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Aim: To determine the prognostic value of cardiopulmonary exercise testing (CPET) for major vascular surgery in South African patients. Methods: CPET has been used in Durban since October 2004 to predict cardiac risk for high-risk patients undergoing major vascular surgery. A submaximal 'anaerobic threshold' (AT) test was conducted on all high-risk patients. Patients were classified into two groups: 'low AT' where the oxygen consumption at the AT was <1 lml.kg^.min"1 for cycling or < 9ml.kg"1.mkf1 for arm cranking and 'high AT' when the patient surpassed these targets. Analysis of all in-hospital deaths following surgery was conducted by two independent assessors blinded to the CPET test result. Deaths classified as primarily 'cardiac in origin' have been used in this retrospective cohort analysis. Results: The AT measured during CPET was not a statistically significant pre-operative prognostic marker of cardiac mortality. However, the survivors of the patients with a 'low AT' may be identified by their response to increasing metabolic demand between 5 and 7 ml.kg^.min"1. Survivors were more dependent on increasing heart rate, while non-survivors were more dependent on oxygen extraction. When this information is added to the AT, CPET was the only test statistically associated with cardiac mortality, in comparison to Lee's Revised Cardiac Risk Index and the resting left ventricular ejection fraction which were not statistically associated with cardiac death. A hundred percent of patients with a positive test died of cardiac causes, while 11% of the patients with a negative test had cardiac deaths. The risk ratio associated with cardiac death following a positive test was 8.00 [95% CI 3.8-16.9]. The sensitivity was 0.25 [95% CI 0.04-0.64], the specificity was 1.00 [95% CI 0.90-1.00], the positive predictive value was 1.00 [95% CI 0.20-0.95] and the negative predictive value was 0.88 [95% CI 0.74-0.95]. Conclusions: CPET provides valuable prognostic information in our surgical population. / Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2007.

Thesis (M.S.)--University of Texas at El Paso, 2009. / Title from title screen. Vita. CD-ROM. Includes bibliographical references. Also available online.

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

Thesis--Helsinki. / At head of title: University of Helsinki Central Hospital, Surgical Clinic II. Bibliography: p. [128]-134.

Thesis (Ph. D.). University of Lund. Depts. of Anasthesia and Clinical Physiology.

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

Submitted by Valdirene Tenório Da Costa Alegria (valdirenetalegria_@hotmail.com) on 2018-07-05T23:40:07Z No. of bitstreams: 1 VALDIRENE - MESTRADO.pdf: 841257 bytes, checksum: 47c51eb211d0057b65f8dc6ac5fef419 (MD5) / Rejected by Ana Paula Santulo Custódio de Medeiros null (asantulo@rc.unesp.br), reason: - Falta a folha de aprovação: favor solicitar na Seção de Pós-Graduação. Ela deve vir após a ficha catalográfica, tanto na versão impressa como na digital. on 2018-07-06T12:16:03Z (GMT) / Submitted by Valdirene Tenório Da Costa Alegria (valdirenetalegria_@hotmail.com) on 2018-07-07T01:39:01Z No. of bitstreams: 1 Valdirene - Dissertação.pdf: 869988 bytes, checksum: f267b5b5c0e01435a242938d2477f291 (MD5) / Approved for entry into archive by Adriana Aparecida Puerta null (dripuerta@rc.unesp.br) on 2018-07-10T13:12:46Z (GMT) No. of bitstreams: 1 alegria_vtc_me_rcla.pdf: 869988 bytes, checksum: f267b5b5c0e01435a242938d2477f291 (MD5) / Made available in DSpace on 2018-07-10T13:12:46Z (GMT). No. of bitstreams: 1 alegria_vtc_me_rcla.pdf: 869988 bytes, checksum: f267b5b5c0e01435a242938d2477f291 (MD5) Previous issue date: 2018-05-28 / O processo de envelhecimento é dinâmico e progressivo, com alterações fisiológicas que podem resultar em alterações na capacidade pulmonar, mobilidade e equilíbrio. O objetivo deste estudo foi avaliar o efeito das variáveis de função pulmonar estática na capacidade de exercício na mobilidade e no equilíbrio de indivíduos acima de 50 anos. E avaliar o efeito da mobilidade e equilíbrio de indivíduos acima de 50 anos na capacidade de exercício. Os indivíduos passaram por anamnese, avaliação da função pulmonar estática por meio da Espirometria, Teste de Esforço Cardiorrespiratório por meio do Incremental Shuttle Walking Test, do Teste de Caminhada de Seis Minutos e do Teste de Escada e para avaliação da mobilidade foram submetidos ao teste Timed Up and Go e avaliados por meio da Escala de Equilíbrio de Berg. Para análise estatística foi utilizado software SigmaStat®, os dados foram apresentados em média±desvio padrão e as variáveis foram correlacionadas por meio do Teste de Correlação de Pearson (p<0,05). A amostra foi composta por 46 indivíduos sendo 37 (80,5%) mulheres e 9 (19,5%) homens, com idade média de 61,02±8,29 anos. Em relação aos resultados de correlação da função pulmonar com os testes de esforço, mobilidade e equilíbrio; os testes de esforço apresentaram correlação com as variáveis espirométricas. Na amostra, os indivíduos com menor tempo no TUG e melhores condições de equilíbrio foram os que apresentaram melhor função pulmonar. Quanto melhor a mobilidade melhor os resultados nos testes de esforço. Conclui-se que a função pulmonar tem efeito sobre a condição e resposta cardiorrespiratória, mobilidade e equilíbrio de indivíduos acima de 50 anos. / The aging process is dyn amic and progressive, with physiological changes that can result in pulmonary capacities, mobility and balance alterations. The objective of this study was to evaluate the effect of static pulmonary function variables in the outcome of different tests of f ield effort, mobility and balance of subjects abov e 50 years. And evaluate the effec t of mobility and balance of subjects above 50 years in the result of three different effort tests. The subjects went through anamnesis, assessment of static lung function through Spiro metry, Cardiorespiratory Test through Incre mental Shuttle Walking Test, Six - Minute Walk Test and Stairs Test and to assess mobility they were submitted to the Timed Up and Go test and evaluated through the Berg Balance S cale. For statistical a nalysis SigmaStat ® software was used, the data are presented as average ± standard deviation and the variables were correlated through the Pearson Correlation Test (p <0.05). The sample consisted of 46 individuals, 37 (80.5%) women and 9 (19.5%) men, with a mean age of 61.02 ± 8.29 years. Regarding the results of correlation of pulm onary function with the effort tests mobility and balance; stress tests were correlated with spirometric var iables. In this sample, the individuals with the shortest TUG time in and the best balance conditions were the ones with the best pulmonary funct ion. When mobility improve results stress tests also improve. It is concluded that pulmonary function has an effect on the condition and cardiorespiratory response, mobility and b alance of individuals over 50 years.

Chronic obstructive pulmonary disease (COPD) is in up to 90 % of all cases caused by smoking. COPD often has negative effects on circulation, effects that first and foremost can be observed as respiratory insufficiency. Reduced function of the right ventricle of the heart is common in patients suffering from chronic obstructive pulmonary disease, especially if they also have hypoxemi; insufficient levels of oxygen in blood or tissue. The incidence of this cardiac complication reduces the survival time. It is possible in chronic obstructive pulmonary disease that the pressure in the pulmonary circulation gradually increases resulting in pulmonary hypertension followed by a slow adaptation of the right ventricle by hypertrophy of the myocardium. To investigate a correlation between COPD and pulmonary hypertension COPD patients were subjected to spirometry and ultrasound on heart. Of 14 examined patients 5 had developed pulmonary hypertension. A correlation between obstruction in the COPD- patients and an increase in left ventricular diameter was found. DLCO (diffusion capacity) of the lungs is directly connected to PA (pulmonary arterial pressure). The lower DLCO, the higher risk to develop pulmonary hypertension. However, we could not find a significant correlation between COPD and pulmonary hypertension in this study even if most patients had a decreased DLCO.

Class of 2012 Abstract / Specific Aims: The epithelial sodium channels (ENaC) found on the apical membranes of epithelial cells including those lining the respiratory tract are the rate limiting step of the absorption of excess fluid from the airspace of the alveoli. ENaC function is modulated by the effects of various physiologic signals such as the adrenergic and purinergic pathways, in addition to other local channels which control the flow of negatively charged ions such as the cystic fibrosis transmembrane conductance regulator (CFTR). We sought to determine the influence of genetic variation on the alpha subunit of ENaC at amino acid position 663 on baseline exhaled ions and pulmonary function in patients with CF. Methods: We assessed pulmonary function ( forced vital capacity[FVC], forced expiratory volume in one second [FEV1], forced expiratory flow maximum[FEFmax]) using a Medical Graphics cardiopulmonary testing device (Minneapolis, MN). Measures of exhaled sodium (Na+) and chloride (Cl-) were obtained using exhaled breathe condensate collected on a Jaeger Ecoscreen condenser unit (Cardinal Health, Yorba Linda, CA) with Na+ quantification using an atomic absorption spectrophotometer (Analyst 100; Perkin Elmer, Norwalk, CT) and Cl- anion quantification using a Dionex AS11 HC column. Healthy n=31 (n=18[58%], 9[29%], and 4[13%] subjects; Body mass index (BMI)=23±1, 25±2, and 25±2kg/ m2 for AA, AT and TT groups respectively). CF n= 42 (n=33[79%], 7[16%], and 2[5%] subjects; BMI equals 23±7, 19±0.4, and 20±2.2kg/m2 for AA, AT and TT groups respectively). Main Results: We found that the distribution of genotypes in CF differed from healthy subjects, with the AA genotype in 80% of CF and 59% in healthy. No significant difference were demonstrated in healthy subjects between genotype groups for pulmonary function and exhaled chloride while the genotypes did differ in exhaled Na (Na=2.9±0.4, 1.7±0.3, and 3.7±1.1mmol/L for AA, AT, and TT respectively, ANOVA p=0.07). CF subjects with the AA genotype had a higher baseline exhaled Cl-, FEV1, and FEFmax than those in the AA group (Cl=0.125±0.038,0.0 27±0.007, and 0.033±0.02 mmol/L ; FEV1=71±5, 68±11, and 40±22L; FEFmax=86±4, 72±7, and 44±24L/sec; for AA, AT, and TT respectively, ANOVA p<0.05, Tukey [AA vs. TT] p<0.05) while exhaled Na+ and FVC were similar between genotypes. Conclusions: Our results suggest that CF subjects with the AA genotype of the alpha subunit of the ENaC have a higher baseline exhaled Cl- and a resulting increase in pulmonary function when compared to the overactive TT groupCF patients with the TT αENaC genotype are likely candidates for early identification and treatment with inhaled ENaC inhibitors or other modulators of this pathway in order to improve survival.