Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America

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.Univ Fed Pelotas, BR-96020220 Pelotas, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilNatl Inst Resp Dis, Mexico City, DF, MexicoUniv Republica, Montevideo, UruguayCatholic Univ Chile, Santiago, ChileCent Univ Venezuela, Caracas, VenezuelaUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Health status perception and airflow obstruction in five Latin American cities: the PLATINO study

Background: COPD is a highly prevalent disease but underdiagnosed, undertreated and possibly under-recognized by patients. Limited information exists regarding patients' perception of COPD severity. We compared patients' general, health status perception, degree of breathlessness and physical activity limitation with the severity of their respiratory condition measured by airway obstruction, in a population-based sample.Methods: We used postbronchodilator FEV(1)/FVC < 0.70 to define COPD. Patients' perception of their general. health status was derived from the question in general, you would say that your health is: excellent, very good, good, fair or poor?Results: Spirometry was performed in 5314 subjects: an FEV(1)/FVC ratio below 0.70 was found in 759 subjects. in persons with COPD, general. health status decreased with increasing GOLD stages. Over one-half of subjects with stage 2 and one third of those with stages 3 and 4 reported their health status as good to excellent. There was also a disparity between airway obstruction severity and breathlessness intensity. Although the more severe COPD stages were frequently associated with significant compromise of work and everyday activities, patients often tended to provide an optimistic self evaluation of their health status.Conclusions: the discrepancy observed between general health status, dyspnea severity, physical activity limitation and airway obstruction most likely reflect patients' underperception of disease severity, emphasizing the need for improving case-finding measures and multi-component evaluation of COPD subjects. (C) 2009 Elsevier B.V. All rights reserved.Boehringer Ingelheim GmbHCent Univ Venezuela, Hosp Univ Caracas, Serv Neumonol, Caracas 1030, VenezuelaUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90066 USAInst Resp Dis, Mexico City 14080, DF, MexicoUniv Republica, Hosp Maciel, Montevideo, UruguayUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilPontificia Univ Catolica Chile, Dept Salud Publ, Santiago, ChilePontificia Univ Catolica Chile, Catedra Neumol, Santiago, ChileUniv Fed Pelotas, Fac Med, BR-96030002 Pelotas, RS, BrazilUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilWeb of Scienc

Chronic obstructive pulmonary disease and body mass index in five Latin America cities: the PLATINO study

Background: the body mass index (BMI) is a prognostic factor for chronic obstructive pulmonary disease (COPD). Despite its importance, little information is available regarding BMI alteration in COPD from a population-based study. We examined characteristics by BMI categories in the total and COPD populations in five Latin-American cities, and explored the factors influencing BMI in COPD.Methods: COPD was defined as a postbronchodilator forced expiratory volume in the first second/forced vital capacity (FEV(1)/FVC)= 30.0 kg/m(2)).Results: Interviews were completed in 5571 subjects from 6711 eligible individuals, and spirometry was performed in 5314 subjects. There were 759 subjects with COPD and 4555 without COPD. Compared with the non-COPD group, there was a higher proportion of COPD subjects in the underweight and normal weight categories, and a lower proportion in the obese category. Over one-half COPD subjects had BMI over 25 kg/m(2). No differences in BMI strata among countries were found in COPD subjects. Factors associated with lower BMI in mates with COPD were aging, current smoking, and global initiative for chronic obstructive lung disease (GOLD) stages III - IV, whereas wheeze and residing in Santiago and Montevideo were associated with higher BMI. in females with COPD, current smoking, lower education, and GOLD stages II - IV were associated with lower BMI, while dyspnea and wheeze were associated with higher BMI.Conclusions: BMI alterations are common in COPD with no significant differences among countries. Current smoking, age, GOLD stages, education level, residing in Santiago and Montevideo, dyspnea and wheeze were independently associated with BMI in COPD. (c) 2008 Elsevier B.V. All rights reserved.Cent Univ Venezuela, Fac Med, Hosp Univ Caracas, Serv Neumonol, Caracas 1030, VenezuelaInst Resp Dis, Mexico City 14080, DF, MexicoUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilUniv Republica, Hosp Maciel, Fac Med, Montevideo 2610, UruguayPontificia Univ Catolica Chile, Fac Med, Dept Salud Publ, Santiago, ChileUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90066 USAUniv Fed Pelotas Duque Caxias, Fac Med, Pelotas, RS, BrazilUniversidade Federal de São Paulo, BR-04021070 São Paulo, BrazilWeb of Scienc

N+3 Aircraft Concept Designs and Trade Studies

Appendices A to F present the theory behind the TASOPT methodology and code. Appendix A describes the bulk of the formulation, while Appendices B to F develop the major sub-models for the engine, fuselage drag, BLI accounting, etc