Navegando por Palavras-chave "chronic obstructive"

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    Avaliação da capacidade de exercício em portadores de doença pulmonar obstrutiva crônica: comparação do teste de caminhada com carga progressiva com o teste de caminhada com acompanhamento
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2006-04-01) Rosa, Fernanda Warken [UNIFESP]; Camelier, Aquiles Assunção [UNIFESP]; Mayer, Anamaria [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the applicability of the incremental (shuttle) walk test in patients with chronic obstructive pulmonary disease and compare the performance of those patients on the shuttle walk test to that of the same patients on the encouraged 6-minute walk test. METHODS: A cross-sectional study was conducted, in which 24 patients with chronic obstructive pulmonary disease were selected. In random order, patients were, after an initial practice period, submitted to a shuttle walk test and an encouraged 6-minute walk test. RESULTS: The patients obtained a higher heart rate (expressed as a percentage of that predicted based on gender and age) on the encouraged 6-minute walk test (84.1 ± 11.4%) than on the shuttle walk test (76.4 ± 9.7%) (p = 0.003). The post-test sensation of dyspnea (Borg scale) was also higher on the encouraged 6-minute walk test. On average, the patients walked 307.0 ± 89.3 meters on the shuttle walk test and 515.5 ± 102.3 meters on the encouraged 6-minute walk test (p < 0.001). There was a good correlation between the two tests in terms of the distance walked (r = 0.80, p < 0.001). CONCLUSION: The shuttle walk test is simple and easy to implement in patients with chronic obstructive pulmonary disease. The encouraged 6-minute walk test produced higher post-test heart rate and greater post-test sensation of dyspnea than did the shuttle walk test.
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    Can bronchodilators improve exercise tolerance in COPD patients without dynamic hyperinflation?
    (Soc Brasileira Pneumologia Tisiologia, 2014-03-01) Scuarcialupi, Maria Enedina Aquino; Berton, Danilo Cortozi; Cordoni, Priscila Kessar; Squassoni, Selma Denis; Fiss, Elie; Neder, Jose Alberto [UNIFESP]; Fac Ciencias Med Paraiba; Univ Fed Rio Grande do Sul; Fac Med ABC; Queens Univ; Kingston Gen Hosp; Universidade Federal de São Paulo (UNIFESP)
    Objective: To investigate the modulatory effects that dynamic hyperinflation (UFO, defined as a reduction in inspiratory capacity (lC), has on exercise tolerance after bronchodilator in patients with COPD. Methods: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET). On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometiy and submaximal CPET at constant speed up to the limit of tolerance (Tlim). The patients who showed Delta lC(peak-rest) < 0 were considered to present with DH (DH+). Results: In this sample, 21 patients (70%) had DH. The DH+ patients had higher airflow obstruction and lower Tlim than did the patients without Did (DH-). Despite equivalent improvement in FEV1 after bronchodilator, the DH- group showed higher Delta lC(bronchodilator-placebo) at rest in relation to the DH+ group (p < 0.05). However, this was not found in relation to Delta lC at peak exercise between DH+ and DH- groups (0.19 +/- 0.17 L vs. 0.17 +/- 0.15 L, p > 0.05). in addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60% vs. 10% [3-53%]; p > 0.05). Conclusions: Improvement in TLim was associated with an increase in lC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise.
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    Fractal correlation property of heart rate variability in chronic obstructive pulmonary disease
    (Dove Medical Press Ltd, 2011-01-01) Carvalho, Tatiana Dias de [UNIFESP]; Pastre, Carlos Marcelo; Godoy, Moacir Fernandes de; Fereira, Celso [UNIFESP]; Pitta, Fabio O.; Abreu, Luiz Carlos de; Ramos, Ercy Mara Cipulo [UNIFESP]; Valenti, Vitor Engrácia [UNIFESP]; Vanderlei, Luiz Carlos Marques; Univ Estadual Paulista; Universidade Federal de São Paulo (UNIFESP); Fac Med Sao Jose do Rio Preto; Universidade Estadual de Londrina (UEL); Fac Med ABC
    Background: It was reported that autonomic nervous system function is altered in subjects with chronic obstructive pulmonary disease (COPD). We evaluated short-and long-term fractal exponents of heart rate variability (HRV) in COPD subjects.Patients and methods: We analyzed data from 30 volunteers, who were divided into two groups according to spirometric values: COPD (n = 15) and control (n = 15). for analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 30 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal] and RMSSD [root-mean square of differences]) and frequency domains (low frequency [LF], high frequency [HF], and LF/HF), and the short-and long-term fractal exponents were obtained by detrended fluctuation analysis. We considered P < 0.05 to be a significant difference.Results: COPD patients presented reduced levels of all linear exponents and decreased short-term fractal exponent (alpha-1: 0.899 +/- 0.18 versus 1.025 +/- 0.09, P = 0.026). There was no significant difference between COPD and control groups in alpha-2 and alpha-1/alpha-2 ratio.Conclusion: COPD subjects present reduced short-term fractal correlation properties of HRV, which indicates that this index can be used for risk stratification, assessment of systemic disease manifestations, and therapeutic procedures to monitor those patients.
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    Influência das características sociodemográficas e clínicas e do nível de dependência na qualidade de vida de pacientes com DPOC em oxigenoterapia domiciliar prolongada
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2012-06-01) Cedano, Simone [UNIFESP]; Belasco, Angélica Gonçalves Silva [UNIFESP]; Traldi, Fabiana [UNIFESP]; Machado, Maria Christina Lombardi Oliveira [UNIFESP]; Bettencourt, Ana Rita de Cassia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate and correlate the quality of life (QoL) of COPD patients on long-term home oxygen therapy (LTOT) with their sociodemographic/clinical characteristics and level of dependence. METHODS: This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. RESULTS: We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender) were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. CONCLUSIONS: Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.