Can static hyperinflation predict exercise capacity in COPD?

Introduction: The diagnosis and severity assessment of COPD relies on spirometry, and in particular the FEV1. However, it has been proposed that hyperinflation and air-trapping are better predictors of exercise capacity and mortality than the FEV1. Research: QUESTION: Does static hyperinflation predict exercise capacity? Methods: We conducted an observational prospective study. Patients with COPD referred to the lung function laboratory were consecutively recruited. Patients with hyperinflation (the experimental group) were compared to patients without hyperinflation (the control group). The sample sizes were determined assuming an effect size of 0.5 and a power of 0.80. Results: We recruited 124 participants, of whom 87% were male, the mean age was 66.1 ± 8.8 years. 67% were symptomatic (GOLD B or D). Airflow limitation was moderate to severe in the majority of patients (median FEV1 47%, IQR 38-65%) and 43% of patients had static hyperinflation. The median 6MWD was 479 meters (404-510) and peak workload in CPET was 64 watts (46-88) with peak VO2 1.12 L/min, 0.89-1.31 L/min. Patients with lower FEV1, DLCO and IC/TLC and higher RV/TLC had reduced exercise capacity in both 6MWT and CPET, measured as lower distance, greater desaturation and ∆Borg dyspnoea, and reduced workload, peak VO2 and peak VE and higher desaturation and ventilatory limitation (VE/MVV). An IC/TLC < 0.33 predicted reduced exercise performance (peak O2 <60%). Dyspnoea assessed by mMRC and QoL measured by CAT and CCQ were also worse in the hyperinflation in COPD patients. Conclusion: In COPD patients, IC/TLC and RV/TLC are valuable predictors of exercise performance in both 6MWT and CPET and PRO.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Persistence of Left Superior Vena Cava Associated to Esophageal Atresia: Presentation of 5 Cases

Objectivos: A atresia do esófago está associada a uma variedade de malformações congénitas de outros órgãos. A persistência da veia cava superior esquerda e uma das malformações venosas torácicas mais comuns, ocorrendo em 0,3% da população. O objectivo deste estudo é caracterizar a persistência da veia cava superior esquerda nos doentes com atresia do esófago tratados no Hospital Dona Estefânia. Métodos: Estudo retrospectivo dos doentes admitidos por atresia do esófago desde Janeiro 2002 a Dezembro 2013. As seguintes variáveis foram estudadas, considerando, idade gestacional, o peso à nascença, o sexo, tipo de atresia do esófago, ecocardiograma no pré-operatório, malformações associadas, abordagem cirúrgica, eventual ecocardiograma no pós-operatório e angioressonância. Resultados: De um total de 107 doentes, em cinco casos foi diagnosticada persistência da veia cava superior esquerda. Destes, apenas um tinha diagnostico pré-natal. A restante investigação revelou um doente com atresia duodenal e outro com malformação do aparelho urinário, coloboma e malformação bilateral dos pavilhões auriculares. Todos os cinco doentes foram submetidos a toracotomia, esofagoesofagostomia primária após laqueação da fístula traqueo-esofágica e angio-ressonância para caracterizar a malformação vascular. Não houve registo de complicações, quer intra-operatórias quer pós-operatórias. Conclusão: Apesar do estudo pré-operatório, apenas se diagnosticou persistência da veia cava superior esquerda num dos doentes. O diagnóstico é geralmente feito de forma incidental durante a colocação rotineira de catéteres venosos centrais à esquerda. É importante identificar estes doentes e caracterizar o seu padrão de retorno venoso cardíaco, pelo risco de complicações embó1icas paradoxais para o sistema arterial

Reference equations for the 6-minute walk distance in healthy Portuguese subjects 18-70 years old

Introduction Six-minute walk test (6MWT) is used for evaluating functional exercise capacity. To the best of our knowledge, there are no reference equations to predict six-minute walk distance (6MWD) for the Portuguese population. The aims of the present study were to measure anthropometric data and 6MWD in a sample of healthy Portuguese population, to establish reference equations to predict 6MWD and to compare our equations with those obtained by previously published studies. Methods We conducted an observational prospective study. We consecutively recruited 158 healthy 18–70 years old subjects from Porto district, who performed two 6MWTs using a standardized protocol. The best 6MWD was used for further analysis. Results The mean 6MWD was 627.8 m (SD = 73.3 m). The variables that were significantly associated with the 6MWD were age, sex, BMI and ΔHR (Heart Rateat the end of the test − HRat rest). We found three explanatory models for 6MWD, the best with an explanatory power of 38%: 6MWD = 721.7 − 1.6 × Age − 4.0 × BMI + 0.9 × ΔHR + 58.4 × Sex. We verified that 6MWD decreased 1.6 m per year of age, and 4.0 m per unit of BMI and increased 0.892 m per beat per minute. Moreover, on average, males walk 58.4 m more than females (p < 0.001). Applying equations from other studies to our population resulted in an overestimation or underestimation of the 6MWD. Conclusion The present study was the first to describe the 6MWD in healthy Portuguese people aged 18–70 years old and to propose predictive equations. These can contribute to improving the evaluation of Caucasian Mediterranean patients with diseases that affect their functional capacity

Grass and Olea Airborne Pollen Allergens in Outdoor Air Samples and its Correlation with Pollen Counts

RATIONALE: In Portugal, grass and Olea europaea pollen are certainly one of the main sources of athmospheric aeroallergens and as such, one of the main causes of respiratory allergy. For these reasons, it is useful the development of new strategies for prevention and treatment of these pathologies. The aim of this study was to evaluate the putative correlation between the concentration of some of the major allergens of and with their pollen counts. METHODS: On a meteorological platform at the town center of Evora (south Portugal), ambient air was sampled at 800L/min with a Chemvol high-volume cascade impactor equipped with stages PM>10μm, 10 μm>PM>2.5μm. The polyurethane impacting substrate was extracted with 0.1M NH4HCO3, pH8.1, supplemented with 0.1% BSA. The major pollen allergens from grass Phleum p 5 and olive Ole e 1 were determined with allergen specific ELISA's. Airborne pollen of and Olea europaea simultaneously monitored with a Burkard Seven Day Recording Volumetric Spore TrapÒ, between the 30th of April and the 8th of July of 2009. Both samplers were placed side-by-side with air input at the same level. RESULTS: During the pollen season of 2009, high values of grass pollen were recorded between May 2th and June 1 th. It was also observed that the air content of Phl p5 or Ole e1 aeroallergens were directly correlated with airborne pollen counts of Poaceae and Oleaceae, respectively. CONCLUSIONS: Results suggest that the directly quantification of aeroallergens may contribute, together with pollen counts of air samples, to define the allergic risk with higher precision

Residual feed intake and its effect on carcass and meat characteristics of feedlot Zebu cattle.

the objective of this study was to evaluate the residual feed intake (RFI) and its relation with performance, carcass and meat characteristics of Zebu animals. A total of 40 Zebu steers with initial age of 18 months and initial live weight of 350 kg were confined in feedlot for 112 days. The average daily gain (ADG) and dry matter intake (DMI) were obtained every 14 days. Residual feed intake was determined by the difference between observed and predicted DMI, based on the metabolic weight and the ADG. Animals were classified into the RFI groups: high (>0.5 standard deviation of the mean - least efficient), medium (±0.5 standard deviation of the mean) and low (<0.5 standard deviation of the mean - most efficient). Daily cost with feeding and per kilogram of weight gain was determined. Characteristics of carcass (weight, yield, subcutaneous fat) meat (pH, shear force and color) were assessed. Animals with low RFI presented lower DMI. The variation in DMI between the low and the high RFI groups promoted difference in the daily cost with feeding and per kilogram of weight gain, with animals of low RFI presenting costs 5 and 9% lower, respectively. Carcass and meat characteristics differed over the RFI groups. The knowledge of the RFI of the animals enables a more efficient system, with reduction in the costs with feeding, without promoting alterations on the performance and carcass characteristics of the meat from Zebu animals

Reactivity, performance, color and tenderness of meat from Zebu cattle finished in feedlot.

The objective of this study was to study the animal reactivity and correlate it with performance and meat quality of cattle finished in feedlots. A total of 20 animals of the Tabapuã breed and 20 animals of the Nellore breed were confined for 112 days: 28 days of adaptation and 84 days of data collection. Performance was determined by the average daily weight gain (ADG) and average dry matter intake (DMI) estimated through the use of indicators. On the 1st, 42nd and 84th days of the experiment, two methods were used to measure the animal reactivity: animal reactivity in mobile cage and visual reactivity during handling. The characteristics of meat quality were evaluated by the color, shear force and pH24 after slaughter (pH24). Through the study of correlation, the degree and direction of linear association on animal reactivity, performance and meat quality were established. Regression equations were generated for the parameters evaluated according to the values of animal reactivity. Correlations between mobile cage and visual reactivity were 0.77, 0.56 and 0.45 in the 1st, 2nd and 3rd evaluations, respectively. There was no correlation between animal reactivity and DMI. The correlations between ADG, pH24, and color with animal reactivity were -0.31, 0.40, 0.47 and -0.34, and -0.33 for mobile cage, 0.74, 0.71 and -0.51, for visual reactivity, respectively. The parameters of meat quality varied according to the reactivity. Undesirable values of pH24, animal reactivity and color were found when mobile cage reactivity was higher than 780, 590 and 540, respectively. In general, animals that show greater reactivity tend to have lower daily weight gain and lower meat quality. The reactivity can be used in animal breeding programs, in order to improve performance and meat quality of Zebu cattle finished in feedlot

Tubular Colorectal Duplication

info:eu-repo/semantics/publishedVersio