Shah, Krupa Rashmin, Shah, Krupa Rashmin
Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of death worldwide and requires close monitoring and follow up to prevent exacerbations that lead to hospitalizations (CDC, 2015). COPD is often underdiagnosed or misdiagnosed for asthma and also under-treated because providers are not utilizing the recommended diagnostic tool, spirometry, for patients who present with chronic respiratory symptoms (Decramer et al., 2015). The purpose of this study is to assess perceived barriers to spirometry use among primary care providers (PCP) including nurse practitioners (NP) and physician assistants (PA) within Arizona. The aim of this project is to assess for commonalities in barriers and determine practice and educational implications and areas for future research to increase knowledge about the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines so that spirometry is performed more frequently. A survey was administered to PCPs (NPs and PAs) in Arizona through medical professional organizations. Basic demographic data was collected, in addition to questions assessing practice assessment, perceived barriers to spirometry, and utilization of smoking cessation methods and COPD prevention methods. A total of 47 responses were used for the data analysis. Females accounted for 87% (n=41) of the total sample size, and males accounted for 13% (n=6). There were 89% (n=42) NPs and 11% (n=5) PAs. Only 53% (n=25) stated that they have access to a spirometer and 47% (n=22) stated they did not have access to the tool. The most common barriers to spirometry use were concerns about testing quality and accuracy (28%, n=13), cost of the tool (23%, n=11), uncertainty about interpretation (21%, n=10), and unfamiliarity (21%, n=10). Other causes include concerns for reimbursement (11%, n=6), not enough time with patient (11%, n=5), preference to send for pulmonary function tests (11%, n=5), and lastly uncertain about impact of results on clinical practice (6%, n=3). In conclusion, the results call for further practice and educational interventions to mitigate these barriers and provide better support to providers who care for those with chronic respiratory symptoms. Further research into this issue can help lead to interventions and increase knowledge about the GOLD guidelines to improve patient outcomes.
Berman, Benjamin P., Pandey, Abhishek, Li, Zhitao, Jeffries, Lindsie, Trouard, Theodore P., Oliva, Isabel, Cortopassi, Felipe, Martin, Diego R., Altbach, Maria I., Bilgin, Ali
Purpose: Lung function is typically characterized by spirometer measurements, which do not offer spatially specific information. Imaging during exhalation provides spatial information but is challenging due to large movement over a short time. The purpose of this work is to provide a solution to lung imaging during forced expiration using accelerated magnetic resonance imaging. The method uses radial golden angle stack-of-stars gradient echo acquisition and compressed sensing reconstruction. Methods: A technique for dynamic three-dimensional imaging of the lungs from highly undersampled data is developed and tested on six subjects. This method takes advantage of image sparsity, both spatially and temporally, including the use of reference frames called bookends. Sparsity, with respect to total variation, and residual from the bookends, enables reconstruction from an extremely limited amount of data. Results: Dynamic three-dimensional images can be captured at sub-150 ms temporal resolution, using only three (or less) acquired radial lines per slice per timepoint. The images have a spatial resolution of 4.6 x 4.6 x 10 mm. Lung volume calculations based on image segmentation are compared to those from simultaneously acquired spirometer measurements. Conclusion: Dynamic lung imaging during forced expiration is made possible by compressed sensing accelerated dynamic three-dimensional radial magnetic resonance imaging. (C) 2015 Wiley Periodicals, Inc.
Lung function and prevalence trends in asthma and COPD : the Obstructive Lung Disease in Northern Sweden Thesis XVIBackman, Helena January 2016 (has links)
Background Asthma and chronic obstructive pulmonary disease (COPD) are common obstructive airway diseases with a substantial burden in terms of morbidity, mortality and costs. Smoking is the single most important risk factor for COPD, and is associated with incident asthma. It is important to know if the prevalence of asthma and COPD is increasing or decreasing in the population in order to effectively allocate health care resources. The definitions of these diseases have varied over time which makes it difficult to measure changes in prevalence. The preferred method is to estimate the prevalence with the same procedures and definitions based on cross-sectional population samples with identical age distributions in the same geographical area at different time points. Measurements of lung function (spirometry) are required to diagnose COPD, and spirometry is used to evaluate disease severity and progress of both asthma and COPD, where observed values are compared to reference values. The most commonly used reference values in Sweden are published during the mid 1980s, and there are few evaluations of how appropriate they are today based on Swedish population samples. The aim of the thesis was to estimate trends in the prevalence of asthma and COPD in relation to smoking habits, and to evaluate and estimate reference values for spirometry. Methods The project was based on population-based samples of adults from the Obstructive Lung Disease in Northern Sweden (OLIN) studies. Postal questionnaires were sent to large cohorts, recruited in 1992 (n=4851, 20-69 years), 1996 (n=7420, 20-74 years) and 2006 (n=6165, 20-69 years), respectively. The questionnaire included questions on respiratory symptoms and diseases, their comorbidities and several possible risk factors including smoking habits. Structured interviews and spirometry were performed in random samples of the responders to the 1992 and 2006 surveys, of which n=660 (in 1994) and n=623 (in 2009) were within identical age-spans (23-72 years). The trend in asthma prevalence was estimated by comparing the postal questionnaire surveys in 1996 and 2006, and the trend in COPD prevalence was estimated by comparing the samples participating in dynamic spirometry in 1994 and 2009, respectively. The prevalence of COPD was estimated based on two different definitions of COPD. Commonly used reference values for spirometry were evaluated based on randomly sampled healthy non-smokers defined in clinical examinations of participants in the 2006 postal questionnaire (n=501). The main focus of the evaluation was the global lung function initiative (GLI) reference values published in 2012, for which Z-scores and percent of predicted values were analysed. New sex-specific reference values for spirometry were estimated by linear regression, with age and height as predictors. These new OLIN reference values were also evaluated on a sample of healthy non-smokers identified in the population-based West Sweden Asthma Study. Results Although the prevalence of smoking decreased from 27.4% to 19.1%, p<0.001, between 1996 and 2006, the prevalence of physician-diagnosed asthma increased from 9.4% to 11.6%, p<0.001. The prevalence of symptoms common in asthma such as recurrent wheeze did not change significantly between the surveys or tended to decrease, while bronchitis symptoms such as cough and sputum production decreased significantly. The evaluation of the GLI reference values showed that the predicted values were significantly lower compared to the observed values in Norrbotten, which makes the percent of predicted too high. This was especially true for FVC percent predicted with a mean of 106%. In general, the deviations were more pronounced among women. New OLIN reference values valid for the Norrbotten sample were modelled and showed a high external validity when applied on the sample from western Sweden. The prevalence of moderate to severe COPD decreased substantially over the 15-year period between 1994 and 2009, regardless of definition. Conclusions In parallel with substantially decreased smoking habits in the population between 1996 and 2006, the prevalence of several airway symptoms decreased while the prevalence of physician-diagnosed asthma increased. These results suggest increased diagnostic activity for asthma, but may also suggest that the asthma prevalence has continued to increase. In contrast to asthma, the prevalence of COPD tended to decrease and moderate to severe COPD decreased substantially. The continuous decrease in smoking in Sweden during several decades prior to the study period is most likely contributing to these results. The evaluation of reference values showed that the GLI reference values were lower than the observed spirometric values in the population, especially for women, why the new up-to date reference values may be of importance for disease evaluation in epidemiology and in the health care as well.
Análise do perfil cardiorrespiratório de pacientes idosos portadores de Doença de Chagas / Analysis of cardio respiratory profile of elderly patients with Chagas diseaseDe Biasi, Carla Patrícia Santoro 12 March 2010 (has links)
Orientador: Eros Antonio de Almeida / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T09:50:38Z (GMT). No. of bitstreams: 1 DeBiasi_CarlaPatriciaSantoro_M.pdf: 728047 bytes, checksum: 7236f0abe166e5dd7e4cd5a7ca53519d (MD5) Previous issue date: 2010 / Resumo: Causada pelo parasito Tripanossoma cruzi, a doença de Chagas é responsável pela morte de 50 mil brasileiros por ano. Possui grande impacto na produtividade do trabalhador e mostra-se capaz de provocar incapacidade precoce em aproximadamente 670 mil pessoas em todo o mundo anualmente. A reação aguda iniciada pelo parasito pode desencadear desde um quadro de febre, sudorese, cefaléia, hepatoesplenomegalia e adenomegalia, até um quadro grave de miocardite ou encefalite. Na fase crônica podem ocorrer insuficiência cardíaca congestiva de caráter progressivo, arritmias ou bloqueios cardíacos, perda de força muscular respiratória, aumento da freqüência respiratória, ineficácia ventilatória ou aumento do espaço morto. Tendo em vista tais alterações, os objetivos deste trabalho foram investigar o grau de acometimento da força muscular respiratória e o impacto desta sobre o padrão respiratório de chagásicos e avaliar o reflexo do acometimento cardíaco sobre a capacidade funcional. Para a análise dos dados do presente estudo foi realizado exame de ecocardiografia e eletrocardiograma para classificar os indivíduos chagásicos em grupo A e B. Prova de função pulmonar por meio da espirometria, teste de caminhada de seis minutos e verificação da força muscular máxima por meio de um manovacuômetro também foram realizados. A partir da avaliação proposta, observou-se que, apesar de apresentarem alteração da função cardíaca em diferentes níveis de acometimento, indivíduos idosos portadores de doença de Chagas, quando avaliados em níveis submáximos, não evidenciaram alteração alguma de força muscular e padrão respiratório, bem como do desempenho funcional. O padrão respiratório mostrou-se alterado apenas nos pacientes portadores de doença pulmonar concomitante à Doença Chagas. Conclui-se, portanto, que a presença de cardiopatia secundária à doença de Chagas, nos graus de gravidade estudados, não foi capaz de alterar, por si só, tanto a força muscular e padrão respiratórios, como o desempenho funcional submáximo. Além disso, apenas os pacientes que apresentaram doença pulmonar associada demonstraram alteração do padrão respiratório / Abstract: Caused by Tripanossama Cruzi parasite, the Chagas disease is responsible by death of 50 thousand brazilians every year. It causes considerable impact on workers' productivity and it is able to lead to premature incapacity in almost 670.000 people around the world every year. The acute reaction started by the parasite can cause fever, sweating, headache, hepatosplenomegaly, adenomegaly, or even a serious situation of myocarditis and encephalitis. In the chronic phase can occur progressive congestive heart failure, arrhythmias or heart blocks, loss of respiratory muscle strength, increase of respiratory frequency, ventilatory inefficiency or dead space increased. Considering these changes caused by the disease, the objectives of this work were investigate the level of respiratory strength damage and its impact on the respiratory pattern in Chagas patients, and also evaluate the repercussion of the heart disease in the functional capacity. To analyze the datas of this work, echocardiography and eletrocardiography were done in order to classify the Chagas Patients into two groups: "A" and "B". Pulmonar function test through the spirometry, walking six minutes test, and evaluation of maximum respiratory muscle strength using a manometer were also performed. With the proposed evaluation, we observed that, in spite of showing heart dysfunction in many levels of damage, elderly patients with Chagas disease, when evaluated in submaximal levels of physical efforts, showed no changes in strength respiratory muscle, pattern respiratory and functional performance. The pattern respiratory was damaged only in patients with associted lung disease. In conclusion, the presence of cardiopaty, secondarily to Chagas disease on the levels presented by the patients of this study, was not able to change the respiratory muscle strenght, the respiratory pattern and the submaximum functional performance by itself. Moreover, only patients with associated lung disease had damaged respiratory pattern / Mestrado / Gerontologia / Mestre em Gerontologia
Capnografia volumétrica na avaliação de doenças crônicas pulmonares / Volumetric capnography for the evaluation of chronic airways diseasesVeronez, Liliani de Fátima, 1980- 12 March 2014 (has links)
Orientadores: Ilma Aparecida Paschoal, Mônica Corso Pereira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T20:34:20Z (GMT). No. of bitstreams: 1 Veronez_LilianideFatima_D.pdf: 6581224 bytes, checksum: 21912792a141bd85146488626d2e9e24 (MD5) Previous issue date: 2014 / Resumo: As doenças pulmonares obstrutivas de diferentes etiologias se apresentam com envolvimento progressivo das vias aéreas periféricas. As vias aéreas periféricas, conhecidas como zona silenciosa do pulmão, não são adequadamente avaliadas com testes convencionais de função pulmonar. O princípio do gás "washout" eliminação de gases tem sido utilizado para detectar heterogeneidade da ventilação pulmonar e para estimar a localização do processo da doença subjacente. A capnografia volumétrica (CV) analisa o padrão de eliminação de CO2 como uma função do volume expirado. Objetivo: medir os "slopes" da fase 3 normalizados pelo volume corrente expiratório em pacientes com bronquiectasia não-fibrose cística (BQNF ) e em pacientes com bronquite crônica tabágica obstrutiva (BCTO), a fim de comparar os slopes obtidos para os grupos. Métodos: Pacientes com BQNF e com BCTO foram incluídos sequencialmente a partir dos ambulatórios de Insuficiência Respiratória Crônica do HC-Unicamp. Um grupo controle foi estabelecido para grupo BQNF, pareados por sexo e idade. Todos os indivíduos realizaram espirometria, CV e teste da caminhada dos seis minutos (TC6). Duas comparações foram feitas: grupo BQNF vs o grupo controle, e BQNF vs o grupo BCTO. O projeto foi aprovado pelo comitê de ética da nossa instituição. Os testes estatísticos utilizados foram Wilcoxon ou teste t de Student diferenças estatisticamente significativas foram consideradas com p < 0,05. Resultados: na comparação do grupo BQNF (N = 20) vs grupo controle (N = 20), foram encontradas diferenças significativas no IMC e em diversas variáveis funcionais (espirometria, CV, TC6) com os piores resultados observados no grupo BQNF. Na comparação entre o grupo BCTO (N = 20) vs grupo BQNF, embora os pacientes com BCTO tivessem piores valores na espirometria e TC6, as variáveis capnograficas Slp2, Slp3/Ve e Slp3/EtCO2 foram semelhantes. Conclusão: Estes resultados podem indicar que as curvas de eliminação de gás não são suficientemente sensíveis para monitorizar a gravidade das anormalidades estruturais. O papel do slope normalizado da fase 3 pode se explorado como o mais sensível índice de doença das pequenas vias aéreas, embora possa não ser igualmente sensível em discriminar a gravidade das alterações / Abstract: Background: Obstructive lung diseases of different etiologies present with progressive peripheral airway involvement. The peripheral airways, known as silent lung zone, are not adequately evaluated with conventional function tests. The principle of gas washout has been used to detect pulmonary ventilation inhomogeneity and to estimate the location of the underlying disease process. Volumetric capnography (VC) analyses the pattern of CO2 elimination as a function of expired volume. Objective: to measure normalized phase 3 slopes with VC in patients with non-cystic fibrosis bronchiectasis (NCB) and in bronchitic patients with chronic obstructive pulmonary disease (COPD) in order to compare the slopes obtained for the groups. Methods: NCB and severe COPD were enrolled sequentially from an outpatient clinic (Universitary Hospital). A control group was established for NCB group, paired by sex and age. All subjects performed spirometry, VC and Six-Minute Walk Test (6MWT). Two comparisons were made: NCB group vs its control group, and NCB group vs COPD group. The project was approved by the ethical committee of the institution. Statistical tests used were Wilcoxon or Student t-test; statistically significant difference considered with p<0.05. Results: Concerning NCB group (N=20) vs control group (N=20), significant differences were found in BMI and in several functional variables (spirometric, CV, 6MWT) with the worse results observed in NCB group. In the comparison between the COPD group (N=20) vs NCB group, although patients with COPD have had worse spirometric and 6MWT values, the capnographic variables Slp2, Slp3/Ve and Slp3/EtCO2 were similar. Conclusion: These findings may indicate that the gas elimination curves are not sensitive enough to monitor the severity of structural abnormalities. The role of normalized phase 3 slope may be worth explore as a more sensitive index of small airway disease, even though it may not be equally sensitive in discriminating the severity of the alterations / Doutorado / Clinica Medica / Doutora em Clínica Médica
Caracterização da capacidade pulmonar nos detentos de duas penitenciárias da cidade de Guarulhos - SP / Characterization of lung capacity in prisioner of two prisions Guarulhos country, São Paulo, state BrazilVanessa Figueiredo Fraia 18 August 2009 (has links)
Introdução: Os distúrbios ventilatórios decorrente do comprometimento pulmonar da tuberculose ainda é incerto. A importância da tuberculose na população carcerária é motivo de preocupação mundial. As condições precárias de confinamento favorecem tanto a evolução da infecção para doença, como a sua transmissão. Mesmo antes da prisão, muitos detentos estão expostos a fatores de alto risco para a doença, como desnutrição, higiene escassa, aglomeração de pessoas, residência com pouca ventilação. Objetivo: Estudar a função pulmonar através da espirometria em uma amostra de detentos de duas penitenciárias do município de Guarulhos. Metodologia: Estudo descritivo realizado em duas penitenciárias no município de Guarulhos no período de março de 2008 a maio de 2008. Este estudo fez parte do projeto de pesquisa: A Tuberculose no sistema prisional estudo em duas penitenciárias da cidade de Guarulhos SP, com o objetivo de avaliar diferentes métodos de busca de casos de tuberculose pulmonar, neste sentido foi realizado, aproveitando a população, uma avaliação da capacidade pulmonar através da espirometria. Após a realização do questionário e exames previsto no estudo principal, os detentos que relatavam história de tuberculose no passado ou atualmente, algum comprometimento respiratório, foram indicados para realizar o exame de espirometria. Resultados: Dos 2.436 presos foram indicados 629 indivíduos, 486 não conseguiram realizar a espirometria ,sendo que 143 foram incluídos no estudo. A população estudada constitui-se de homens com a idade media de 34 anos. Cerca de 55,2 por cento da população estudada está em regime fechado há mais de 12 meses. Dos indivíduos que relataram tuberculose no passado, 40,9 por cento apresentaram resultado espirométrico restritivo. Os que relataram doenças pulmonares 22,9 por cento apresentaram resultado espirométrico restritivo. Conclusão: Apesar de muitos detentos apresentarem resultado espirometrico normal, foi identificado que 38,9 por cento dos detentos que relataram doença pulmonar apresentam distúrbio ventilatório. A descoberta do distúrbio ventilatório apresentado pelo preso é de grande importância, pois, deste modo pode ser iniciado o tratamento de doenças respiratórias, melhora dos sintomas e da qualidade de vida desta população. / Introduction: Ventilatory disorders due to pulmonary tuberculosis damage are yet uncertain. The relevance of tuberculosis among prison population is a reason of world concern. The precarious conditions of confinement promote as the evolution of the infection through a disease as its transmission.Even before prison, many prisoners are exposed to high risk factors of getting ill, such as malnutrition, lousy hygiene, people agglomeration, and bad ventilation. Objective: To study the pulmonary function through spirometry in a sample formed by prisoners of two prisions from the municipality of Guarulhos.Methodology: Descriptive study made in two prisions of the municipality of Guarulhos. Data were collected between March and May of 2008. This study has composed the project The tuberculosis in prision system Study in two prisions city Guarulhos (SP), aiming to evaluate different methods of search of pulmonary tuberculosis. In view of this, it was made an evaluation with the same population of their pulmonary capacity through spirometry. After the questionnaire and medical examinations expected in the main study, the subjects reported history of tuberculosis in the past or recently, some with respiratory damages have been selected to the spirometric evaluation.Results: Of the 2.436 prisoners have been selected 629 male being than it is to 143 have been inclusive at this study. The population studied it is man with medium age 34 years old. About 55,2 per cent from the population studied is well into regime closed for more than 12 months. Of individuals who reported tuberculosis 40,9 per cent they presented result spirometric restrictive , the reported that the lung disease 22,9 per cent they presented result spirometric restrictive. Conclusion: Though many prisoners present result normal spirometric, therefore identified 38,9 per cent the many prisoners present Ventilatory disorders. The discovery of ventilatory disorders it´s of great importance because this way can be initiated the tratament of pulmonary disease, improvement of respiratory symptoms and quality of life this population.
Heese, Hans de Villiers
02 August 2017
This thesis is a report on the value and limitations of the practical application of the Forced Expiratory Volume and Forced Vital Capacity test in children aged from 7 to 16 years. The first part deals with review of the literature on lung function and evolution of the Forced Expiratory Volume and Forced Vital Capacity test. The method and apparatus used in the test, the establishment of "normal values", the correlation of these values and certain anthropometric data, the establishment of prediction formulae for normal values, a study of the effect of factors such as sex, "learning" and repeatability, posture, daily and day-to-day variations, and the inhalation of isoprenaline on these normal values are reported. The second part deals with the practical application of the test in various pathological conditions affecting the cardio-respiratory system. The effect of respiratory disorders on ventilatory function is reported and an attempt is made to assess the effect of management, medical treatment and prognosis of a respiratory disorder at any given stage of that disorder acknowledging always that the complete evaluation of a patient requires more than laboratory tests.
Dave, Havya, King, Chase, Jones, Curry, Stoltz, Amanda
05 April 2018
At least 11 million Americans are diagnosed with chronic obstructive pulmonary disease (COPD), and there is a high likelihood millions more suffer from the disease but are undiagnosed. Spirometry is a medical test to determine how well a patient’s lungs work, and is used to diagnosis COPD. Despite this test’s utility, resident providers may be uneducated about or uncomfortable with administering spirometry. Past research has demonstrated that brief educational interventions can lead to clinically significant improvements in knowledge of spirometry. The purpose of this study is to compare family medicine residents’ responses regarding the use of spirometry in a rural Family Medicine Residency clinic before and after an educational program on the topic. Researchers will administer a survey to resident physicians at the Family Physicians of Bristol clinic about their knowledge regarding spirometry; residents will then be resurveyed after an educational program. It is expected that resident providers will show significant gains in their knowledge of spirometry after the completion of the educational program. Results of this project will be useful in identifying methods to increase medical providers’ awareness and comfort with spirometry, which will hopefully lead to increased accurate diagnosis of airway diseases.
Kineziterapijos efektyvumas, gydant bronchine astma sergančius 11-15 metų vaikus / The efficiency of physical therapy in children aged 11 – 15 years with bronchial asthmaKeraitė, Kristina 23 May 2005 (has links)
60 children with bronchial asthma were investigated of the age of 11-15. Children, who were investigated, were divided into 2 groups: the first group consisted of 30 children, who did exercises in the sport hall; the second group consisted of 30 children, who did exercises in the water. Physical therapy for both groups was provided for 30 minutes 6 days a week 1 time per day. Physical therapy included active gymnastic exercises using various physical therapy tools. It was provided two lung ventilation tests with spirometer “Spiromed 250”: the first test was taken before starting to do physical therapy, the second one was taken in the end of physical therapy. We examined the forced expiratory vital capacity (FVC), volume of forced expiration within the first second (FEVı), Gaensler index (FEVı/FVC), peak expiratory flow (PEF), maximum expiratory flow, when 50% of the forced vital capacity has been exhaled (MEF50%). The results of our investigation showed that gymnastic exercises in the water have more positive effect than gymnastic exercises in the sport hall for children with bronchial asthma.
Comparação dos testes de escada, caminhada e espirometria preditos com os obtidos no pós-operatório de ressecções pulmonares /Pancieri, Marcos Vinicius Cataneo. January 2009 (has links)
Resumo: A ressecção de tecido pulmonar funcionante leva a uma redução definitiva dos volumes e capacidades pulmonares, podendo seus valores serem preditos para o pós-operatório (ppo) através de uma regra de três simples. Como os valores espirométricos só avaliam os pulmões em repouso e não a real capacidade física do indivíduo, partiu-se da hipótese de que os testes de escada (TE) e de caminhada de 6 minutos (TC6) poderiam também se alterar proporcionalmente ao pulmão funcionante ressecado. Verificar se os testes usados como preditores de risco cirúrgico (VEF1, TC6, TE) se alteram proporcionalmente ao pulmão funcionante ressecado. O estudo incluiu pacientes candidatos a toracotomia para ressecção pulmonar que preenchiam os critérios de inclusão e concordaram em participar da pesquisa. No pré-operatório (pré) e no mínimo 3 meses após a cirurgia (pós), realizaram espirometria, teste de escada e teste de caminhada, no mesmo dia, com intervalo mínimo de 20 minutos entre os testes. A curva de capacidade vital foi realizada com o paciente sentado, pelo menos por três vezes, escolhendo-se aquela em que o VEF1 foi maior. O TC6 foi realizado segundo as normas da American Thoracic Society, em corredor plano de 120 metros à sombra. O TE foi realizado em escada com uma inclinação de 30°, à sombra, composta por 6 lances, com 12 degraus por lance (72 degraus), cada degrau medindo 16,9cm, num total de 12,16m de altura. O paciente foi orientado a subir todos os degraus no menor tempo possível, com incentivo verbal, padronizado a cada lance. O tempo em segundos percorrido na subida da altura total foi denominado tempo de escada (tTE). Os cálculos dos valores preditos para o pós-operatório (ppo) para o VEF1 e TC6 foram realizados por regra de três simples direta, a partir dos resultados... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Resection of the functioning lung tissue leads to a definite reduction in the lung volumes and capacities, and postoperative (ppo) values can be predicted through a simple rule of three. As spirometric values only evaluate lungs at rest and not the individual's real physical capacity, stair-climbing test (SCT) and 6-minute walk test (6MW) were suggested to change proportionally to the resected functioning lung. To verify whether tests used as predictors of surgical risk (FEV1, 6MW, SCT) change proportionally to the resected functioning lung. The study included patients candidate for thoracotomy for lung resection and who fulfilled the inclusion criteria, agreeing to participate in the investigation. In the preoperative period (pre) and at least three months after surgery (pos), the patients were subjected to spirometry, stair-climbing and walk tests on the same day, with a minimal interval of 20 minutes between tests. The vital capacity curve was done with the patient sit and repeated at least three times; the curve with the highest FEV1 was chosen. 6MW was carried out, according to the American Thoracic Society standards, in a 120m plain alley in the shade. SCT was also done in the shade in a 30°-inclination staircase of 12 steps in each of the six sets (72 steps) and each step measured 16.9cm in a total of 12.16m height. The patient was instructed to climb up all steps as fast as possible, being verbally stimulated, which was standardized for each set of steps. The time in seconds for total climb-up was named stair-climbing time (tSCT). The predicted postoperative (ppo) values for FEV1 and 6MW were calculated through direct simple rule of three, based on the results obtained in the preoperative tests and according to the number of lost functioning segments; for tSCT, values were determined through inverse rule of three. The values of pre,... (Complete abstract click electronic access below) / Orientador: Jair Cortez Montovani / Coorientador: Daniele Cristina Cataneo / Banca: Paulo Eduardo Oliveira de Carvalho / Banca: Antonio J. M. Catâneo. / Mestre
Page generated in 0.0349 seconds