based and field-based exercise tests in subjects with bronchiectasis. Methods: This was a cross-sectional study involving 72 non-oxygen-dependent participants (28 men; mean age = 48.3 ± 14.5 years; and mean FEV1 = 54.1 ± 23.4% of the predicted value). The participants underwent cardiopulmonary exercise testing (CPET) on a treadmill and constant work-rate exercise testing (CWRET) on the same day (1 h apart). In another visit, they underwent incremental shuttle walk testing (ISWT) and endurance shuttle walk testing (ESWT; 1 h apart). Desaturation was defined as a reduction in SpO2 ≥ 4% from rest to peak exercise. Results: CPET results were compared with ISWT results, as were CWRET results with ESWT results. There was no difference in the magnitude of desaturation between CPET and ISWT (−7.7 ± 6.3% vs. −6.6 ± 5.6%; p = 0.10) and between CWRET and ESWT (−6.8 ± 5.8% vs. −7.2 ± 6.3%; p = 0.50). The incremental tests showed an agreement in the magnitude of desaturation in the desaturation and no desaturation groups (42 and 14 participants, respectively; p < 0.01), as did the endurance tests (39 and 16 participants; p < 0.01). The magnitude of desaturation was similar among the participants who did or did not reach at least 85% of the maximum predicted HR. Conclusions: Field exercise tests showed good precision to detect desaturation. Field tests might be an alternative to laboratory tests when the clinical question is to investigate exercise-induced desaturation in subjects with bronchiectasis.


RESUMO Objetivo: Investigar a validade dos testes de caminhada de campo para identificar dessaturação durante o exercício, comparando os testes de exercício laboratoriais e clínicos de campo quanto às respostas cardiorrespiratórias e percepção de esforço em indivíduos com bronquiectasia não fibrocística. Métodos: Estudo transversal com 72 participantes não dependentes de oxigênio (28 homens; média de idade: 48,3 ± 14,5 anos; média do VEF1: 54,1 ± 23,4% do previsto). Os participantes foram submetidos ao teste de exercício cardiopulmonar (TECP) incremental em esteira e ao constant work-rate exercise testing (CWRET, teste de exercício com carga constante) em esteira, com intervalo de 1 h. Em outra visita, foram submetidos ao incremental shuttle walk test (ISWT, teste de caminhada incremental) e ao endurance shuttle walk test (ESWT, teste de caminhada de resistência), com intervalo de 1 h. A definição de dessaturação foi uma redução da SpO2 ≥ 4% do repouso ao pico do exercício. Resultados: O TECP e o ISWT resultaram em dessaturação de magnitude comparável (−7,7 ± 6,3% vs. −6,6 ± 5,6%; p = 0,10), assim como o fizeram o CWRET e o ESWT (−6,8 ± 5,8% vs. −7,2 ± 6,3%; p = 0,50). Houve concordância entre o TECP e o ISWT quanto ao número de participantes que apresentaram e não apresentaram dessaturação, respectivamente (42 e 14; p < 0,01), bem como entre o CWRET e o ESWT (39 e 16; p < 0,01). A magnitude da dessaturação foi semelhante nos participantes que atingiram ≥ 85% da FC máxima prevista ou não. Conclusões: Os testes de exercício de campo apresentaram boa precisão para detectar dessaturação. Os testes de campo podem ser uma alternativa aos testes de laboratório quando o objetivo é investigar a dessaturação durante o exercício em indivíduos com bronquiectasia.


Subject(s)
Humans , Male , Adult , Middle Aged , Bronchiectasis , Exercise Test , Oxygen Consumption , Forced Expiratory Volume , Cross-Sectional Studies , Walking , Exercise Tolerance , Laboratories
7.
J. bras. pneumol ; 47(1): e20200033, 2021. tab
Article in English | LILACS | ID: biblio-1134930

ABSTRACT

ABSTRACT Objective: To evaluate the frequency of asthma-COPD overlap (ACO) in patients with COPD and to compare, from a clinical, laboratory, and functional point of view, patients with and without ACO, according to different diagnostic criteria. Methods: The participants underwent evaluation by a pulmonologist, together with spirometry and blood tests. All of the patients were instructed to record their PEF twice a day. The diagnosis of ACO was based on the Proyecto Latinoamericano de Investigación en Obstrucción Pulmonar (PLATINO, Latin American Project for the Investigation of Obstructive Lung Disease) criteria, the American Thoracic Society (ATS) Roundtable criteria, and the Spanish criteria. We investigated patient histories of exacerbations and hospitalizations, after which we applied the COPD Assessment Test and the modified Medical Research Council scale, to classify risk and symptoms in accordance with the GOLD criteria. Results: Of the 51 COPD patients, 14 (27.5%), 8 (12.2%), and 18 (40.0) were diagnosed with ACO on the basis of the PLATINO, ATS Roundtable, and Spanish criteria, respectively. The values for pre-bronchodilator FVC, post-bronchodilator FVC, and pre-bronchodilator FEV1 were significantly lower among the patients with ACO than among those with COPD only (1.9 ± 0.4 L vs. 2.4 ± 0.7 L, 2.1 ± 0.5 L vs. 2.5 ± 0.8 L, and 1.0 ± 0.3 L vs. 1.3 ± 0.5 L, respectively). When the Spanish criteria were applied, IgE levels were significantly higher among the patients with ACO than among those with COPD only (363.7 ± 525.9 kU/L vs. 58.2 ± 81.6 kU/L). A history of asthma was more common among the patients with ACO (p < 0.001 for all criteria). Conclusions: In our sample, patients with ACO were more likely to report previous episodes of asthma and had worse lung function than did those with COPD only. The ATS Roundtable criteria appear to be the most judicious, although concordance was greatest between the PLATINO and the Spanish criteria.


RESUMO Objetivo: Avaliar a frequência de asthma-COPD overlap (ACO, sobreposição asma-DPOC) em pacientes com DPOC e comparar, do ponto de vista clínico, laboratorial e funcional, os pacientes com e sem essa sobreposição conforme diferentes critérios diagnósticos. Métodos: Os participantes foram submetidos à avaliação com pneumologista, espirometria e exame sanguíneo, sendo orientados a manter o registro do PFE duas vezes ao dia. O diagnóstico de ACO deu-se através dos critérios Projeto Latino-Americano de Investigação em Obstrução Pulmonar (PLATINO), American Thoracic Society (ATS) Roundtable e Espanhol. Foram investigados os históricos de exacerbações e hospitalizações e aplicados os instrumentos COPD Assessment Test e escala Medical Research Council modificada, utilizados para a classificação de risco e sintomas da GOLD. Resultados: Entre os 51 pacientes com DPOC, 14 (27,5%), 8 (12,2%) e 18 (40,0) foram diagnosticados com ACO segundo os critérios PLATINO, ATS Roundtable e Espanhol, respectivamente. Pacientes com sobreposição significativamente apresentaram pior CVF pré-broncodilatador (1,9 ± 0,4 L vs. 2,4 ± 0,7 L), CVF pós-broncodilatador (2,1 ± 0,5 L vs. 2,5 ± 0,8 L) e VEF1 pré-broncodilatador (1,0 ± 0,3 L vs. 1,3 ± 0,5 L) quando comparados a pacientes com DPOC. Os níveis de IgE foram significativamente mais elevados em pacientes com sobreposição diagnosticados pelo critério Espanhol (363,7 ± 525,9 kU/L vs. 58,2 ± 81,6 kU/L). O histórico de asma foi mais frequente em pacientes com a sobreposição (p < 0,001 para todos os critérios). Conclusões: Nesta amostra, pacientes com ACO relataram asma prévia com maior frequência e possuíam pior função pulmonar quando comparados a pacientes com DPOC. O critério ATS Roundtable aparenta ser o mais criterioso em sua definição, enquanto os critérios PLATINO e Espanhol apresentaram maior concordância entre si.


Subject(s)
Humans , Asthma/complications , Asthma/diagnosis , Asthma/epidemiology , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Spirometry , Forced Expiratory Volume , Hospitalization , Laboratories
8.
Chinese Medical Journal ; (24): 1552-1560, 2021.
Article in English | WPRIM | ID: wpr-887612

ABSTRACT

BACKGROUND@#Chronic obstructive pulmonary disease (COPD) is a common public health problem worldwide. Recent studies have reported that socioeconomic status (SES) is related to the incidence of COPD. This study aimed to investigate the association between SES and COPD among adults in Jiangsu province, China, and to determine the possible direct and indirect effects of SES on the morbidity of COPD.@*METHODS@#A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province, China. Participants were selected using a multistage sampling approach. COPD, the outcome variable, was diagnosed by physicians based on spirometry, respiratory symptoms, and risk factors. Education, occupation, and monthly family average income (FAI) were used to separately indicate SES as the explanatory variable. Mixed-effects logistic regression models were introduced to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for examining the SES-COPD relationship. A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES.@*RESULTS@#The mean age of the 2421 participants was 56.63 ± 9.62 years. The prevalence of COPD was 11.8% (95% CI: 10.5%-13.1%) among the overall sample population. After adjustment for age, gender, residence, outdoor and indoor air pollution, body weight status, cigarette smoking, and potential study area-level clustering effects, educational attainment was negatively associated with COPD prevalence in men; white collars were at lower risk (OR: 0.60, 95% CI: 0.43-0.83) of experiencing COPD than blue collars; compared with those within the lower FAI subgroup, participants in the upper (OR: 0.68, 95% CI: 0.49-0.97) tertiles were less likely to experience COPD. Such negative associations between all these three SES indicators and COPD were significant among men only. Education, FAI, and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC), FEV1, FVC, and FEV1 percentage of predicted. Education, FAI, and occupation had indirect effects on pulmonary function indices of all participants mainly through smoking status, indoor air pollution, and outdoor air pollution. We also found that occupation could affect post-bronchodilator FEV1/FVC through body mass index.@*CONCLUSIONS@#Education, occupation, and FAI had an adverse relationship with COPD prevalence in Jiangsu province, China. SES has both direct and indirect associations with pulmonary function impairment. SES is of great significance for COPD morbidity. It is important that population-based COPD prevention strategies should be tailored for people with different SES.


Subject(s)
Adult , Aged , China/epidemiology , Cross-Sectional Studies , Forced Expiratory Volume , Humans , Male , Middle Aged , Prevalence , Pulmonary Disease, Chronic Obstructive/epidemiology , Risk Factors , Social Class , Spirometry , Vital Capacity
9.
Article in Chinese | WPRIM | ID: wpr-887497

ABSTRACT

OBJECTIVE@#To observe the regulatory effect of electroacupuncture (EA) on small airway function and exercise tolerance in patients with stable chronic obstructive pulmonary disease (COPD).@*METHODS@#A total of 62 patients with stable COPD were randomized into an observation group (31 cases, 1 case dropped off) and a control group (31 cases, 5 cases dropped off). On the base of routine medication and aerobic exercise, the patients of the two groups all received EA at Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and Yingchuang (ST 16). In the observation group, filiform needles were used and inserted perpendicularly, 3 mm in depth. In the control group, the placebo needling method was performed, in which the needle was not inserted through skin at each point. In both groups, electric stimulation with low-frequency electronic pulse instrument was exerted, with continuous wave, 2 Hz in frequency, lasting 30 min each time in the two groups. The treatment was given once every other day, 3 times a week, for 14 treatments totally. Before and after treatment, the following indexes were compared in patients between the two groups, i.e. the lung function indexes (forced expiratory volume in first second [FEV1], forced vital capacity [FVC], the ratio of FEV1 to FVC [FEV1/FVC], maximal voluntary ventilation [MVV], the percentage of maximal expiratory flow [MEF] at 25% of FVC exhaled [MEF25], MEF50 and MEF75 in predicted value), cardiopulmonary exercise test indexs (metabolic equivalent [METS], oxygen uptake per kg body weight [VO@*RESULTS@#After treatment, FVC%, MVV%, MEF75%, MEF50%, VO@*CONCLUSION@#Electroacupuncture can improve the respiratory function and exercise tolerance in COPD patients through removing small airway obstruction and increasing ventilation.


Subject(s)
Electroacupuncture , Exercise Tolerance , Forced Expiratory Volume , Humans , Pulmonary Disease, Chronic Obstructive/therapy , Respiratory Function Tests
10.
Article in Chinese | WPRIM | ID: wpr-879844

ABSTRACT

OBJECTIVE@#To study the correlation between the bronchial dilation test (BDT) and asthma control level in children with asthma.@*METHODS@#A total of 153 children with asthma, aged 5-14 years, who attended the outpatient service from March 2016 to March 2018 were enrolled. According to the presence or absence of atopic constitution, they were divided into an allergic group with 79 children and a non-allergic group with 74 children. The correlation between BDT and Childhood Asthma Control Test (C-ACT) scores was analyzed for both groups.@*RESULTS@#All basic pulmonary function parameters were positively correlated with C-ACT scores in the non-allergic group (@*CONCLUSIONS@#The improvement rate of BDT is well correlated with C-ACT scores in children with asthma, suggesting that BDT can be used as an index for predicting asthma control level.


Subject(s)
Adolescent , Asthma , Child , Child, Preschool , Dilatation , Forced Expiratory Volume , Humans , Lung , Vital Capacity
11.
Article in English | WPRIM | ID: wpr-922399

ABSTRACT

OBJECTIVES@#To establish a predictive equation for commonly used pulmonary ventilation function parameters in children aged 6-<16 years in northeast China.@*METHODS@#A total of 504 healthy children from Liaoning, Jilin, and Heilongjiang provinces of China were selected for the prospective study, among whom there were 242 boys and 262 girls. The JAEGER MasterScreen Pneumo spirometer was used to measure pulmonary ventilation function. With the measured values of 10 parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV@*RESULTS@#The boys aged 9-<10 years and 15-<16 years had significantly higher body height, FVC, and FEV@*CONCLUSIONS@#A new predictive equation for the main pulmonary ventilation function parameters has been established in this study for children aged 6-<16 years in northeast China, which provides a basis for accurate judgment of pulmonary function abnormalities in clinical practice.


Subject(s)
Child , China , Female , Forced Expiratory Volume , Humans , Male , Prospective Studies , Pulmonary Ventilation , Reference Values , Schools , Vital Capacity
12.
J. bras. pneumol ; 47(6): e20210124, 2021. tab, graf
Article in English | LILACS | ID: biblio-1356421

ABSTRACT

ABSTRACT Objective: The identification of persistent airway obstruction is key to making a diagnosis of COPD. The GOLD guidelines suggest a fixed criterion-a post-bronchodilator FEV1/FVC ratio < 70%-to define obstruction, although other guidelines suggest that a post-bronchodilator FEV1/FVC ratio < the lower limit of normal (LLN) is the most accurate criterion. Methods: This was an observational study of individuals ≥ 40 years of age with risk factors for COPD who were referred to our pulmonary function laboratory for spirometry. Respiratory symptoms were also recorded. We calculated the prevalence of airway obstruction and of no airway obstruction, according to the GOLD criterion (GOLD+ and GOLD−, respectively) and according to the LLN criterion (LLN+ and LLN−, respectively). We also evaluated the level of agreement between the two criteria. Results: A total of 241 individuals were included. Airway obstruction was identified according to the GOLD criterion in 42 individuals (17.4%) and according to the LLN criterion in 23 (9.5%). The overall level of agreement between the two criteria was good (k = 0.67; 95% CI: 0.52-0.81), although it was lower among the individuals ≥ 70 years of age (k = 0.42; 95% CI: 0.12-0.72). The proportion of obese individuals was lower in the GOLD+/LLN+ category than in the GOLD+/LLN− category (p = 0.03), as was the median DLCO (p = 0.04). Conclusions: The use of the GOLD criterion appears to be associated with a higher prevalence of COPD. The agreement between the GOLD and LLN criteria also appears to be good, albeit weaker in older individuals. The use of different criteria to define airway obstruction seems to identify individuals with different characteristics. It is essential to understand the clinical meaning of discordance between such criteria. Until more data are available, we recommend a holistic, individualized approach to, as well as close follow-up of, patients with discordant results for airway obstruction.


RESUMO Objetivo: A identificação de obstrução persistente das vias aéreas é fundamental para o diagnóstico de DPOC. As diretrizes da GOLD sugerem um critério fixo - relação VEF1/CVF pós-broncodilatador < 70% - para definir obstrução, embora outras diretrizes sugiram que a relação VEF1/CVF pós-broncodilatador < o limite inferior da normalidade (LIN) é o critério mais preciso. Métodos: Estudo observacional com indivíduos ≥ 40 anos de idade com fatores de risco para DPOC encaminhados ao nosso laboratório de função pulmonar para espirometria. Também foram registrados sintomas respiratórios. Calculamos a prevalência de obstrução e de ausência de obstrução das vias aéreas segundo o critério GOLD (GOLD+ e GOLD−, respectivamente) e segundo o critério LIN (LIN+ e LIN−, respectivamente). Avaliamos também o grau de concordância entre os dois critérios. Resultados: Foram incluídos 241 indivíduos. Obstrução das vias aéreas foi identificada segundo o critério GOLD em 42 indivíduos (17,4%) e segundo o critério LIN em 23 (9,5%). A concordância global entre os dois critérios foi boa (k = 0,67; IC95%: 0,52-0,81), embora tenha sido menor entre os indivíduos ≥ 70 anos de idade (k = 0,42; IC95%: 0,12-0,72). A proporção de obesos foi menor na categoria GOLD+/LIN+ do que na categoria GOLD+/LIN− (p = 0,03), assim como a mediana de DLCO (p = 0,04). Conclusões: A utilização do critério GOLD parece estar associada a uma maior prevalência de DPOC. A concordância entre os critérios GOLD e LIN também parece ser boa, embora seja mais fraca em indivíduos mais velhos. A utilização de diferentes critérios para definir obstrução das vias aéreas parece identificar indivíduos com diferentes características. É essencial compreender o significado clínico da discordância entre esses critérios. Até que mais dados estejam disponíveis, recomendamos uma abordagem holística e individualizada e também um acompanhamento cuidadoso dos pacientes com resultados discordantes para obstrução das vias aéreas.


Subject(s)
Humans , Aged , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Airway Obstruction/diagnosis , Airway Obstruction/etiology , Airway Obstruction/epidemiology , Spirometry , Vital Capacity , Forced Expiratory Volume , Risk Factors
13.
Iatreia ; 33(3): 229-238, jul.-set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1143074

ABSTRACT

RESUMEN Objetivo: evaluar el uso del cuestionario COPD-PS y el dispositivo portátil Vitalograph COPD- 6, como estrategia para el diagnóstico temprano de la enfermedad pulmonar obstructiva crónica (EPOC) en dos unidades de atención primaria de la empresa social del estado (E.S.E): Metrosalud, Medellín-Colombia en 2017. Métodos: estudio transversal de detección temprana de la EPOC, en personas mayores de 35 años sin diagnóstico previo de la enfermedad u otras complicaciones respiratorias subyacen-tes, a las cuales se les aplicó la prueba de tamizaje de COPD-PS para identificar factores de riesgo respiratorio y, posteriormente, la prueba de volumen espiratorio forzado (VEF1/VEF6) con el dispositivo portátil Vitalograph COPD-6. Resultados: de 1.485 pruebas de tamizaje COPD-PS, 198 presentaron un puntaje igual o su-perior a 4, por lo que se les realizó la prueba con el dispositivo Vitalograph. De los cuales, 147 (74,2 %) resultaron positivos. Discusión: el subregistro de la EPOC se describe actualmente como un grave problema mundial. El uso del cuestionario COPD-PS para la identificación de pacientes con factores de riesgo y del Vitalograph COPD-6 como prueba de función pulmonar, pueden ser herramientas útiles para implementar una estrategia efectiva en la reducción del subregistro de la EPOC.


SUMMARY Objective: To evaluate the use of the COPD-PS questionnaire and the Vitalograph COPD-6 portable device, as a strategy for the early diagnosis of chronic obstructive pulmonary disease (COPD) in two primary care units of the state social enterprise (ESE): Metrosalud, Medellin-Colombia in 2017. Methods: A cross-sectional study to early detection of COPD, in people older than 35 years without previous diagnosis of the disease or other underlying respiratory diseases. The "COPD-PS" case detection-screening test was applied for identify respiratory risk fac-tors and then the forced expiratory volume test (VEF1/VEF6) with the portable device Vitalograph-COPD-6. Results: Of 1485 COPD-PS screening tests, 198 had a score equal to or greater than four, so they were tested with the Vitalograph device, of which 147 (74.2%) were positive. Discussion: The underreporting of Chronic Obstructive Pulmonary Disease (COPD) is currently described as a serious problem worldwide. The use of the COPD-PS questionnaire for the identification of patients with risk factors and the Vitalograph COPD-6 as a lung function test, can be useful tools to implement an effective strategy to reduce COPD underreporting.


Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive , Forced Expiratory Volume
14.
Gac. méd. Méx ; 156(4): 283-289, Jul.-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1249912

ABSTRACT

Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is the most prevalent respiratory problem in the world. Patients with human immunodeficiency virus (HIV) infection have a higher prevalence of smoking and recurrent lung infections and are at higher risk of COPD. Objective: To determine the prevalence of COPD in HIV-diagnosed patients referred to an infectious diseases hospital. Method: Individuals with HIV infection without previous or ongoing antiretroviral treatment, with chronic respiratory symptoms, with or without a history of exposure for the development of COPD were included. Pre- and post-bronchodilation spirometry, high-resolution computed tomography, viral load determination and CD4 count were carried out. Spirometry measurements were compared with Wilcoxon’s test. Results: Sixty-six HIV-diagnosed patients, with a mean age of 31.5 years were included; 64 were males and two females. The prevalence of COPD was 7.6 %. The group with obstruction had a lower CD4 count (27.3 versus 225.9) and higher viral load (165,000 versus 57,722), in comparison with the group without obstruction. A positive correlation was observed between lower viral load and higher forced expiratory volume in 1 second/forced vital capacity ratio. Conclusion: HIV-positive patients with a lower CD4 count and a higher viral load show a decrease in spirometry values.


Resumen Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) es el problema respiratorio de mayor prevalencia en el mundo. Los pacientes con infección por virus de la inmunodeficiencia humana (VIH) tienen mayor prevalencia de tabaquismo e infecciones pulmonares recurrentes y mayor riesgo de EPOC. Objetivo: Determinar la prevalencia de la EPOC en pacientes con diagnóstico de VIH referidos a un hospital de infectología. Método: Se incluyeron individuos con infección por VIH sin tratamiento antirretroviral previo o actual, con sintomatología respiratoria crónica, con o sin antecedentes de exposición para desarrollar EPOC. Se realizó espirometría pre y posbroncodilatación, tomografía computarizada de alta resolución, determinación de carga viral y conteo de CD4. Las mediciones espirométricas se compararon con prueba de Wilcoxon. Resultados: Se incluyeron 66 pacientes con diagnóstico de VIH, con edad de 31.5 años; 64 hombres y dos mujeres. La prevalencia de EPOC fue de 7.6 %. El grupo con obstrucción presentó menor conteo de CD4 (27.3 versus 225.9) y mayor carga viral (165 000 versus 57 722), en comparación con el grupo sin obstrucción. Se observó correlación positiva entre menor carga viral y mayor relación de volumen espiratorio forzado al primer segundo/capacidad vital forzada. Conclusión: Los pacientes VIH-positivos con menor conteo de CD4 y mayor carga viral presentan disminución de los valores espirométricos.


Subject(s)
Humans , Male , Female , Adult , Smoking/epidemiology , HIV Infections/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Spirometry , Tomography, X-Ray Computed , HIV Infections/virology , Vital Capacity , Forced Expiratory Volume , Prevalence , Cross-Sectional Studies , Risk Factors , CD4 Lymphocyte Count , Viral Load
15.
Cuad. Hosp. Clín ; 61(1): [7], jul. 2020. ilus.
Article in Spanish | LILACS, LIBOCS | ID: biblio-1118888

ABSTRACT

INTRODUCCIÓN: el objetivo de este estudio fue verificar si los puntos de corte fijos y el límite inferior de lo normal (LLN) para el volumen espiratorio forzado en un segundo (FEV1) y el volumen espiratorio forzado en 6 segundos (FEV6) FEV1/FEV6 y el FEV6 son una medida alternativa para el FEV1 y la capacidad vital forzada (FVC), FEV1/FVC y la FVC en la detección de la enfermedad pulmonar obstructiva crónica (EPOC), en una muestra de pacientes del oriente boliviano. MÉTODOS: se analizaron un total de 92 pruebas espirométricas, 66 varones y 26 mujeres con riesgo de EPOC. La población del estudio incluyó a residentes de la ciudad de Santa Cruz de la Sierra-Bolivia (ciudad cosmopolita) de 35 a 90 años de edad. RESULTADOS: la sensibilidad y la especificidad fueron del 97,0% y el 96,9%, respectivamente, cuando se compararon los valores de corte fijos de FEV1/FEV6 de 0,73 con los de FEV1/FVC < 0,7 como regla estándar, según las recomendaciones del global obstructive lung diseases (GOLD) para detectar la obstrucción de las vías respiratorias. La sensibilidad y la especificidad fueron de 93,4% y 81,2%, respectivamente, cuando el LLN de FEV1/FVC y FEV1/FEV6 fueron utilizados. CONCLUSIONES: en conclusión, el FEV6 es un sustituto válido de la CVF para detectar la obstrucción de las vías respiratorias, ya sea utilizando puntos de corte fijos o el LLN. Se necesitan más estudios para verificar estos resultados en una población más grande y para establecer los valores predictivos espirométricos locales.


INTRODUCTION: the aim of this study was to verify if fixed cut-off points and lower limit of normal (LLN) for forced expiratory volume in one second (FEV1)/FEV6 and FEV6 as an alternative for FEV1/forced vital capacity (FVC) and FVC are valid for the detection of obstructive lung disease in a sample of Bolivian subjects. METHODS: a total of 92 spirometric consecutive tests from subjects, 66 males and 26 females at risk for COPD were analyzed. The study population included residents of city Santa Cruz de la Sierra, (Bolivia) aged from 35 to 90 yrs., from various ethnical origins (cosmopolitan city). RESULTS: sensibility and specificity were 97.0% and 96.9%, respectively when fixed cut-off values of FEV1/FEV6 of 0.73 was compared to FEV1/FVC<0.7 as standard, according to GOLD recommendations to detect airway obstruction. Sensibility and specificity were 100% and 89.5%, respectively when LLN of FEV1/FVC and FEV1/FEV6 were used. CONCLUSIONS: in conclusion, FEV6 is a valid surrogate for FVC to detect airway obstruction, either using fixed cut-off points or LLN. Further study is needed to verify these results in a larger population and to establish local spirometric predicted values


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Forced Expiratory Volume , Sensitivity and Specificity , Pulmonary Disease, Chronic Obstructive , Women , Vital Capacity
16.
J. pediatr. (Rio J.) ; 96(2): 255-264, Mar.-Apr. 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1135013

ABSTRACT

Abstract Objective: To compare the values of the markers for volumetric capnography and spirometry and their ability to classify children and adolescents with asthma, cystic fibrosis (CF), and healthy controls. Methods: This was a cross-sectional study that included 103 patients with controlled persistent allergic asthma, 53 with CF and a healthy control group with 40 volunteers (aged 6 to 15 years), of both sexes. The individuals underwent volumetric capnography and spirometry. Results: Phase III slope (SIII), SIII standardized by exhaled tidal volume (SIII/TV) and capnographic index (SIII/SII) × 100 (KPIv) were different among the three groups assessed, with highest values for CF. The relation between the forced expiratory volume in one second and the forced vital capacity (FEV1/FVC) was the only spirometric marker that presented difference on the three groups. On individuals with normal spirometry, KPIv and FEV1/FVC were different among the three groups. The ROC curve identified the individuals with asthma or CF from the control group, both through volumetric capnography (better to identify CF in relation to the control using KPIv) and through spirometry (better to identify asthma in relation to the control). KPIv was the best parameter to distinguish asthma from CF, even in individuals with normal spirometry. Conclusion: Volumetric capnography and spirometry identified different alterations in lung function on asthma, CF, and healthy controls, allowing the three groups to be distinguished.


Resumo Objetivo Comparar os valores dos marcadores para capnografia volumétrica e espirometria e sua capacidade de classificar crianças e adolescentes com asma, fibrose cística (FC) e controles saudáveis. Métodos Foi realizado um estudo transversal que incluiu 103 pacientes com asma alérgica persistente controlada, 53 com FC e um grupo controle saudável com 40 voluntários (6 a 15 anos), de ambos os sexos. Os indivíduos foram submetidos a capnografia volumétrica e espirometria. Resultados O slope da fase III (SIII), SIII padronizada pelo volume tidal exalado (SIII/VT) e o índice capnográfico (SIII/SII) × 100 (KPIv) foram diferentes entre os três grupos avaliados, com maiores valores para o grupo FC. A relação entre o volume expiratório forçado no primeiro segundo e a capacidade vital forçada (VEF1/CVF) foi o único marcador de espirometria com diferenças nos três grupos. Nos indivíduos com espirometria normal, o KPIv e VEF1/CVF foram diferentes entre os três grupos. A curva ROC diferenciou os indivíduos com asma ou FC daqueles do grupo controle, ambos através da capnografia volumétrica (melhor para identificar a FC em relação aos controles pelo KPIv) e por meio da espirometria (melhor para identificar a asma em relação aos controles). O KPIv foi o melhor parâmetro para distinguir a asma da FC, mesmo em indivíduos com espirometria normal. Conclusão A capnografia volumétrica e a espirometria identificaram diferentes alterações de função pulmonar na asma, na FC e nos controles saudáveis, permitiram que os três grupos fossem diferenciados.


Subject(s)
Humans , Male , Female , Child , Adolescent , Asthma , Cystic Fibrosis , Spirometry , Vital Capacity , Forced Expiratory Volume , Cross-Sectional Studies , Capnography
17.
Rev. chil. enferm. respir ; 36(1): 13-17, mar. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1115457

ABSTRACT

Las guías ATS/ERS recomiendan utilizar valores de referencia nacionales para la interpretación de la espirometría. En 2014 se publicaron valores de referencia en población general chilena adulta, que difieren de los de Knudson actualmente en uso. Sin embargo, la mayoría de los laboratorios de función pulmonar siguen utilizando estas últimas ecuaciones. En 2012 se publicaron las ecuaciones multi-étnicas de la Global Lung Function Initiative (GLI) a fin de estandarizar mundialmente la interpretación de los exámenes de función pulmonar Nuestro objetivo fue comparar la concordancia de los informes espirométricos utilizando las ecuaciones más usadas en Chile versus las GLI. Métodos: Se comparó la concordancia en interpretación del patrón espirométrico (normal, obstructivo y restrictivo) y el grado de alteración, entre GLI con Gutiérrez 2014, con Knudson, y con NHANES III según las recomendaciones de la Sociedad Chilena de Enfermedades Respiratorias, a través del coeficiente de concordancia Kappa (K). Se estudiaron 315 sujetos mayores de 40 años (55% mujeres, edad: 59,3 ± 9,2 años), fumadores o ex fumadores, sanos o con EPOC, sometidos a una espirometría con broncodilatador como parte de un reconocimiento respiratorio. Se graficaron las diferencias utilizando el método de Bland-Altman. Resultados: La concordancia para patrón entre GLI con Gutiérrez 2014, con Knudson y con NHANES III fue buena (K = 0,73; 0,71 y 0,77 respectivamente), al igual que para patrón y grado de alteración (K = 0,68; 0,67 y 0,76 respectivamente). Conclusiones: Encontramos una buena concordancia entre las ecuaciones más usadas en Chile y las de GLI, en una muestra que incluyó adultos, fumadores, ex fumadores sanos y enfermos.


ATS/ERS recommend the use of national reference values for the interpretation of spirometry. Reference values were published (2014) in general adult Chilean population, which are different from those of Knudson currently in use. However, most pulmonary function laboratories continue to use these latter equations. Multi-ethnic Global Lung Function Initiative (GLI) equations were published (2012) in order to standardize the interpretation of pulmonary function tests worldwide. Our objective was to evaluate the agreement in the spirometric reports between the most used equations in Chile with those from GLI. Methods: We compared the agreement in the interpretation of the spirometric pattern (normal, obstructive and restrictive) and the degree of alteration between GLI with Gutiérrez 2014, with Knudson and with NHANES III according to recommendations of the Chilean Society of Respiratory Diseases, through the Kappa concordance coefficient (K). The sample correspond to 315 adults over 40 years of age (55% women, 59.3 ± 9.2 years-old), smokers or ex-smokers, healthy or with COPD, who underwent spirometry with a bronchodilator as part of a respiratory check-up. Differences were plotted using the Bland-Altman method. Results: agreement for pattern between GLI with Gutiérrez 2014, with Knudson and with NHANES III was good (K = 0.73, 0.71 and 0.77 respectively) and also was good for the pattern and degree of alteration (K = 0.68, 0.67 and 0.76 respectively). Conclusions: We found a good agreement between the equations most used in Chile and those from the GLI, for a sample that includes subjects with and without lung disease, smokers and ex-smokers.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Spirometry/methods , Spirometry/standards , Lung/physiology , Models, Theoretical , Reference Values , Respiratory Function Tests/methods , Respiratory Function Tests/standards , Societies, Medical , Vital Capacity/physiology , Forced Expiratory Volume/physiology
18.
Neumol. pediátr. (En línea) ; 15(4): 484-490, 2020. tab, ilus
Article in Spanish | LILACS | ID: biblio-1146395

ABSTRACT

Cystic Fibrosis is a multisystemic inherited disease that requires ongoing care by multidisciplinary teams. The objective of this study is to describe changes on nutrition and lung function in a cohort of patients in a Cystic Fibrosis (CF) Care Center at the Hospital Infantil Universitario San José in Bogotá (HIUSJ), between 2010 and 2013.Is a descriptive study in a cohort of CF patients during four years of follow-up. The quantitative variables were described using medians and interquartile ranges, and the qualitative variables with absolute frequencies and percentages. Descriptive statistics was used to summarize the findings. Of the 63 patients in the initial group, 47 (74.6%) completed the follow-up time. The age range was between 3 to 30 years. The median BMI increased as follows: 17.9 (RIQ: 12.5-25.6) in 2010, 18.6 (RIQ: 12.9-24.8) in 2011, 18.9 RIQ (13.6-26.5) in 2012 and 19.0 (RIQ: 13.5-25.8) in 2013, with lower values in men. The forced expiratory volume in the first second (FEV1) at admission was classified as severe (FEV1 <40%) in 7.1%, moderate (FEV1 40-69%) in 35.7%, mild (FEV1 70-79%) in 7.1% and as normal (FEV1> 80%) in 50%. It is concluded that during the 4 years of follow-up at the HIUSJ CF Center there is an improvement in BMI and a deterioration in lung function in the whole group. The importance of establishing more reference centers to improve clinical outcomes and of implement a National registry to follow up over time are highlighted.


La fibrosis quística es una enfermedad hereditaria, multisistémica, cuyo manejo continuo requiere de equipos multidisciplinarios de salud. El objetivo de este trabajo es describir la evolución nutricional y de la función pulmonar en una cohorte de pacientes en el centro de atención integral de la fibrosis quística (FQ), del Hospital Infantil Universitario San José de Bogotá (HIUSJB), entre 2010 y 2013. Estudio descriptivo, en una cohorte de pacientes, en seguimiento durante cuatro años. Las variables cuantitativas fueron descritas mediante medianas y rangos intercuartílicos y las cualitativas con frecuencias absolutas y porcentajes. De los 63 pacientes del grupo inicial, 47 (74.6%), completaron el tiempo de seguimiento. El rango de edad fue de 3 a 30 años. La mediana del IMC (índice de masa corporal) se incrementó así: 17.9 (RIQ:12.5-25.6) en el 2010, 18.6 (RIQ:12.9-24.8) en el 2011, 18.9 ( RIQ(13.6-26.5) en el 2012 y 19.0 (RIQ:13.5-25.8) en el 2013, con menores valores en los hombres. El volumen espiratorio forzado en el primer segundo (VEF1) al ingreso fue clasificado como severo (VEF1<40%) en el 7.1%, moderado (VEF1 40-69%) en el 35.7%, leve (VEF1 70-79%) en el 7.1% y como normal (VEF1>80%) en el 50%. Se concluye que durante los 4 años de seguimiento en el programa de FQ del HIUSJ, ocurre una mejoría del IMC en todo el grupo y un deterioro de la función pulmonar. Se resalta la importancia de constituir más centros de referencia para mejorar los desenlaces clínicos e implementar un registro Nacional para hacer seguimiento a través del tiempo.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Respiratory Function Tests , Nutritional Status , Delivery of Health Care, Integrated , Cystic Fibrosis/physiopathology , Pseudomonas aeruginosa/isolation & purification , Staphylococcus aureus/isolation & purification , Body Mass Index , Clinical Evolution , Forced Expiratory Volume , Epidemiology, Descriptive , Cohort Studies , Follow-Up Studies , Cystic Fibrosis/microbiology , Hospitalization/statistics & numerical data
19.
Clinics ; 75: e1512, 2020. tab, graf
Article in English | LILACS | ID: biblio-1055871

ABSTRACT

OBJECTIVES: This study aimed to analyze the efficiency of physiotherapy techniques in sputum induction and in the evaluation of pulmonary inflammation in asthmatic children and adolescents. Although hypertonic saline (HS) is widely used for sputum induction (SI), specific techniques and maneuvers of physiotherapy (P) may facilitate the collection of mucus in some asthmatic children and adolescents. METHODS: A randomized crossover study was performed in patients with well-controlled asthma, and 90 sputum samples were collected. Children and adolescents were assessed using spirometry and randomized at entry into one of three sputum induction techniques: (i) 3% hypertonic saline - HS technique; (ii) physiotherapy (oscillatory positive expiratory pressure, forced expiration, and acceleration of expiratory flow) - P technique; and (iii) hypertonic saline + physiotherapy - HSP technique. ClinicalTrials.gov: NCT03136042. RESULTS: The total cells (mL) and the percentage (%) of differential inflammatory cells were similar in all techniques. The sputum weight (g) in the HSP technique was significantly higher than that in the HS technique. In all techniques, the percentage of viable cells was >50%, and there was no difference between the HS and P techniques. Moreover, sputum induction did not cause any alterations in the pulmonary function of patients. CONCLUSION: The physiotherapy sputum collection technique was effective in obtaining viable cells from mucus samples and yielded the same amount of sputum as the gold standard technique (hypertonic saline). In addition, the physiotherapy maneuvers were both safe and useful for sputum induction in asthmatic children and adolescents with well-controlled asthma.


Subject(s)
Humans , Child , Adolescent , Asthma/complications , Saline Solution, Hypertonic , Sputum , Physical Therapy Modalities , Forced Expiratory Volume , Cross-Over Studies
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