Diferenças clínicas, radiológicas e espirométricas entre os pacientes pós-covid-19 estratificados de acordo com a gravidade inicial da doença

Introduction: in March 2020, the SARS-CoV-2 pandemic was declared by the WHO, accounting for more than six million deaths and 600 million confirmed cases. Studies are required to understand the persistence of symptoms after acute infection, which may correlate with the initial severity of the disease. Objective: to evaluate and compare the clinical, spirometric and radiological characteristics of patients affected by the post-COVID syndrome, stratified according to the severity of the acute infection by Sars-Cov-2. Methodology: this is a cross-sectional study, carried out from outpatient consultations in a convenience sample. The study included 232 patients, seen from November 2020 to October 2021. Patients were divided into 2 groups: with COVID-19, without admission to an intensive care unit; and with admission to the intensive care unit. Results: 232 patients affected by COVID-19 were evaluated, 69.4% of whom were female; average age of 50 ± 12.8 years. The most common comorbidities were systemic arterial hypertension (44.0%) and diabetes mellitus (21.1%). Of the patients studied, 45.7% were hospitalized during the acute phase of the disease, and fifty (21.6%) were allocated to an intensive care unit (ICU). Regarding spirometry, the pattern of restrictive disorder was verified only in patients admitted to the ICU. On chest tomography, the pattern of organizing pneumonia was associated with patients who required admission to the intensive care unit. Conclusion: this study shows that restrictive ventilatory disorder and the presence of organizing pneumonia were associated with more severe initial conditions.Introdução: em março de 2020, a pandemia do SARS-CoV-2 foi declarada pela OMS, contabilizando mais de seis milhões de mortes e 600 milhões de casos confirmados. São necessários estudos para compreender a persistência dos sintomas após a infecção aguda, que podem se correlacionar com a gravidade inicial da doença. Objetivo: avaliar e comparar as características clínicas, espirométricas e radiológicas dos pacientes acometidos pela síndrome pós-COVID, estratificados conforme gravidade da infecção aguda pelo Sars-Cov-2. Metodologia: trata-se de estudo de corte transversal, realizado a partir de consultas ambulatoriais em amostra de conveniência. O estudo incluiu 232 pacientes, atendidos de novembro de 2020 a outubro de 2021. Os pacientes foram divididos em 2 grupos: com COVID-19, sem internamento em unidade de terapia intensiva; e com internamento em unidade de terapia intensiva. Resultados: foram avaliados 232 pacientes acometidos pela COVID-19, sendo 69,4% do sexo feminino; idade média de 50 ± 12,8 anos. As comorbidades mais frequentes foram hipertensão arterial sistêmica (44,0%) e diabetes mellitus (21,1%). Dos pacientes estudados, 45,7% foram internados durante a fase aguda da doença, sendo que cinquenta (21,6%) foram alocados em unidade de terapia intensiva (UTI).  Em relação à espirometria, o padrão de distúrbio restritivo foi verificado apenas nos pacientes internados em UTI. Na tomografia de tórax, o padrão de pneumonia em organização foi associado a pacientes que precisaram de internamento em unidade de terapia intensiva. Conclusão: este estudo evidencia que o distúrbio ventilatório restritivo e a presença de pneumonia em organização tiveram associação com quadros iniciais mais graves

Gut microbiota changes in airway diseases: a systematic review

Introduction: studies have highlighted the importance of gut microbiota (GM) to the host immune defenses, influencing the hostdevelopment and physiology. Changes in the composition and diversity of GM have been detected in some disease and could beimplicated in the pathophysiological mechanisms of them. Objective: the purpose of this study was to show an overview of thecurrent knowledge about the GM of patients with airway diseases (AD). Methodology: the literature search was performed in fourdatabases, using a combination of the descriptors: “Gastrointestinal Microbiome”, “Gut Microbiome”, “Gut Microbiota”, “Cystic Fibrosis”(CF), “Asthma”, “Pulmonary Hypertension” (HP) and/or “Chronic Obstructive Pulmonary Disease” (COPD). Results: fifteen studieswere herein included: ten of CF and five of asthma. No study about other AD matched the inclusion criteria. In all studies about CF,changes were detected in GM, particularly quantitative and qualitative microbial changes. For asthma, data showed changes in GMalso including a reduction of microbial richness, evenness and diversity and in the Bacteroidetes/Firmicutes ratio. Conclusions: thecurrent data indicate the existence of GM changes in AD. However, due to the few studies for asthma and the lack of investigationson HP and COPD, it was not possible to confirm whether these GM changes are observed in other AD. Furthermore, this review showsthe necessity of more studies in this area to characterize dysbiosis and which alterations are more frequent observed in AD patients

Inflammatory and immunological profiles in patients with COPD: relationship with FEV 1 reversibility

Antonio Carlos Moreira Lemos. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. “Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento”.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-04-07T17:12:06Z No. of bitstreams: 1 Queiroz CF Inflammatory....pdf: 348865 bytes, checksum: 0b48b3adec5197138c3b44899ecaa672 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-04-07T17:24:27Z (GMT) No. of bitstreams: 1 Queiroz CF Inflammatory....pdf: 348865 bytes, checksum: 0b48b3adec5197138c3b44899ecaa672 (MD5)Made available in DSpace on 2017-04-07T17:24:27Z (GMT). No. of bitstreams: 1 Queiroz CF Inflammatory....pdf: 348865 bytes, checksum: 0b48b3adec5197138c3b44899ecaa672 (MD5) Previous issue date: 2016Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Pneumologia. Ambulatório Magalhães Neto. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Pneumologia. Ambulatório Magalhães Neto. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Pneumologia. Ambulatório Magalhães Neto. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Pneumologia. Ambulatório Magalhães Neto. Salvador, BA, BrasilUniversidade do Estado da Bahia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilTo determine whether COPD severity correlates with sputum cell counts, atopy, and asthma. Methods: This was a cross-sectional study involving 37 patients with COPD and 22 healthy subjects with normal lung function (controls). Sputum cell counts were determined by microscopy after centrifugation of samples. Skin prick tests were performed, and serum cytokines were determined by ELISA. Results: Patients were stratified by bronchodilator response: a non-reversible airflow limitation (nonRAL) group comprised 24 patients showing no significant post-bronchodilator change in FEV1; and a partially reversible airflow limitation (partialRAL) group comprised 13 patients showing FEV1 reversibility (post-bronchodilator FEV1 increase ≥ 12%). The proportion of eosinophils in sputum was higher in the partialRAL group than in the nonRAL group (p < 0.01), and there was an inverse correlation between the proportion of eosinophils and FEV1 (p < 0.05). However, none of the patients had a history of asthma and skin prick test results did not differ between the two groups. In the patient sputum samples, neutrophils predominated. Serum levels of TNF, IL-6, IL-8, and RANTES (CCL5) were higher in patients than in controls (p < 0.001) but did not differ between the two patient groups. Conclusions: COPD patients with partial FEV1 reversibility appear to have higher sputum eosinophil counts and greater airway hyperresponsiveness than do those with no FEV1 reversibility. However, we found that COPD severity did not correlate with atopy or with the cytokine profile

Inflammatory and immunological profiles in patients with COPD: relationship with FEV 1 reversibility

ABSTRACT Objective: To determine whether COPD severity correlates with sputum cell counts, atopy, and asthma. Methods: This was a cross-sectional study involving 37 patients with COPD and 22 healthy subjects with normal lung function (controls). Sputum cell counts were determined by microscopy after centrifugation of samples. Skin prick tests were performed, and serum cytokines were determined by ELISA. Results: Patients were stratified by bronchodilator response: a non-reversible airflow limitation (nonRAL) group comprised 24 patients showing no significant post-bronchodilator change in FEV1; and a partially reversible airflow limitation (partialRAL) group comprised 13 patients showing FEV1 reversibility (post-bronchodilator FEV1 increase ≥ 12%). The proportion of eosinophils in sputum was higher in the partialRAL group than in the nonRAL group (p < 0.01), and there was an inverse correlation between the proportion of eosinophils and FEV1 (p < 0.05). However, none of the patients had a history of asthma and skin prick test results did not differ between the two groups. In the patient sputum samples, neutrophils predominated. Serum levels of TNF, IL-6, IL-8, and RANTES (CCL5) were higher in patients than in controls (p < 0.001) but did not differ between the two patient groups. Conclusions: COPD patients with partial FEV1 reversibility appear to have higher sputum eosinophil counts and greater airway hyperresponsiveness than do those with no FEV1 reversibility. However, we found that COPD severity did not correlate with atopy or with the cytokine profile

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved