Navegando por Palavras-chave "spirometry"

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    Broncoprovocação com solução salina hipertônica em crianças asmáticas
    (Sociedade de Pediatria de São Paulo, 2012-09-01) Costa, Cínthia Maria Xavier [UNIFESP]; Lanza, Fernanda de Cordoba [UNIFESP]; Solé, Dirceu [UNIFESP]; Centro Universitário de Ensino Superior de Maceió; Universidade Nove de Julho; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To verify if the bronchoprovocation test with 4.5% hypertonic saline solution allows to detect the gradient of response in asthmatic children and adolescents, according to asthma severity. METHODS: 75 asthmatic patients aged six to 18 years-old were evaluated in this cross-sectional study. They were classified according to asthma severity in: intermittent or mild persistent (IM) and moderate or severe persistent (MS). They were also classified according to sensitization to inhaled allergens in atopics: positive skin prick test to Dermatophagoides pteronyssinus, D. farinae and Blomia tropicalis; or non- atopic with negative skin prick tests. All patients underwent a bronchoprovocation test with 4.5% hypertonic saline solution. The result of the bronchoprovocation test was considerd positive if at least a reduction of 20% in the forced expiratory volume in one second (FEV1) was noted. RESULTS: 60 individuals were atopic. The bronchoprovocation test was positive more frequently in the MS group than in the IM one (93 versus 65%). Less time was needed for a 20% fall of FEV1 in the MG compared to the IL group [90 (30 - 330) versus 210 (30 - 690) seconds; p<0.05]. The percentage of FEV1 fall was higher in the MG group than in the IL one [26,4% (14 - 63) versus 20% (0 - 60); p<0.05]. CONCLUSIONS: The 4.5% hypertonic saline solution bronchoprovocation test is safe and easy to perform. It detects a gradient of response in asthmatic children and adolescents regarding asthma severity. Higher frequency of positive tests, shorter time for FEV1 fall, and higher percentage of FEV1 fall were observed in moderate and severe asthmatic patients.
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    Diagnostic Labeling of COPD in five Latin American cities
    (Amer Coll Chest Physicians, 2007-01-01) Talamo, Carlos; Montes de Oca, Maria; Halbert, Ron; Perez-Padilla, Rogelio; Jardim, José Roberto B. [UNIFESP]; Muino, Adriana; Lopez, Maria Victorina; Valdivia, Gonzalo; Pertuze, Julio; Moreno, Dolores; Menezes, Ana Maria B.; PLATINO Team; Hosp Univ Caracas; Univ Calif Los Angeles; Inst Resp Dis; Universidade Federal de São Paulo (UNIFESP); Univ Republica; Pontificia Univ Catolica Chile; Fed Univ Pelotas
    Background: COPD is a major worldwide problem with a rising prevalence. Despite its importance, there is a lack of information regarding underdiagnosis and misdiagnosis of COPD in different countries. As part of the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar study, we examined the relationship between prior diagnostic label and airway obstruction in the metropolitan areas of five Latin American cities (S (a) over tildeo Paulo, Santiago, Mexico City, Montevideo, and Caracas).Methods: A two-stage sampling strategy was used in each of the five areas to obtain probability samples of adults aged 40 years. Participants completed a questionnaire that included questions on prior diagnoses, and prebronchodilator and postbronchodilator spirometry. A study diagnosis of COPD was based on airway obstruction, defined as a postbronchodilator FEV1/FVC < 0.70.Results: Valid spirometry and prior diagnosis information was obtained for 5,303 participants; 758 subjects had a study diagnosis of COPD, of which 672 cases (88.7%) had not been previously diagnosed. the prevalence of undiagnosed COPD was 12.7%, ranging from 6.9% in Mexico City to 18.2% in Montevideo. Among 237 subjects with a prior COPD diagnosis, only 86 subjects (36.3%) had postbronchodilator FEV1/FVC < 0.7, while 151 subjects (63.7%) had normal spirometric values. in the same group of 237 subjects, only 34% reported ever undergoing spirometry prior to our study.Conclusions: Inaccurate diagnostic labeling of COPD represents an important health problem in Latin America. One possible explanation is the low rate of spirometry for COPD diagnosis.
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    O impacto da insuficiência cardíaca crônica na avaliação funcional respiratória de pacientes com doença pulmonar obstrutiva crônica
    (Universidade Federal de São Paulo (UNIFESP), 2014-11-26) Souza, Aline Soares de [UNIFESP]; Serafini, Jose Alberto Neder Serafini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Cardiovascular comorbidity is the most prevalent and relevant clinical condition in chronic obstructive pulmonary disease (COPD), and thus the increased interest in understanding the functional alterations arising from overlapping heart failure (HF) with reduced left ventricular ejection fraction. Our aim is to investigate the impact of heart failure with reduced left ventricular ejection fraction on COPD patients’ pulmonary function. Seventy-five patients of both genders, over forty-five years-old, at a stable phase of the disease, presenting with forced expiratory volume in one second/ forced vital capacity (FEV1/FVC) ratio < 0,7 either or not associated to stable HF with EF ≤ 45% were considered. The following parameters were evaluated:dynamic and static lung volumes, small airways closure (given by the difference between slow vital capacity (SVC) and FVC), ventilation distribution by inert gases,carbon monoxide lung diffusion capacity (DLCO), and blood gases (via arterialized sample). The COPD+HF group presented with lower airflow obstruction (FEV1/FVC ratio = 44 ± 12 % vs 28 ± 11%), dynamic and static lung volumes (total lung capacity (TLC) = 6.7 ± 1.1 L vs 5.9 ± 0.9 L e FEV1 1.4 ± 0.16 L vs 1.8 ± 0.6 L), besides lower bronchodilator flow and volume responses (23 vs 3% e 44 vs 28%, espectively) (P<0.05). The inspiratory volumes were higher in CPOD+HF group, due to a higher tidal volume (1.0 ± 0.2 L vs 0.8 L ± 0.5 L; P=0.08) and higher inspiratory-to-total lung capacity (IC/TLC) ratio (42 ± 10 % vs 36 ± 10 %; P<0.05). There was no significant difference between groups concerning to DLCO and arterial oxygen tension in arterialised blood (p>0.05). Further post-hoc analyses matched by the severity of FEV1 found such results. The study results reveal an important lung volume reduction effect of HF over COPD, which lead to higher inspiratory reserve volumes and keeping of (or preserving the) intrapulmonary gas exchange.
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    The long-term stability of portable spirometers used in a multinational study of the prevalence of chronic obstructive pulmonary disease
    (Daedalus Enterprises Inc, 2006-10-01) Pérez-Padilla, Rogelio; Vazquez-Garcia, Juan Carlos; Marquez, Maria Nelly; Jardim, José Roberto de Brito [UNIFESP]; Pertuze, Julio; Lisboa, Carmen; Muino, Adriana; Lopez, Maria Victorina; Talamo, Carlos; Montes de Oca, Maria; Valdivia, Gonzalo; Menezes, Ana Maria Baptista [UNIFESP]; PLATINO Team; Inst Nacl Enfermedades Resp; Univ Republica; Universidade Federal de São Paulo (UNIFESP); Pontificia Univ Catolica Chile; Univ Cent Venezuela; Univ Fed Pelotas
    BACKGROUND: We report the performance of an ultrasound-based portable spirometer (EasyOne) used in a population-based survey of the prevalence of chronic obstructive pulmonary disease, conducted in 5 Latin American cities: Sao Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and Caracas, Venezuela (the Latin American COPD Prevalence Study [PLATINO]). METHODS: During the survey period (which ranged from 3 months to 6 months in the various locations) we collected daily calibration data from the 70 EasyOne spirometers used in the 5 survey cities. The calibrations were conducted with a 3-L syringe, and the calibration data were stored in the spirometer's database. RESULTS: Ninety-seven percent of the calibration volumes were within +/- 64 mL (2.1%) of the 3-L calibration signal. Excluding data from the first city studied (Sao Paulo), where one calibration syringe had to be replaced, 98% of the calibration checks were within +/- 50 mL (1.7%). The measured volume was affected only minimally by the syringe's peak flow or emptying time. CONCLUSION: In these 70 EasyOne spirometers neither calibration nor linearity changed during the study. Such calibration stability is a valuable feature in spirometry surveys and in the clinical setting.
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    Spirometric reference values in 5 large Latin American cities for subjects aged 40 years or over
    (Ediciones Doyma S/l, 2006-07-01) Perez-Padilla, Rogelio; Valdivia, Gonzalo; Muino, Adriana; Lopez, Maria Victorina; Marquez, Maria Nelly; Oca, Maria Montes de; Talamo, Carlos; Lisboa, Carmen; Pertuze, Julio; Jardim, Jose Roberto B. [UNIFESP]; Menezes, Ana Maria B.; Grp Trabajo PLATINO; Inst Nacl Enfermedades Resp; Pontificia Univ Catolica Chile; Univ Republica; Cent Univ Venezuela; Universidade Federal de São Paulo (UNIFESP); Univ Fed Pelotas
    OBJECTIVE: in clinical practice, spirometry is a extremely useful test that requires strict quality control, an appropriate strategy for interpretation, and reliable reference values. the aim of this study was to report spirometric reference values for 5 cities in Latin America.PATIENTS and METHODS: From data for 5315 subjects who had undergone spirometry in the PLATINO study in Caracas, Mexico City, Santiago, São Paulo, and Montevideo, we selected information for 906 (17%) individuals aged between 40 years and 90 years to provide reference values. the chosen subjects had never smoked, were asymptomatic, had not been diagnosed with lung disease, and were not obese. Multiple regression models were constructed with the following spirometric parameters: forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6), peak expiratory flow, forced vital capacity (FVC), FEV1/FEV6, FEV1/FVC, and forced midexpiratory flow rate. Height, sex, and age were also included in the model.RESULTS: Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black population of the same survey by 20%.CONCLUSIONS: the proposed reference values are an improvement on those currently available for Latin America because the participants were chosen by population sampling methods and standardized up-to-date methodology was used.
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    Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America
    (European Respiratory Soc Journals Ltd, 2007-12-01) Menezes, Ana Maria Baptista [UNIFESP]; Hallal, P. C.; Perez-Padilla, R.; Jardim, J. R. B.; Muino, A.; Lopez, M. V.; Valdivia, G.; Oca, M. Montes de; Talamo, C.; Pertuze, J.; Victora, Cesar Gomes [UNIFESP]; PLATINO; Univ Fed Pelotas; Universidade Federal de São Paulo (UNIFESP); Natl Inst Resp Dis; Univ Republica; Catholic Univ Chile; Cent Univ Venezuela
    The aim of the present study was to evaluate the association between history of tuberculosis and airflow obstruction.A population-based, multicentre study was carried out and included 5,571 subjects aged >= 40 yrs living in one of five Latin American metropolitan areas: São Paulo (Brazil); Montevideo (Uruguay); Mexico City (Mexico); Santiago (Chile); and Caracas (Venezuela). Subjects performed pre- and post-bronchodilator spirometry and were asked whether they had ever been diagnosed with tuberculosis by a physician.The overall prevalence of airflow obstruction (forced expiratory volume in one second/forced vital capacity post-bronchodilator < 0.7) was 30.7% among those with a history of tuberculosis, compared with 13.9% among those without a history. Males with a medical history of tuberculosis were 4.1 times more likely to present airflow obstruction than those without such a diagnosis. This remained unchanged after adjustment for confounding by age, sex, schooling, ethnicity, smoking, exposure to dust and smoke, respiratory morbidity in childhood and current morbidity. Among females, the unadjusted and adjusted odds ratios were 2.3 and 1.7, respectively.In conclusion, history of tuberculosis is associated with airflow obstruction in Latin American middle-aged and older adults.
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    Worldwide burden of COPD in high- and low-income countries. Part II. Burden of chronic obstructive lung disease in Latin America: the PLATINO study
    (Int Union Against Tuberculosis Lung Disease (i U A T L D), 2008-07-01) Menezes, Ana Maria Baptista [UNIFESP]; Perez-Padilla, Rogerio; Hallal, Pedro Curi; Jardim, José Roberto [UNIFESP]; Muino, A.; Lopez, M. V.; Valdivia, G.; Pertuze, Julio; Oca, Maria Montes de; Talamo, C.; PLATINO Team; Univ Fed Pelotas; Inst Nacl Enfermedades Resp; Universidade Federal de São Paulo (UNIFESP); Univ Republica; Pontificia Univ Catolica Chile; Cent Univ Venezuela
    SETTING: Five Latin American cities: Sao Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; Caracas, Venezuela.OBJECTIVE: To describe the burden of chronic obstructive pulmonary disease (COPD) in Latin America.DESIGN: This is a multi Centre study. Post-bronchodilator spirometry was used and the main outcome measure was FEV(1)/FVC < 0.7 (fixed ratio criterion). Global Obstructive Lung Disease (GOLD) stages were also analysed.RESULTS: The combined population aged >= 40 years in the five countries included in the study was approximately 85.3 million. Of these, it was estimated that 12.2 million have airflow obstruction, which corresponds to our prevalence estimate of 14.3%. The proportion of subjects in Stages II-IV of the GOLD classification was 5.6%. Risk factors presenting the highest actiological fractions for COPD were age, current smoking, indoor exposure to coal and exposure to dust in the workplace. Smoking, the modifiable factor with the strongest aetiological fraction for COPD, affects 29.2% of adults aged >= 40 years in these cities, corresponding to approximately 25 million smokers in this age group.CONCLUSION: Prevention of smoking and exposure to pollutants, such as coal and dust, are the interventions most likely to succeed against COPD in Latin America. The information obtained by a collaborative study has been vast and encouraging for other similar studies.