Correlación de la distancia recorrida en la caminata de 6 minutos y puntajes de comorbilidad Charlson y Elixhauser / Correlation of distance traveled in the 6 minute walk and Charlson and Elihauser comorbidity scores

Introduction: The walking test of 6 minutes (6MW) is a test that merges the answer of different systems (respiratory, cardiovascular, metabolic, skeletal muscle and neurosensorial) and offers an useful objective result to lead therapeutic measurements and stablish a prognosis, it's possible that the comorbid patient lowers their functional reserve and alters the result of the test not only because of the presence of pathologies cardiorespiratory, nevertheless, information about the correlation between the scores of comorbidity and the traveled distance in the 6MW is limited. Objective: Determine the correlation between the traveled distance in the 6MW and the scores of comorbidities of Charlson and Elixhauser. Methods: A cross-sectional study was made, in patients taken to the 6MW made between 2006 until March 2020, in a hospital of high complexity; there were included patients older than 18 years old, whose clinic history record and walk of 6 minutes were available. The index of Charlson and Elixhauser were calculated in the 6MW, a bivariate analysis was made between the antecedents of pathologies and the traveled distance, independently and adjusted, the spearman correlation coefficient was calculated for the different scores and the distance in meters of the 6MW, was considerate a significative p: <0,05. Results: to the final analysis 491 subjects entered, the average age was of 69 years old (sd: 14,9), 54% male, the 15,3% had an abnormal walk less than the 80% of the expected, the diseases that were considered had a statistically significant relation with the decrease of the distance in the 6MW were arterial hypertension (p: <0,001), chronic heart failure (p=0,037), heart arrhythmia (p=0,003), smoking (p=0,022), chronic pulmonary obstruction disease (p: <0,001), dementia (p=0,03diabetes mellitus with target organ damage (p=0,01), moderate to severe chronic kidney disease (p=0,012), obesity (p=0,036) y lymphoma (p=0,038 the spearman correlation coefficient between the traveled distances and Charlson was of -0,343 (IC95%:-0,420 -0,264)(p: < 0,001) and -0,213(IC95%:-0,285 -0,116)(p: <0,001) with the Elixhauser index. Conclusion: The distances walked in meters in the 6MW has a reverse low correlation with the comorbidity index, the diseases that were not cardiopulmonary and that related independently with changes in the traveled dist ance are smoking, dementia, diabetes mellitus, chronic kidney disease, obesity, and lymphoma. Key words: Comorbidities, Walk, Test, Cardiopulmonary, Charlson, Elixhauser

Pathology of pulmonary hypertension and schistosomiasis mansoni

We report a case of a 33-year-old woman with grade IV pulmonary hypertension and end stage cor pulmonale secondary to chronic schistosomiasis (bilharziasis). The pathophysiology and morphologic features are discussed. Schistosomiasis is an important etiology to consider in the differential diagnosis of pulmonary hypertension

Causas anatômicas do "cor pulmonale" crônico em hospital universitário da regiäo de Campinas, SP: estudo necroscópico retrospectivo / Anatomical causes of cor pulmonale in an university hospital of the region of Campinas, SP

Os autores analisaram em necrópsias as causas que levaram ao cor pulmonale crônico (CPC). Em 917 necrópsias de pacientes com a idade variando entre 11 e 90 anos, realizadas no período de 1965 a 1975, havia 64 casos de cor pulmonale crônico (6,9%). A freqüência de CPC foi maior em pessoas brancas, do que em pretas e pardas; näo houve diferença quanto ao sexo. A maioria dos casos de CPC (85,9%) ocorreu entre a 5§ a 8§ década da vida. As causas mais freqüêntes de CPC (71,6%) foram: enfisema (34,3%), fibrose pulmonar por tuberculose (18,7%), fibrose pulmonar por outras etiologias e pneumonias crônicas (9,3%) e bronquectasia (9,3%). A raridade da paracoccidioidomicose (3/64 casos) e da esquistossomose (1/64 casos) deve-se à sua baixa freqüência nesta casuística necroscópica