[Variability in walk test conditions in pulmonary rehabilitation programs in Latin America and on the Iberian peninsula]. / Variabilidad en las condiciones de la prueba de la marcha realizada en el contexto de programas de rehabilitación pulmonar en América Latina y en la Península Ibérica.

OBJECTIVE: 1) To determine the frequency of use of the 6-minute walk test in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula; 2) to identify how the test is performed and possible variations from center to center. MATERIALS AND METHODS: A questionnaire was sent to 55 pulmonary rehabilitation centers in Latin America, Portugal, and Spain. RESULTS: Forty-nine (89.1%) centers answered the questionnaire. Forty-seven (95.9%) perform a walk test lasting 6 minutes; 22 (46.8%) take the longest distance of 2 tests as the real one; and 35 (74.5%) carry out the test in a corridor. The course distance ranged from 17 to 90 meters, but in 21 (44.7%) centers, the corridor was between 17 and 30 meters long. In 29 (61.7%) centers, the patients are routinely informed about the time that had elapsed during the test. Verbal encouragement is used in 44 (93.6%) centers. Thirty-eight (80.8%) use supplemental oxygen when a patient needs it. An increase in absolute values in the distance covered is used as a parameter indicating improvement at 21 (46.7%) sites while at 15 (33.3%) other centers the percentage increase is taken as a measure of improvement. CONCLUSIONS: The 6-minute walk test is widely used for the evaluation of the exercise capacity at the pulmonary rehabilitation centers of Latin America and the Iberian Peninsula. However, there is great variability in the way the test is performed.

Variabilidad en las condiciones de la prueba de la marcha realizada en el contexto de programas de rehabilitación pulmonar en América Latina y en la Península Ibérica / Variability in walk test conditions in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula

Objetivos: Determinar la frecuencia de utilización de la prueba de la marcha de 6 min en el contexto de los programas de rehabilitación pulmonar que se llevan a cabo en América Latina y en la Península Ibérica. Definir la forma con la que se realiza esta prueba y las posibles variaciones que presenta en los distintos centros. Material y métodos: Se remitió un cuestionario a 55 centros de rehabilitación pulmonar localizados en América Latina, Portugal y España. Resultados: Respondieron al cuestionario 49 centros (89,1%); en 47 (95,9%) se realizó la prueba de la marcha con una duración de 6 min; en 22 (46,8%) se aceptó la mayor distancia recorrida por el paciente en 2 pruebas como el valor real de la prueba de la marcha; en 35 (74,5%) se realizó la prueba de la marcha en un pasillo; la distancia recorrida osciló entre 17 y 90 m, pero en 21 centros (44,7%) el pasillo tenía una longitud de 17 a 30 m. En 29 centros (61,7%) se informó sistemáticamente a los pacientes del tiempo transcurrido durante la prueba de la marcha; en 44 (93,6%) se animó verbalmente al paciente mientras realizaba la prueba; en 38 (80,8%) se utilizó oxígeno suplementario cuando el paciente lo necesitó. El incremento de los valores absolutos en la distancia recorrida se utilizó como parámetro para determinar la mejoría en 21 centros (46,7%), mientras que en otros 15 (33,3%) se utilizó como parámetro de mejoría el porcentaje de incremento en la distancia recorrida. Conclusiones: La prueba de la marcha de 6 min se utiliza con mucha frecuencia para la evaluación de la capacidad de ejercicio de los pacientes en los centros de rehabilitación pulmonar de América Latina y de la Península Ibérica. Sin embargo, hay grandes variaciones en la forma con la que se lleva a cabo la prueba

Objective: 1) To determine the frequency of use of the 6-minute walk test in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula; 2) to identify how the test is performed and possible variations from center to center. Materials and methods: A questionnaire was sent to 55 pulmonary rehabilitation centers in Latin America, Portugal, and Spain. Results: : Forty-nine (89.1%) centers answered the questionnaire. Forty-seven (95.9%) perform a walk test lasting 6 minutes; 22 (46.8%) take the longest distance of 2 tests as the real one; and 35 (74.5%) carry out the test in a corridor. The course distance ranged from 17 to 90 meters, but in 21 (44.7%) centers, the corridor was between 17 and 30 meters long. In 29 (61.7%) centers, the patients are routinely informed about the time that had elapsed during the test. Verbal encouragement is used in 44 (93.6%) centers. Thirty-eight (80.8%) use supplemental oxygen when a patient needs it. An increase in absolute values in the distance covered is used as a parameter indicating improvement at 21 (46.7%) sites while at 15 (33.3%) other centers the percentage increase is taken as a measure of improvement. Conclusions: The 6-minute walk test is widely used for the evaluation of the exercise capacity at the pulmonary rehabilitation centers of Latin America and the Iberian Peninsula. However, there is great variability in the way the test is performed

Avaliação das equações de referência para predição da distancia percorrida no teste de caminhada de seis minutos em idosos saudaveis brasileiros / Evaluation of the reference equations for predicting walking distances during six-minute walk tests among healthy elderly brazilian subjects

O objetivo deste estudo foi compara as distancias percorridas por idosos no teste de caminhada de seis minutos (TC6) com as distencias previstas pelas equacoesde Enrigh & Sherril, de Troosters et al. e de Enrigh et al. Metodo: 38 idosos saudaveis com idade entre 64 e 82 anos realizaram o TC6 duas vezes. A pressao arterial, as frequencias cardiaca e respiratoria e a saturacao de oxigenio foram mrnsuradas antes e ao final do teste. A analise estatistica empregou o coeficiente de correlacao de Pearson, sendo considerado significativo p<0,05. Resultados: os homens percorreram uma distancia de 410,5 metro e as mulheres, de 371,0 metros. As distancias previstas pelas equacoes de Enrigh & Sherril e Troosters et al. correlacionaram-se com as distancias caminhadas pelas mulheres (r=0,7), nao apresentando correlacao estatisticamente significativa com as distancias percorridas pelos homens. As distancias previstas pela equacao de Enrigh et al. correlacionaram-se com as distancias percorridas por homens (r=0,6) e mulheres (r=0,7). Conclusoes: os resultados demonstram que houve grande variacao entre as distancias percorridas por idosos brasileiros e as previstas pelas equacoes, sendo necessaria a realizacao de estudos adicionais para confirmar a aplicabilidade dessas equacoes para a populacao idosa brasileira

Músculos respiratorios y rehabilitación pulmonar en asmáticos / Respiratory muscles and pulmonary rehabilitation of asthmatics

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An expression system matures: a highly efficient and cost-effective process for phytase production by recombinant strains of Hansenula polymorpha.

An efficient process was developed for the low-cost production of phytases using Hansenula polymorpha. Glucose or glucose syrups, previously reported as repressive substrates, were used as main carbon sources during fermentation. Glucose was even the most productive substrate for high-level production of phytases. Compared with the process using glycerol, the standard carbon source used for this process until now, the use of glucose led to a reduction of more than 80% in the raw materials costs. In addition, exceptionally high concentrations of active enzyme (up to 13.5 g/L) were obtained in the medium, with phytase representing over 97% of the total accumulated protein. These levels greatly exceed those reported so far for any yeast-based expression system. Very efficient downstream processing procedures were developed with product recovery yields over 90%. Both the fermentation and downstream processing were successfully tested in pilot scale up to 2000 L. As a result, H. polymorpha can be used as a highly competitive system for low-cost phytase production.

Simultaneous production and decomposition of clavulanic acid during Streptomyces clavuligerus cultivations.

Clavulanic acid (CA) was produced by Streptomyces clavuligerus in medium containing glycerol and soy meal or soy meal extract. With regard to growth and CA productivity, the microorganism showed significant differences if solid soy meal as such or its extract were applied as the major nitrogen source. If the extract is used, growth and CA production take place simultaneously and in the stationary phase the CA concentration is stagnant or reduces. If soy meal is used, growth is threefold faster and CA is only generated in the stationary phase. In the case of using the soy meal extract, the decrease of the CA concentration is mainly due to decomposition or re-metabolisation of CA in the presence of the microorganism. This conclusion is supported by in vivo and in vitro data on CA decomposition.