Vivendo bem com DPOC: orientações para o autocuidado / Vivendo bem com DPOC: orientações para o autocuidado

Produto do projeto: Impacto da coordenação e acompanhamento do cuidado por telemonitoramento na qualidade da assistência prestada aos usuários do SUS portadores de doenças crônicas, egressos de internação hospitalar em Belo Horizonte, MG, Brasil.

pH in exhaled breath condensate and nasal lavage as a biomarker of air pollution-related inflammation in street traffic-controllers and office-workers

OBJECTIVE: To utilize low-cost and simple methods to assess airway and lung inflammation biomarkers related to air pollution. METHODS: A total of 87 male, non-smoking, healthy subjects working as street traffic-controllers or office-workers were examined to determine carbon monoxide in exhaled breath and to measure the pH in nasal lavage fluid and exhaled breath condensate. Air pollution exposure was measured by particulate matter concentration, and data were obtained from fixed monitoring stations (8-h work intervals per day, during the 5 consecutive days prior to the study). RESULTS: Exhaled carbon monoxide was two-fold greater in traffic-controllers than in office-workers. The mean pH values were 8.12 in exhaled breath condensate and 7.99 in nasal lavage fluid in office-workers; these values were lower in traffic-controllers (7.80 and 7.30, respectively). Both groups presented similar cytokines concentrations in both substrates, however, IL-1β and IL-8 were elevated in nasal lavage fluid compared with exhaled breath condensate. The particulate matter concentration was greater at the workplace of traffic-controllers compared with that of office-workers. CONCLUSION: The pH values of nasal lavage fluid and exhaled breath condensate are important, robust, easy to measure and reproducible biomarkers that can be used to monitor occupational exposure to air pollution. Additionally, traffic-controllers are at an increased risk of airway and lung inflammation during their occupational activities compared with office-workers. .

rapid and accurate method for prevention and control of methicillin-resistant staphylococcus aureus in the ICU

Methicillin-resistant S. aureus [MRSA] oxacillin - resistant S. aureus [ORSA] is frequently encountered in health-care settings. Early screening for MRSA nasal colonization can identify patients requiring isolation and can be part of an effective infection control program. This study aimed to provide same-day results to facilitate rapid diagnosis and therapy MRSA to avoid hospital-acquired infections. A total of 80 patients from the medical intensive care units [ICUs] of El-Demerdash Hospital, Cairo Egypt, were screened for MRSA colonization. Two nasal swabs were collected from each patient, the first vortexed in the Liquid Stuart medium and two aliquots of 200 micro l were collected from the medium and tested. For direct culture, the 200 micro l aliquot was inoculated directly onto MRSA screening medium agar plate and incubated at 35[degree sign]C for 24-48h. The other 200 micro l aliquot was first cultured in a pre-enrichment broth medium for 24 hours at 35[degree sign]C, thereafter cultured onto MRSA screening medium agar for another 24-48 hr at 35[degree sign]C. The second swab was used to screen MRSA by a qualitative real-time PCR. Sixty six swabs [82.5%] were negative by culture and real time PCR for MRSA. Fourteen swab samples [17.5%] were positive by both methods. None was positive by culture only [0%], while the PCR assay detected additional four MRSA positive specimens [i.e 5%]. The sensitivity, specificity, positive-predictive value and negative-predictive value for PCR were 100%, 93.9%, 77.8% and 100%, respectively. Real-time PCR testing of nasal specimens can be used as a rapid and reliable technique for MRSA surveillance programs in the ICUs

Role of Nasal irrigation in treatment of acute sinusitis [comparative study between alkaline nasal wash and curcumin herbal extract]

Acute sinusitis treatment may be with medications such as antibiotics or in few cases surgery. Natural options are also available. The present study was done to evaluate the efficacy of curcumin herbal extract as nasal irrigation versus alkaline nasal wash as an adjuvant treatment of acute sinusitis. Ninety patients were enrolled in this study, suffering from acute sinusitis. Patients were taken from outpatient clinic of multicenters in Kingdom of Saudi-Arabia from Jan. to June 2009 their age ranged from 25-48 years [mean 32 +/- 2 years]. There were 60 males and 30 females. Patients were divided into 3 equal groups. The first group was treated with curcumin nasal spray 3m1 in each nostril of concentration 1mg/ml twice daily for 10 days. Another group was treated by standerized alkaline nasal wash for 10 days [3 times daily] Both groups also were given the ordinary treatment in the form of antibiotics, analgesic and mucolytics. The third group was given the ordinary treatment only for 10 days .The results of the present study showed a considerable difference between nasal curcumin treatment and other groups. Nasal curcumin was superior to alkaline nasal wash in reducing or eliminating symptoms of acute sinusitis also endoscopically the curcumin group showed a considerable improving for both nasal mucosa and clearance of nasal discharge. Curcumin herbal treatment could help in treatment of acute sinusitis by its anti inflamatory, anti microbial effects

Correlation between some parameters in active seasonal allergic rhinitis: a controlled clinico-immunological study

Allergic rhinitis is a global disease with increasing prevalence worldwide. It is characterized by inflammatory cells and mediators of which, eosinophil and IgE, are playing a central role. IgA with its two forms [serum IgA and secretory IgA] is one of the respiratory system defense mechanisms against pathogens, however, its role and its relation to other allergic inflammatory parameters is still under investigation. This study was conducted on twenty allergic rhinitis patients and ten apparently healthy persons as a control to test the correlation between different parameters in allergic rhinitis including; eosinophil count, IgE, IgA levels and symptoms score in active symptomatic seasonal allergic rhinitis. Results showed that blood eosinophil percentage and nasal eosinophil count as well as serum IgE were significantly increased in patients than controls. Secretory IgA [sIgA] in nasal secretion but not serum IgA was significantly increased in patients group indicating excess local production; which is probably a part in the allergic reaction. There was a positive correlation between serum eosinophil percentage and eosinophil count in nasal secretion and serum IgE levels, which may suggest that eosinophil count in nasal secretions; could be a reliable tool in diagnosis of allergic rhinitis. sIgA in nasal secretions increased in patient's group and is found to be positively correlated to nasal eosinophil count, which may suggest a role of sIgA in the pathogenesis of allergic rhinitis. Although there was a positive correlation between nasal obstruction score and nasal eosinophil count, however, as it is a subjective scoring, it can't be relied on until accurate objective scoring is used to measure nasal obstruction. The present study stressed on the importance of meticulous history taking [symptoms score]. The results stressed on the opinion that serum IgE and eosinophil count are good markers for allergic rhinitis, also, nasal cytology for eosinophil count could be used to assist in diagnosis; it is easy, simple and east to help in differentiation of allergic from non allergic rhinitis. The findings of IgA raise the point that it's measurement could be a good tool to be added to the battery of parameters for diagnosis or evaluation of the severity of allergic rhinitis together with follow up of patients. IgE, IgA, IgG: immunoglobulin E, A, G., sIgA: secretory IgA., HDM: House dust mites, Fc: fraction crystalline, ELISA: Enzyme linked Immunosorbent Assay, ECP: eosinophilic cationic protein, PO: eosinophil peroxidase, EDN: eosinophil- derived neurotoxin, TNF-alpha: tumor necrosis factor alpha, SAR=seasonal allergic rhinitis, HPF: high power field