ABSTRACT
OBJECTIVES: To review the mechanisms involved in the origin of malnutrition in patients with chronic obstructive pulmonary disease (COPD), and to make a systematic review of randomized controlled studies, to clarify the contribution of nutritional supplementation in patients with stable COPD. METHOD: A systematic review of articles published in the field of nutrition, in any language and from several sources, including Medline, Embase, Cinahl, and the Cochrane Registry on COPD, as well as studies presented at congresses in the US and Europe. RESULTS: Studies on nutritional supplementation for more than two weeks showed a very small effect, not reaching statistical significance. A linear regression study found that old age, relative anorexia, and high inflammatory response are associated with non-response to nutritional therapy. CONCLUSION: Currently, there is no evidence that nutritional supplementation is truly effective in patients with COPD. Factors associated with non-response suggest a relationship with the degree of inflammation, including high TNF-alpha levels. Measuring inflammation markers may be useful to determine prognosis and adequate therapy. Treatment with anti-inflammatory cytokines or cytokine inhibitors seems promising for the future.
Subject(s)
Humans , Protein-Energy Malnutrition/etiology , Lung Diseases, Obstructive , Infant Nutritional Physiological Phenomena , Body Composition , Body Mass Index , Protein-Energy Malnutrition/diet therapy , Linear Models , BiomarkersABSTRACT
Objetivo: Determinar, em pacientes com DPOC submetidos a reabilitaçäo pulmonar (RP), as características clínico-funcionais, da avaliaçäo inicial, relacionadas com o ganho aeróbico efetivo (GAE) após treinamento físico supervisionado. Material e métodos: Antes e após um programa multidisciplinar de RP, foram efetuados em 36 homens com DPOC (25 com doença leve a moderada): avaliaçäo clínica e antropométrica, teste da marcha incentivada de seis minutos (TM6), espirometria, gasometria arterial, mensuraçäo das pressöes respiratórias máximas e teste de exercício cardiopulmonar máximo limitado por sintomas (MGC-CPX System). Como parte do programa, os pacientes foram submetidos a treinamento supervisionado de membros...
Subject(s)
Lung Diseases, Obstructive/rehabilitationSubject(s)
Humans , Male , Adult , Bronchi/pathology , Bronchography , Bronchoscopy , Trachea , Tracheobronchomegaly/diagnosisABSTRACT
É relatado um caso de pneumonia supurativa por Salmonella typhimurium em adulto, predisposto `a infecçäo devido a diabetes melito e desnutriçäo, diagnosticada através de punçäo pulmonar. O tratamento se prolongou por 2 e 1/2 meses com cura do processo
