Dissertations / Theses on the topic 'Lungs Diseases, Obstructive Australia'
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Roberts, Della Kim. "The family experience with chronic obstructive pulmonary disease." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24422.
Full textApplied Science, Faculty of
Nursing, School of
Graduate
Lo, Iek-long, and 羅奕龍. "Impacts of cognitive impairment on acute exacerbations of chronic obstructive pulmonary disease among Chinese elderly patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45830770.
Full textUbhi, Baljit Kaur. "A metabolomic study of chronic obstructive pulmonary disease (COPD) and its phenotypes." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.608237.
Full textBayliss, Daniel John. "Evaluation of outcomes of a six-month exercise maintenance pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1137788.
Full textSchool of Physical Education
Li, Meng. "Hospitalization cost analysis of COPD patients in Guangdong province." Thesis, University of Macau, 2018. http://umaclib3.umac.mo/record=b3952154.
Full textRycroft, Ashley McLean. "Development of a constant rate step test to assess exertional dyspnea in the primary care setting in patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112359.
Full textMethods. This test involved 4 stepping rates (18, 22, 26, 32 steps.min-1) equivalent to approximately 4.5, 5.3, 6.0, and 7.2 MET with the ultimate goal that in its final development, the assessment will be made a single stepping rate based on disease severity. Stable COPD patients (N = 43; 65 +/- 6.5 years; FEV1 = 49 +/- 16% pred.; SpO2 (%) rest: 95 +/- 2) were equipped with a portable Jaeger Oxycon MobileRTM metabolic system and followed an audio signal for stepping up and down a single 20 cm step for 3 minutes. Borg dyspnea scores were obtained at the end each stepping bout. A 10-min rest was given between each stepping bout.
Results. Of the 43 patients, 80% completed stages 1 and 2, 74 and 37% stages 3 and 4 while no patient of MRC class 4 or 5 (N = 8) completed stage 1. Breathing frequency (breaths.min-1) spanned from 26.5 +/- 4.1 to 39.0 +/- 6.4 but VT (L) remained unchanged (1.4 +/- 0.3 vs. 1.5 +/- 0.4) from stage 1 to 4 while Borg scores were 3 +/- 1, 4 +/- 1, 5 +/- 2, 6 +/- 3 respectively and SpO2 (%) were 92 +/- 5, 91 +/- 4, 91 +/- 4 and 90 +/- 4.
Conclusions. Preliminary findings indicate that a 3-minute constant rate step test may present a feasible alternative to laboratory testing to assess exertional dyspnea in moderately severe COPD. In this population, a stepping rate of 26 steps.min-1 could be sustained by the majority of patients while producing a level of dyspnea potentially amenable to therapy.
This study was supported by an unrestricted grant from Boehringer-Ingelheim/Pfizer.
Henophy, Sara Catherine 1983. "Test-re-test reproducibility of constant rate step and shuttle walking tests for the assessment of exertional dyspnea in patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=116085.
Full textMethods: Stable COPD patients (N=43; 65 +/- 6.5 years; FEV1 = 49 +/- 16% pred.) equipped with a portable Jaeger Oxycon MobileRTM metabolic system repeated the walking or stepping tests on two occasions separated by 7 to 14 days. At each visit, participants performed, in a randomized order, four externally paced 3-min bouts of shuttle walking at speeds of 1.5, 2.5, 4.0 and 6.0 km·h-1 or of stepping at a constant rate of 18, 22, 26 and 32 steps·min-1, respectively. Each exercise bout was separated by a 10-min rest period. Ventilation, heart rate, gas exchange parameters and Borg dyspnea score were obtained for each bout during the last 30-seconds of exercise.
Results: The majority of patients completed stepping or walking at the slowest cadence but only 33% completed walking at 6.0 km·h -1 and 40% completed stepping at 32 steps·min-1. Test-retest Pearson correlation coefficients for ventilation, heart rate, gas exchange parameters and dyspnea scores over the four exercise bouts, all exceeded 0.80 with the highest coefficient found for ventilation (r≥.95). Intra-class correlation coefficients were similar to Pearson. Bland & Altman representation showed that a similar proportion of dyspnea data points (92 vs. 96%) lied within 2 SD of the mean difference between test-retest values for dyspnea Borg scores during walking and stepping.
Conclusion: Results show very good reproducibility for both 3-min shuttle walking and stepping exercise protocols in patients with COPD.
This study was supported by an unrestricted grant from Boehringer-Ingelheim/Pfizer.
Harvey, K. "Ipratropium bromide mediated myocardial injury in in vitro models of myocardial ischaemia/reperfusion." Thesis, Coventry University, 2015. http://curve.coventry.ac.uk/open/items/f03ffc6e-3554-4062-99c2-1c243feb582a/1.
Full textBaril, Jacinthe. "Interaction between circulatory and respiratory exercise adaptation in chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF)." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97901.
Full textDe, Klerk Danelle Ria. "An adapted rehabilitation programme for a cross section of South African chronic obstructive pulmonary disease patients." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/776.
Full textHaddad, Donna L. "Nutritional status indicators in hospitalized patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=67536.
Full textChun, Wai-chun, and 秦惠珍. "Evidence based smoking cessation guidelines for hospitalized chronic obstructive pulmonary disease smokers." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44623264.
Full textRittmaster, Dana. "Anthropometric, clinical and lifestyle determinants of exercise energy expenditure in patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82412.
Full textDe, Souza Melissa. "Central circulatory adaptations to low and high intensity cycling in patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=84021.
Full textChu, Ling-fung, and 朱凌峯. "Plasma inflammatory biomarkers in stable COPD patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48333682.
Full textpublished_or_final_version
Medicine
Master
Master of Medical Sciences
Barry, Vaughn W. "A physical activity assessment of pulmonary patients participating in pulmonary rehabilitation." Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1380094.
Full textSchool of Physical Education, Sport, and Exercise Science
Falls, Richard Drew. "SUBJECTIVE AND OBJECTIVE RESPONSES TO VARIED DOSES OF AN INHALED BRONCHODILATOR (ALBUTEROL)." Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275382.
Full textMoutafis, Roxanne Alexis. "Symptomatology and life quality as predictors of emergent use." Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/277089.
Full textChan, Kan-kam, and 陳根錦. "Disablement, power resources and powerlessness of silicotic patients in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B31249644.
Full textSaudny-Unterberger, Helga. "Impact of nutritional support on changes in functional status during an acute exacerbation of chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23294.
Full textForced vital capacity (FVC % predicted) improved significantly over the study period in treated vs control subjects (+11.10 $ pm$ 4.63 vs $-$4.50 $ pm$ 2.14; p = 0.026). Nitrogen balances were calculated for 9 subjects, and all were in negative balance ($-$8.42 $ pm$ 1.74 g nitrogen/d) with no difference between groups.
Because of the high doses of methylprednisolone administered (69.6 $ pm$ 8.3 mg/d), and their known catabolic effects, we examined whether the dose affected nitrogen balance and muscle strength. Both nitrogen balance (r = $-$0.73; p = 0.025) and grip strength (r = $-$0.76; p $<$ 0.001) worsened with higher doses of steroids. The catabolic process may have resulted from elevated energy requirements, inadequate intake of protein and energy or been induced by high doses of steroids.
Hospitalized COPD patients are highly stressed and catabolic, and the means to preventing protein wasting during an acute exacerbation of their disease remains to be established. (Abstract shortened by UMI.)
Lau, Kwok-wai, and 劉國威. "The involvement of serotoninergic system in cigarette smoke-induced oxidative stress and inflammation: relevantto chronic obstructive pulmonary disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B47869616.
Full textpublished_or_final_version
Medicine
Doctoral
Doctor of Philosophy
Mitchell, K. "The effectiveness of a Self-management Programme of Activity Coping and Education - SPACE FOR COPD - in Primary Care." Thesis, Coventry University, 2013. http://curve.coventry.ac.uk/open/items/6c81b0ca-bac5-4499-9b42-208db13cb468/1.
Full textPienaar, Lunelle Lanine. "COPD patients in the northern suburbs of the Western Cape Metropole hospitalised due to acute exacerbation : baseline study." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/21897.
Full textENGLISH ABSTRACT: Acute exacerbation is an important event of COPD as it causes significant disability and mortality. Especially repeated hospitalisation of patients with acute exacerbation has been associated with reduce quality of life and excessive hospitalisation cost. Chronic Obstructive Pulmonary Disease causes significant functional limitations that translate into enormous economic and societal burden. Study Aim: To describe the profile and selected outcomes of Chronic Obstructive Pulmonary Disease (COPD) patients admitted with acute exacerbation to hospitals in the northern suburbs of the Western Cape. Study design: A multicenter retrospective descriptive single subject design was used. Method: Patients admitted with the diagnosis of COPD with acute exacerbation in the time period 01June 2004-01June 2005 were followed up retrospectively for a period of 12 months. The demographics, medical condition on admission and past presentation of acute exacerbation, length of stay in hospital and the number of readmissions for acute exacerbation in the 12 month period were collected and recorded on a self designed data capture sheet. Results: One hundred and seventy eight patients were admitted with acute exacerbation at the three hospitals. The mean age of the patients were 63 (±11.73), more males than females (103: 75) were admitted. Subjects spent a mean of 5.67 (±6.55), days in hospital with every admission and admission frequency of up to eight periods were recorded. Of the n=178 admitted, 56% had one admission and 44% had 2 or more admissions in the study year. This resulted in a total of 338 hospital admissions with the 78 subjects responsible for the majority of admissions (238) Subjects presenting with two or more co-morbidities had a significantly greater risk of multiple re admissions. Subjects with three or more admissions had two or more co morbidities (p=0.001), comparatively those with one admission had only one co morbidity. Congestive cardiac failure (p=0.01) as well as the lack of Long Term Oxygen Therapy p=0.017) were associated with increase risk of three or more admissions. Conclusion: Patients admitted with acute exacerbation to the hospitals where the study was conducted presented with an age ranging from 30-95 years. Patients with 2 or more admissions experience up to eight readmissions episodes in the study year. This is a cause of concern in respect of the burden of disease on especially the younger economically viable South African population. In the current study factors that influenced readmission were the presence of two or more co morbid diseases, specifically the presence of congestive cardiac failure as well as the lack of LTOT. Interventions including a pulmonary rehabilitation programme post discharge should be aimed at decreasing frequency of hospitalisation especially in those patients who are a risk of readmission.
AFRIKAANSE OPSOMMING: Verergering van simptome in Kroniese Obstruktiewe Lugweg Siekte (KOLS) is baie belangrik as gevolg van die ongeskiktheid en mortalitieit wat dit veroorsaak. Dit veroorsaak vermindering in die kwaliteit van lewe en verhoog hospitaal koste verbind met die siekte. Die beperkings toe te skrywe aan die Kroniese Obstruktiewe Lugweg Siekte veroorsaak ontsettende ekonomiese en sosiale druk. Doelstelling: Om die profiel en geselekteerde uitkomste van pasiente met Kroniese Obstruktiewe Lugweg Siekte toegelaat met verergering in die hospitale van die noordelike voorstede van die Wes Kaap te beskryf. Studie ontwerp: ʼn Multisentrum retrospektiewe beskrywende enkel persoon studie. Studie metode: Pasiente toegelaat met verergering van Kroniese Obstruktiewe Lugweg Siekte in die periode 01Junie 2004-01Junie 2005 was retrospektief opgevolg vir ‘n periode van 12-maande. Demografiese data, mediese toestand op toelating en ontslag, lengte van hospitaal verblyf en getal toelatings in die 12- maande was gekollekteer en gedokumenteer op self ontwerpde vorms. Resultate: Een-honderd agt en seventig pasiente was toegelaat met verergering by die drie hospitale. Die gemiddelde ouderdom van die studie populasie was 63 (±11.73) met meer mans as vrouens (103: 75) toegelaat. Die studie populasie het gemiddelde dae van 5.67 (±6.55), in die hospitaal deurgebring en toelating frekwensie van agt episodes was gedokumenteer. Van die n=178 toegelaat was 56% eenkeer toegelaat en 44% het 2 of meer toelatings in die studie jaar gehad. Dit het in 338 hospital toelaatings veroorsaak en 78 van die studie populasie verantwoordelik vir die meeste van die toelatings (238). Die groep met drie of meer toelatings in die studie jaar het twee of meer siektetoestande (p=0.001) gehad, teenorgesteld met die wat net een toelaat was met een siektetoestand. Hart versaaking (p=0.01) en die gebrek aan suurstof by die huis (p=0.017) was verbind met meer risiko van drie of meer toelating. Samevatting: Die ouderdoms verskil was wydbeskrywend van 30-95 jaar van die pasiente wat in die studie jaar toegelaat is by die drie hospitale. Pasiente wat 2 of meer keer toegelaat is het tot agt hertoelatings in die studie jaar gehad. Kommerwekkend is die uitwerking van die siekte op die jonger werkend populasie in Suid Afrika. In die studie was hertoelating beinvloed deur die teenwoordigheid van twee of meer siektetoestande, spesifiek hart versaaking sowel as die gebrek aan suurstof by die huis. Intervensies insluitende pulmonale rehabilitasie na ontslag se doel moet wees om vermindering van heraaldelike hospitalisasie in hoë risiko pasiente vir hospitalisasie.
Goussard, Pierre. "Bronchoscopic assessment and management of children presenting with clinically significant airway obstruction due to tuberculosis." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97039.
Full textENGLISH ABSTRACT: Tuberculosis (TB) in children is a common infectious disease in the world affecting approximately 550 000 children annually and contributing to approximately 10-15% of the TB caseload. The estimate is that 75% of the children who have TB live in the 22 countries that have the highest burden of TB disease. In these 22 countries, the technology required to make the diagnosis and manage complicated cases is limited. The epidemiological data required to estimate the proportion of children with severe disease requiring intervention at a global level are lacking. Airway involvement is commonly seen in children with primary TB, but only in a small group of children the compression is severe, needing intervention. The incidence of children with airway obstruction requiring intervention due to primary TB in the chemotherapeutic era is not known. The incidence of complicated lymph node disease in two recent reports varied from 8-38% in children younger than 15 years of age. Flexible bronchoscopy (FB) is an invasive procedure performed under general anesthetic is used to assess the airways of children. Few studies have been published on the use of FB in the diagnosis of paediatric TB and most have concentrated on the use of bronchoscopy as an intervention for obtaining samples to diagnose pulmonary TB (PTB). All previous studies only examined broncho-alveolar lavage (BAL) for Ziehl Neelsen (ZN) positive organisms and mycobacterial culture. All the published studies are from developed countries with a very low incidence of PTB in children. It has been postulated that HIV positive children with TB are more likely to have airway obstruction, but this hypothesis has not been studied. The same is true for children infected with drug-resistant strains of tuberculosis. Similarly, there have been few reports on the correlation between the findings at bronchoscopy and those found on chest computer tomography (CT). The aim of this research project was to systematically determine airways involvement in childhood pulmonary TB and assess the role paediatric bronchoscopy plays in the diagnosis, sample collection and the management of severe airway obstruction. The first part of the thesis describes the bronchoscopic assessment of airway obstruction due to pulmonary TB in children, specifically concentrating on the areas of the airway involved and the severity of the obstruction. We investigated which factors determine the severity of airway obstruction and this included age, sex, HIV status and drug sensitivities. We have shown that there was no difference in airway obstruction in HIV positive children and in children with drug resistance TB. More severe airway obstruction was seen in the younger child. The second question that was analysed is the value of flexible bronchoscopy in collecting samples for TB culture and drug sensitivity testing. It has previously been reported that BAL culture was inferior to gastric lavage in isolating the bacilli. We set out to evaluate which factors determine if a child will be culture-positive on BAL. Most childhood pulmonary TB is postulated to have a low yield of ZN positive cases. We found a higher yield from BAL as was previously reported, and the yield was increased if segmental or lobar pneumonia was present on the chest radiography. We developed novel interventions of finding the organism and increasing the yield from BAL. About 80% of children with PTB have enlarged subcarinal lymph nodes. We performed a trans-bronchial needle aspiration (TBNA) biopsy of these lymph nodes for culture. This technique enables us to differentiate the cause of enlarged mediastinal lymph nodes. This is especially important in children who are HIV positive, as they are prone to have other causes of enlarged lymph nodes. We successfully performed TBNA, even in very young infants, which resulted in a diagnostic yield of 55%. The use of Xpert has been described on other tissue, but not on BAL. We wanted to test if the use of Xpert on BAL is feasible in children, and determine if it will increase the diagnostic yield by using BAL samples. The third aspect of this research was to compare flexible bronchoscopy findings with those of chest CT scan finding. Firstly, the aim was to describe the CT scan findings of mediastinal glands and lungs in children with significant airway obstruction due to PTB. The second aim was to investigate how these two investigations of airway obstruction compared, with particular emphasis on their advantages and disadvantages. The areas of airway obstruction as well as the severity of the obstruction as determined by CT scan were very similar to the findings with bronchoscopy. The final part under this aspect of the study was to analyze airway shape using a computer model to asses if this could predict TB. This was done by extracting components of the airway surface mesh and branch radius and orientation features. This method showed the potential of computer-assisted detection of TB and other airway pathology by using airway shape deformation analysis. The fourth aspect investigated was to determine which children with severe airway obstruction would benefit from a surgical intervention. Surgical enucleation is done via a lateral thoracotomy in children with severe airway obstruction. We investigated which factors determine the need for surgical enucleation, the optimal timing of this intervention, and – if surgical enucleation was done as an emergency intervention – which factors would predict for this. The combination of trachea, left main bronchus and bronchus intermedius involvement was the best predictor for children requiring surgical enucleation. Involvement of the smaller airway divisions did not play a significant role. Children needing enucleation were younger and had more severe airway obstruction. The fifth aspect of this thesis was to measure the outcome following surgical enucleation. Measurements used included clinical measurements, radiological measurements and bronchoscopy. The response in children treated surgically were compared to those treated medically by estimating airway size with flexible bronchoscopy. Both groups showed significant improvement with the magnitude of improvement greater in those surgically treated. We have demonstrated in this thesis that the site and severity of severe airway obstruction can be assessed by either bronchoscopy or chest CT scan. Approximately one third of children with severe airway compression due to TB lymph nodes can be successfully treated surgically with a low morbidity and mortality.
AFRIKAANSE OPSOMMING: Tuberkulose (TB) by kinders is wêreldwyd ’n algemene siekte wat jaarliks ongeveer 550 000 kinders raak en sowat 10-15% van die algehele TB-siektelas uitmaak. Na raming kom 75% van alle kinders met TB van die 22 lande met die hoogste TB-siektelas. Hierdie 22 lande beskik oor beperkte tegnologie om die siekte te diagnoseer en ingewikkelde gevalle te bestuur. Die vereiste epidemiologiese data om te raam watter persentasie kinders wêreldwyd ernstig siek is en intervensie vereis, ontbreek ook. Lugwegaantasting word algemeen by kinders met primêre TB aangetref. Tog is die kompressie by slegs ’n klein groepie kinders so erg dat dit intervensie vereis. Die voorkoms van kinders in die chemoterapeutiese era met primêre-TB-verwante obstruksie van die lugweë wat intervensie vereis, is onbekend. In twee onlangse verslae het die voorkoms van gekompliseerde limfkliersiekte by kinders jonger as 15 jaar van 8% tot 38% gewissel. Buigbare brongoskopie is ’n indringende prosedure wat onder algemene verdowing uitgevoer word om kinders se lugweë te ondersoek. ’n Paar studies is reeds gepubliseer oor die gebruik van buigbare brongoskopie om pediatriese TB te diagnoseer. Die meeste daarvan het gekonsentreer op die gebruik van brongoskopie as intervensie vir die insameling van monsters om pulmonêre TB (PTB) te diagnoseer. Alle vorige studies het uitsluitlik ondersoek ingestel na brongo-alveolêre spoeling (BAS) vir die opsporing van Ziehl Neelsen- (ZN-)positiewe materiaal en vir kweking. Geen ander diagnostiese tegnieke is tot dusver ondersoek nie, wat die waarde daarvan vir populasies met ’n hoë siektelas beperk. Boonop is alle gepubliseerde studies in ontwikkelde lande met ’n baie lae voorkoms van PTB by kinders onderneem. Daar word aangevoer dat MIV-positiewe kinders met TB meer waarskynlik aan obstruksie van die lugweë sal ly, hoewel hierdie hipotese nog nie bestudeer is nie. Dieselfde geld vir kinders wat aan middelweerstandige vorme van TB ly. Daar is ook weinig verslae oor die verband tussen die bevindinge van brongoskopie en dié van rekenaartomografie (RT) van die borskas. Die doel van hierdie navorsing was om stelselmatig vas te stel hoe pulmonêre TB by kinders die lugweë aantas, en watter rol pediatriese brongoskopie in diagnose, monsterinsameling en die hantering van ernstige obstruksie van die lugweë speel. Die eerste deel van die tesis beskryf die brongoskopiese voorkoms van PTB-verwante obstruksie van die lugweë, met bepaalde klem op die aangetaste dele van die lugweg en die erns van die obstruksie. Daar is ondersoek ingestel na watter faktore die erns van die obstruksie bepaal, onder meer ouderdom, geslag, MIV-status en middelsensitiwiteit. Die resultate toon geen verskil in obstruksie by MIV-positiewe kinders en kinders met middelweerstandige TB nie, hoewel ernstiger obstruksie van die lugweë by die jonger kind opgemerk is. Die tweede kwessie wat ontleed is, is die waarde van buigbare brongoskopie in die verkryging van monsters vir TB-kweking en toetse vir middelsensitiwiteit. Daar is voorheen aangemeld dat BAS-kweking minder doeltreffend is as gastriese spoeling om die basille te isoleer. Hierdie studie was daarop toegespits om te beoordeel watter faktore bepaal of ’n kind kwekingspositief met BAS sal wees. Die meeste PTB by kinders toon na bewering ’n lae opbrengs van ZN-positiewe gevalle. Tog het BAS in hierdie studie ’n hoër opbrengs gehad as wat voorheen aangemeld is, welke opbrengs hoër was met die aanwesigheid van segmentale of lobêre pneumonie op die borskasradiogram. Innoverende intervensies is ontwikkel om die organisme op te spoor en die opbrengs met BAS te verhoog. Sowat 80% van kinders met PTB het vergrote subkarinale limfkliere. ’n Transbrongiale naaldaspirasie- (TBNA-)biopsie is gevolglik vir die doeleinde van kweking op hierdie kliere uitgevoer. Hierdie tegniek het die navorser in staat gestel om tussen die verskillende oorsake vir vergrote mediastinale limfkliere te onderskei. Dít is veral belangrik by MIVpositiewe kinders, wat geneig is om ander oorsake vir vergrote limfkliere te toon. Die TBNA-biopsies is selfs by baie jong babas suksesvol uitgevoer, wat tot ’n diagnostiese opbrengs van 55% gelei het. Die gebruik van Xpert op ander weefsel as BAS is al voorheen beskryf. Die navorser wou dus vasstel of die gebruik van Xpert by BAS haalbaar is by kinders, en of dit die diagnostiese opbrengs deur die gebruik van BAS-monsters sal verhoog. Die derde aspek van hierdie navorsing was om die bevindinge van buigbare brongoskopie met dié van RT-skanderings van die borskas te vergelyk. Die doel was eerstens om die bevindinge van die RT-skanderings van mediastinale kliere en longe by kinders met beduidende PTB-verwante lugweg-obstruksie te beskryf. Tweedens wou die navorser vasstel wat die verskille tussen hierdie twee ondersoeke van lugweg-obstruksie is, met bepaalde klem op die voordele en nadele daarvan. Die RT-skandering en die bevindinge van brongoskopie lewer betreklik soortgelyke resultate op wat die aangetaste gedeeltes van die lugweg sowel as die erns van sodanige obstruksie betref. Die laaste doel onder hierdie studieaspek was om die vorm van die lugweg met behulp van ’n rekenaarmodel te ontleed om te bepaal of dit TB kan voorspel. Dít is gedoen deur komponente van die die erns van die obstruksie. Daar is ondersoek ingestel na watter faktore die erns van die obstruksie bepaal, onder meer ouderdom, geslag, MIV-status en middelsensitiwiteit. Die resultate toon geen verskil in obstruksie by MIV-positiewe kinders en kinders met middelweerstandige TB nie, hoewel ernstiger obstruksie van die lugweë by die jonger kind opgemerk is. Die tweede kwessie wat ontleed is, is die waarde van buigbare brongoskopie in die verkryging van monsters vir TB-kweking en toetse vir middelsensitiwiteit. Daar is voorheen aangemeld dat BAS-kweking minder doeltreffend is as gastriese spoeling om die basille te isoleer. Hierdie studie was daarop toegespits om te beoordeel watter faktore bepaal of ’n kind kwekingspositief met BAS sal wees. Die meeste PTB by kinders toon na bewering ’n lae opbrengs van ZN-positiewe gevalle. Tog het BAS in hierdie studie ’n hoër opbrengs gehad as wat voorheen aangemeld is, welke opbrengs hoër was met die aanwesigheid van segmentale of lobêre pneumonie op die borskasradiogram. Innoverende intervensies is ontwikkel om die organisme op te spoor en die opbrengs met BAS te verhoog. Sowat 80% van kinders met PTB het vergrote subkarinale limfkliere. ’n Transbrongiale naaldaspirasie- (TBNA-)biopsie is gevolglik vir die doeleinde van kweking op hierdie kliere uitgevoer. Hierdie tegniek het die navorser in staat gestel om tussen die verskillende oorsake vir vergrote mediastinale limfkliere te onderskei. Dít is veral belangrik by MIVpositiewe kinders, wat geneig is om ander oorsake vir vergrote limfkliere te toon. Die TBNA-biopsies is selfs by baie jong babas suksesvol uitgevoer, wat tot ’n diagnostiese opbrengs van 55% gelei het. Die gebruik van Xpert op ander weefsel as BAS is al voorheen beskryf. Die navorser wou dus vasstel of die gebruik van Xpert by BAS haalbaar is by kinders, en of dit die diagnostiese opbrengs deur die gebruik van BAS-monsters sal verhoog. Die derde aspek van hierdie navorsing was om die bevindinge van buigbare brongoskopie met dié van RT-skanderings van die borskas te vergelyk. Die doel was eerstens om die bevindinge van die RT-skanderings van mediastinale kliere en longe by kinders met beduidende PTB-verwante lugweg-obstruksie te beskryf. Tweedens wou die navorser vasstel wat die verskille tussen hierdie twee ondersoeke van lugweg-obstruksie is, met bepaalde klem op die voordele en nadele daarvan. Die RT-skandering en die bevindinge van brongoskopie lewer betreklik soortgelyke resultate op wat die aangetaste gedeeltes van die lugweg sowel as die erns van sodanige obstruksie betref. Die laaste doel onder hierdie studieaspek was om die vorm van die lugweg met behulp van ’n rekenaarmodel te ontleed om te bepaal of dit TB kan voorspel. Dít is gedoen deur komponente van die lugwegoppervlaknetwerk en vertakkingsradius- en oriëntasiekenmerke te onttrek. Hierdie metode het daarop gedui dat rekenaargesteunde opsporing van TB en ander lugwegpatologie deur middel van ’n ontleding van lugwegvervorming wél potensiaal toon. Die vierde aspek was om te bepaal watter kinders met ernstige obstruksie van die lugweë by intervensie sal baat vind. By sulke kinders word chirurgiese enukleëring deur ’n laterale torakotomie uitgevoer. Die studie het ondersoek ingestel na watter faktore die behoefte aan chirurgiese enukleëring bepaal, wat die optimale tyd vir sodanige intervensie sou wees, en – indien chirurgiese enukleëring as noodintervensie uitgevoer word – watter faktore so ’n noodintervensie sou vereis. Die kombinasie van aantasting van die tragea, linkerhoofbrongus en brongus intermedius was die beste voorspeller van kinders wat chirurgiese enukleëring benodig. Aantasting van die kleiner lugwegverdelings het nie ’n beduidende rol gespeel nie. Kinders wat enukleëring vereis, was jonger en het aan ernstiger obstruksie van die lugweë gely. Die vyfde aspek van hierdie tesis was om die uitkoms na afloop van chirurgiese enukleëring te meet. Kliniese metings, radiologiese metings en brongoskopie is hiervoor gebruik. Die reaksie by kinders wat chirurgies behandel is, is vergelyk met diegene wat medies behandel is deur lugweggrootte met behulp van buigbare brongoskopie te raam. Albei groepe het beduidende verbetering getoon. In die studie het ons getoon dat die ligging en die erns van ernstige lugwegobstruksie kan geassesseer word deur óf brongoskopie of rekenaartomografie van die borskas. Ongeveer een derde van kinders met 'n ernstige lugweg-obstruksie weens TB limfkliersiekte kan suksesvol chirurgies met 'n lae morbiditeit en mortaliteit behandel word.
Reavell, Colleen Frances. "Resolution of muscle wasting during an acute exacerbation of chronic obstructive pulmonary disease (COPD)." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0031/MQ64435.pdf.
Full textBrown, Jennifer Leigh. "The effect of exercise in pulmonary rehabilitation on the quality of life of chronic obstructive pulmonary disease patients." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50143.
Full textENGLISH ABSTRACT: The purpose of the study was to measure the responses of chronic obstructive pulmonary disease patients to an exercise programme in a South Africa setting. Nine subjects were evaluated before and after aerobic and resistance training three times a week for the total of 12 weeks. Each evaluation measured forced expiratory lung function; health-related quality of life; functional capacity; level of dyspnea; body composition; physician global evaluation; and the patient global evaluation. The exercise programme consisted of one-hour exercise sessions, three times a week for 12 weeks. The exercise sessions included elements of aerobic and resistance training of the upper and lower extremities. Functional capacity improved drastically (p < 0.01), as did the physician and the patient global evaluations (p < 0.01 and p < 0.01, respectively). Levels of dyspnea also improved (p < 0.01). Health-related quality of life improved marginally (p = 0.03). No significant change was noted in lung function and body composition. The study concluded that an exercise programme consisting of aerobic and resistance training improves chronic obstructive pulmonary disease patients' health-related quality of life, functional capacity and levels of dyspnea. Exercise also reduces the symptoms of chronic obstructive pulmonary disease as are perceived by the physician and patient alike. Exercise does not change lung function or body composition of chronic obstructive pulmonary disease patients. Exercise in conjunction with appropriate medical treatment has the potential to benefit all chronic obstructive patients in South Africa. Keywords: COPD, quality oflife, functional capacity, rehabilitation, exercise.
AFRIKAANSE OPSOMMING: Die doel van die studie was om die reaksies te meet van pasiënte met chroniese obstruktiewe pulmonêre siekte op 'n oefenprogram in 'n Suid-Afrikaanse konteks. Nege proefpersone is voor en na aërobiese en weerstandsoefening drie keer per week vir 'n totaal van 12 weke geëvalueer. Elke evaluering het die volgende gemeet: geforseerde ekspiratoriese longfunksie, gesondheidsverwante lewenskwalitiet, funksionele kapasiteit; dispneevlak, liggaamsamestelling; geneesheer algehele evaluering asook pasiënt algehele evaluering. Die oefenprogram het uit een-uur sessies bestaan, wat drie keer per week vir 12 weke plaasgevind het. Die oefensessies het elemente van aërobiese en weerstandsoefeninge van die boonste en onderste ledemate ingesluit. Funksionele kapasiteit het drasties verbeter (p < 0.01), net so ook die geneesheer en pasiënt algehele evaluerings (p < 0.01 en p < 0.01, respektiewelik). Dispneevlakke het ook verbeter (p < 0.01). Gesondheidsverwante lewenskwaliteit het marginaal verbeter (p = 0.03). Geen beduidende veranderinge is in die longfunksie en liggaamsamestelling gevind nie. Die studie het bevind dat 'n oefenprogram wat uit aërobiese en weerstandsoefening bestaan gesondheidsverwante lewenskwaliteit, funksionele kapasiteit asook dispneevlakke van pasiënte met chroniese obstruktiewe pulmonêre siekte verbeter. Oefening verminder ook die simptome van chroniese obstruktiewe pulmonêre siekte soos waargeneem deur beide die geneesheer en pasiënt. Oefening verander ook nie longfunksie of liggaamsamestelling van pasiënte met chroniese obstruktiewe pulmonêre siekte nie. Oefening tesame met die geskikte mediese behandeling kan voordelig wees vir chronies obstruktiewe pasiënte in Suid- Afrika. Keywords: KOPS, lewenskwaliteit, funksionele kapasiteit, rehabilitasie, oefening.
Cheung, Hok-leung, and 張學良. "An exploratory study of the ability to go outdoors of elderly people with chronic obstructive pulmonary disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31979427.
Full textBhunthurat, Anurak. "The Vitamin B-6 Status of Patients with Chronic Obstructive Pulmonary Disease." Thesis, North Texas State University, 1986. https://digital.library.unt.edu/ark:/67531/metadc500541/.
Full textBrouqueyre, Laurent. "Hydro-acoustic therapy : design, construction and testing." Thesis, Georgia Institute of Technology, 1999. http://hdl.handle.net/1853/18215.
Full textLau, Wai-lee Cherry, and 劉慧莉. "Outcomes of COPD patients receiving long term oxygen therapy: a retrospective cohort study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B3197014X.
Full textKwok, Hau-chung, and 郭孝聰. "Anxiety and depression in COPD patients of a regional hospital in HongKong: the relationship with disease severityand dyspnoea." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48423592.
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Public Health
Master
Master of Public Health
Li, Xiang, and 李想. "Effects of human mesenchymal stem cells on cigarette smoke-induced lung damage." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B49618209.
Full textpublished_or_final_version
Medicine
Master
Master of Philosophy
Gravel, Geneviève. "The oxygen cost of cycling in patients with chronic obstructive pulmonary disease and the effect of increasing ventilatory requirements /." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82233.
Full textHinze, Candace. "The role of malnutrition in prolonged respiratory failure : the effect of accelerated nutritional rehabilitation." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22740.
Full textLineburger, Eric Benedet [UNESP]. "Relação do índice bispetral e da taxa de supressão do traçado do eletroencefalograma com disfunção cognitiva pós-operatória em cirurgia de revascularização do miocárdio." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/113900.
Full textIntrodução: Não está claro na literatura se os valores do índice bispectral (BIS) e da taxa de supressão do traçado de eletroencefalograma (TS), estão relacionados à disfunção cognitiva pós-operatória (DCPO). Objetivo: Avaliar os valores de BIS e TS e sua relação com a DCPO após cirurgia de revascularização do miocárdio (CRM) em pacientes submetidos a anestesia com sevoflurano (SEVO) guiada pelo BIS. Tipo de estudo: Observacional prospectivo. Local do estudo: Hospital de ensino. Pacientes: Noventa pacientes adultos programados para CRM com ou sem circulação extra-corpórea (CEC). Intervenções: A anestesia foi induzida com propofol, remifentanil e atracúrio e mantida com concentrações expiradas de SEVO (ETSEVO) em valores de concentração alveolar mínima (CAMSEVO) adaptada à idade, tendo como alvo valores de BIS de 40-60. O Mini-Exame do Estado Mental (MEEM) para avaliação cognitiva dos pacientes foi aplicado na admissão hospitalar e três meses após a cirurgia. Variáveis estudadas: Os valores de BIS, TS, ETSEVO e CAMSEVO foram registrados a cada 5 minutos durante o procedimento. Redução de um desvio padrão (DP) ou mais no MEEM basal foi definida como DCPO. Resultados: A proporção de DCPO foi de 40%. Os pacientes foram alocados em dois grupos: com (n = 36) ou sem DCPO (n = 54). Não houve diferença significativa na incidência de DCPO entre os pacientes que foram submetidos à CRM com ou sem CEC (p = 1,0). Quanto às características dos pacientes, somente os valores de índice de massa corporal (IMC) foram maiores no grupo sem DCPO (p = 0,009). Valores médios de BSR, ETSEV e MACSEV foram maiores no grupo sem DCPO (p < 0,05). Em uma análise multivariada, valores menores de TS (Razão de Chances-RC 0,008, Intervalo de Confiança-IC 95% [0,001-0,53], p = 0,02), CAMSEVO (RC 0,001, IC 95% [0,001-0,08], p = 0,008), ETSEVO (RC 0,03, IC 95% [0,002-0,66], p = 0,02) e ...
Background: It is still controversial whether bispectral index (BIS) and burst suppression ratio (BSR) values are related to postoperative cognitive dysfunction (POCD). OBJECTIVE: To evaluate BIS and BSR values and their relation to POCD after coronary artery bypass grafting (CABG) surgery in patients undergoing BIS-guided sevoflurane (SEVO) anaesthesia. DESIGN: Prospective, observational study. SETTING: Teaching hospital. PATIENTS: Ninety adult patients scheduled for on- or off-pump CABG surgery. INTERVENTIONS: Anaesthesia was induced with propofol, remifentanil and atracurium and maintained with end-tidal SEVO (ETSEVO) at age-adapted minimum alveolar concentration (MACSEVO) targeting BIS values of 40-60. Mini-Mental State Examination (MMSE) for cognitive assessment of the patients was applied on hospital admission and at 3 months after surgery. MAIN OUTCOME MEASUREMENTS: BIS, BSR, ETSEVO and MACSEVO values were recorded every 5 minutes during the procedure. A decrease of 1 standard deviation or more from the basal MMSE was defined as POCD. RESULTS: The POCD proportion was 40%. The patients were allocated into two groups: with POCD (n=36) or no POCD (n=54). There was no difference of POCD incidence between patients who were submitted to on- versus off-pump CABG (P=1.0). With regard to the patient’s characteristics, only body mass index (BMI) was higher in the no-POCD group (P=0.009). Mean BSR, ETSEVO and MACSEVO values were higher in the no-POCD group (P<0.05). In a multivariable analysis, lower values of BSR (odds ratio-OR 0.008; 95%CI [0.001-0.53]; P=0.02), MACSEVO (OR 0.001; 95%CI [0.001-0.08]; P=0.008), ETSEVO (OR 0.03; 95%CI [0.002-0.66]; P=0.02) and BMI (OR 0.82; 95%CI [0.70-0.96]; P=0.01) were independent predictors of risk for POCD incidence. BIS values did not influence POCD incidence (OR 1.0; 95%CI [0.95-1.11]; P=0.40). CONCLUSION: BIS-guided SEVO anaesthesia titrated to a range between 40 and 60 is not a predictive factor ...
Pissulin, Flávio Danilo Mungo. "Avaliação de variáveis respiratória, metabólica, hemodinâmica e atividade inflamatória para caracterizar a tríade Doença Pulmonar Obstrutiva Crônica (DPOC), Síndrome da Apnéia Obstrutiva do Sono (SAOS) e Síndrome Metabólica (SM)." Botucatu, 2016. http://hdl.handle.net/11449/145524.
Full textBanca: Camila Renata Corrêa Camacho
Banca: Márcia Guimarães da Silva
Banca: Ricardo Beneti
Banca: Aline Roberta Danaga
Resumo: Introdução: A prevalência da DPOC e da SAOS e o comportamento das atividades inflamatória e metabólica destas doenças, isoladamente, já foi estudada. Entretanto, a sobreposição entre elas (Overlap) e a associação com a obesidade, ainda necessita de investigações. Objetivos: Verificar a incidência da SAOS em portadores de DPOC obeso e as atividades inflamatória e metabólica desta tríade. Métodos: Foram incluídos portadores de DPOC moderado e grave com índice de massa corpórea (IMC) ≥ 27 Kg/cm2 . Além da espirometria que classificou a DPOC, foi realizada polissonografia que diagnosticou ou não a SAOS. Foram avaliados os marcadores bioquímicos de glicemia, hemoglobina glicada (HBC), insulina, leptina, adiponectina, grelina, proteína C-reativa (PCR) e interleucina 6 (IL-6). Resultados: Este estudo transversal incluiu portadores de DPOC com (N=46) e sem (N=20) SAOS com médias de idade, IMC e VEF1, respectivamente, 61.57±11.31 x 59.75±9.68 anos, 34.00±5.67 x 33.89±6.75 kg/cm2, 57.20±16.81 x 53.85±17.65 %pred. As médias de glicemia, HBC, insulina, leptina e adiponectina com ou sem SAOS foram semelhantes. A grelina aumentou com a maior gravidade da SAOS na overlap (186.16±25.56 x 137.10±21.78 pg/ml). Não foi observado aumento da PCR para nenhum grupo. A maior gravidade da DPOC aumentou a IL-6 (5.17±5.79 x 11.18±13.10). Conclusão: A prevalência de SAOS é elevada em pacientes portadores de DPOC com obesidade. A SAOS grave elevou a atividade metabólica pelo aumento da grelina, sem influencia na expressão inflamatória, na tríade com DPOC e obesidade. A gravidade da DPOC produziu maior atividade inflamatória de IL-6.
Abstract: Introduction: The prevalence of COPD and OSA and the behaviour of inflammatory and metabolic activities of each diseases has already been studied. However, the overlap between OSA and COPD, associated to obesity, still needs investigation. Objectives: To determine the incidence of OSA in obese patients with COPD, and inflammatory and metabolic activities of this triad. Methods: moderate and severe COPD patients were included with a body mass index (BMI) ≥ 27 kg / cm2. In addition to spirometry which ranked COPD, polysomnography was performed for OSA diagnosis. Blood glucose, glycated hemoglobin (GH), insulin, leptina, adiponectin, ghrelin, C-reactive protein (CRP) and interleukin 6 (IL-6) were assesed. Results: This cross-sectional study included COPD patients with (N = 46) and without (N = 20) OSA mean age, BMI and FEV1, respectively, 61.57 ±11.31 x 59.75 ±9.68 years, 34.00 ±5.67 x 33.89 ±6.75 kg/cm2, 57.20 ±16.81 x 53.85 ±17.65% pred. Mean blood glucose, GH, insulin, adiponectin and leptin with or without OSA were similar. Ghrelin increased with greater severity of OSA in the overlap group(186.16 ±25.56 x 137.10 ±21.78 pg/ml). There was no difference for CRP, but IL-6 (5.17 ±5.79 x 18.11 ±10.13) was increased in the more severe COPD. Conclusion: The prevalence of OSA is high in COPD patients with obesity. The severe OSAS increased metabolic activity by increasing ghrelin. The severity of COPD produced greater inflammatory activity.
Doutor
Knaut, Caroline [UNESP]. "Avaliação dos efeitos do treinamento do exercício físico aeróbico de curta duração em pacientes hospitalizados com DPOC exacerbado." Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/126435.
Full textIntrodução: Exacerbação aguda (EA) é uma importante causa de perda de funções em pacientes que sofrem de doença pulmonar obstrutiva crônica (DPOC). Afeta negativamente a qualidade de vida, a função pulmonar, a fraqueza muscular, a utilização dos recursos da saúde e a sobrevida. Entretanto, o exercício físico realizado durante a exacerbação pode melhorar a qualidade de vida e a capacidade física do paciente. Nesse contexto, o presente estudo visa avaliar a influência da realização do exercício físico em pacientes hospitalizado por exacerbação da DPOC (EADPOC). Objetivo: O presente estudo visa avaliar os efeitos do exercício fisico aeróbio de curta duração nos pacientes hospitalizados por exacerbação aguda de DPOC no escore da dispneia, na qualidade de vida e na capacidade física. Pacientes e Métodos: Vinte e dois pacientes foram randomizados em dois grupos, o grupo controle que recebeu o tratamento clínico padrão e o grupo de intervenção que realizou o treinamento de exercício físico juntamente com os cuidados clínicos. Os pacientes foram submetidos às seguintes avaliações após 48 horas da hospitalização e após um mês da alta: espirometria, avaliação nutricional, distância percorrida no teste de caminhada de seis minutos (DP6), qualidade de vida, ansiedade e depressão, índice de BODE e intensidade de dispneia. O programa de exercício físico foi composto por treinamento aeróbio em esteira ergométrica, duas vezes ao dia, por 15 minutos cada sessão até o período da alta hospitalar. Resultados: O domínio impacto e o escore total da qualidade de vida apresentaram maior incremento no grupo intervenção em relação ao grupo controle (p < 0,001) quando comparado os momentos. Houve melhora de ambos os grupos após um mês de alta hospitalar no domínio atividade quando comparado ao momento basal, mas sem diferença entre os grupos. Além disso, apenas o grupo de intervenção apresentou...
Introduction: Acute Exacerbation (AE) is an important cause of impairment of function in chronic obstructive pulmonary disease (COPD) patients. Negatively affects the quality of life, lung function, muscle weakness, the use of health resources and survival. However, physical exercise performed during the exacerbation can improve the quality of life and the physical capacity of the patient. In this context, this study aims to evaluate the influence of aerobic exercise in hospitalized COPD patients with exacerbation (AECOPD). Objective: To evaluate the effects of short duration aerobic exercise in AECOPD on dyspnea score, quality of life and exercise capacity. Patients and Methods: Twenty-two patients were randomized in two groups; the control group received standard medical treatment and the intervention group that performed aerobic exercise training. All patients performed spirometry, nutritional assessment, distance covered on the six-minute walk test (6MWD), quality of life (Saint George Respiratory Questionnaire- SGRQ), anxiety and depression ( The Hospital Anxiety and Depression Scale), BODE index and intensity of dyspnea (Baseline Dyspnea Index and Modified Medical Research Council Score) after 48 hours of hospitalization and after one month of discharge. The exercise program consisted of aerobic training on a treadmill twice a day for 15 minutes until to the discharge. Results: The impact domain and the total score of quality of life showed a higher increase in the intervention group compared to the control group (p<0.001) when compared to the moments. Both groups showed improvement in the activity domain of SGRQ after one month of hospital discharge, but they did not show difference between groups. Furthermore, only the intervention group showed significant improvement in the symptom domain of SGRQ (p<0.001) and baseline dyspnea index (p=0.006) after one month. 6MWD and BODE did not show difference between ...
Lineburger, Eric Benedet. "Relação do índice bispetral e da taxa de supressão do traçado do eletroencefalograma com disfunção cognitiva pós-operatória em cirurgia de revascularização do miocárdio /." Botucatu, 2014. http://hdl.handle.net/11449/113900.
Full textBanca: Paulo do Nascimento Junior
Banca: Maria Angela Tardelli
Resumo: Introdução: Não está claro na literatura se os valores do índice bispectral (BIS) e da taxa de supressão do traçado de eletroencefalograma (TS), estão relacionados à disfunção cognitiva pós-operatória (DCPO). Objetivo: Avaliar os valores de BIS e TS e sua relação com a DCPO após cirurgia de revascularização do miocárdio (CRM) em pacientes submetidos a anestesia com sevoflurano (SEVO) guiada pelo BIS. Tipo de estudo: Observacional prospectivo. Local do estudo: Hospital de ensino. Pacientes: Noventa pacientes adultos programados para CRM com ou sem circulação extra-corpórea (CEC). Intervenções: A anestesia foi induzida com propofol, remifentanil e atracúrio e mantida com concentrações expiradas de SEVO (ETSEVO) em valores de concentração alveolar mínima (CAMSEVO) adaptada à idade, tendo como alvo valores de BIS de 40-60. O Mini-Exame do Estado Mental (MEEM) para avaliação cognitiva dos pacientes foi aplicado na admissão hospitalar e três meses após a cirurgia. Variáveis estudadas: Os valores de BIS, TS, ETSEVO e CAMSEVO foram registrados a cada 5 minutos durante o procedimento. Redução de um desvio padrão (DP) ou mais no MEEM basal foi definida como DCPO. Resultados: A proporção de DCPO foi de 40%. Os pacientes foram alocados em dois grupos: com (n = 36) ou sem DCPO (n = 54). Não houve diferença significativa na incidência de DCPO entre os pacientes que foram submetidos à CRM com ou sem CEC (p = 1,0). Quanto às características dos pacientes, somente os valores de índice de massa corporal (IMC) foram maiores no grupo sem DCPO (p = 0,009). Valores médios de BSR, ETSEV e MACSEV foram maiores no grupo sem DCPO (p < 0,05). Em uma análise multivariada, valores menores de TS (Razão de Chances-RC 0,008, Intervalo de Confiança-IC 95% [0,001-0,53], p = 0,02), CAMSEVO (RC 0,001, IC 95% [0,001-0,08], p = 0,008), ETSEVO (RC 0,03, IC 95% [0,002-0,66], p = 0,02) e ...
Abstract: BACKGROUND: It is still controversial whether bispectral index (BIS) and burst suppression ratio (BSR) values are related to postoperative cognitive dysfunction (POCD). OBJECTIVE: To evaluate BIS and BSR values and their relation to POCD after coronary artery bypass grafting (CABG) surgery in patients undergoing BIS-guided sevoflurane (SEVO) anaesthesia. DESIGN: Prospective, observational study. SETTING: Teaching hospital. PATIENTS: Ninety adult patients scheduled for on- or off-pump CABG surgery. INTERVENTIONS: Anaesthesia was induced with propofol, remifentanil and atracurium and maintained with end-tidal SEVO (ETSEVO) at age-adapted minimum alveolar concentration (MACSEVO) targeting BIS values of 40-60. Mini-Mental State Examination (MMSE) for cognitive assessment of the patients was applied on hospital admission and at 3 months after surgery. MAIN OUTCOME MEASUREMENTS: BIS, BSR, ETSEVO and MACSEVO values were recorded every 5 minutes during the procedure. A decrease of 1 standard deviation or more from the basal MMSE was defined as POCD. RESULTS: The POCD proportion was 40%. The patients were allocated into two groups: with POCD (n=36) or no POCD (n=54). There was no difference of POCD incidence between patients who were submitted to on- versus off-pump CABG (P=1.0). With regard to the patient's characteristics, only body mass index (BMI) was higher in the no-POCD group (P=0.009). Mean BSR, ETSEVO and MACSEVO values were higher in the no-POCD group (P<0.05). In a multivariable analysis, lower values of BSR (odds ratio-OR 0.008; 95%CI [0.001-0.53]; P=0.02), MACSEVO (OR 0.001; 95%CI [0.001-0.08]; P=0.008), ETSEVO (OR 0.03; 95%CI [0.002-0.66]; P=0.02) and BMI (OR 0.82; 95%CI [0.70-0.96]; P=0.01) were independent predictors of risk for POCD incidence. BIS values did not influence POCD incidence (OR 1.0; 95%CI [0.95-1.11]; P=0.40). CONCLUSION: BIS-guided SEVO anaesthesia titrated to a range between 40 and 60 is not a predictive factor ...
Mestre
Knaut, Caroline. "Avaliação dos efeitos do treinamento do exercício físico aeróbico de curta duração em pacientes hospitalizados com DPOC exacerbado /." Botucatu, 2015. http://hdl.handle.net/11449/126435.
Full textCoorientador: Victor Zuniga Dourado
Banca: Irma de Godoy
Banca: Oliver Augusto Nascimento
Resumo: Introdução: Exacerbação aguda (EA) é uma importante causa de perda de funções em pacientes que sofrem de doença pulmonar obstrutiva crônica (DPOC). Afeta negativamente a qualidade de vida, a função pulmonar, a fraqueza muscular, a utilização dos recursos da saúde e a sobrevida. Entretanto, o exercício físico realizado durante a exacerbação pode melhorar a qualidade de vida e a capacidade física do paciente. Nesse contexto, o presente estudo visa avaliar a influência da realização do exercício físico em pacientes hospitalizado por exacerbação da DPOC (EADPOC). Objetivo: O presente estudo visa avaliar os efeitos do exercício fisico aeróbio de curta duração nos pacientes hospitalizados por exacerbação aguda de DPOC no escore da dispneia, na qualidade de vida e na capacidade física. Pacientes e Métodos: Vinte e dois pacientes foram randomizados em dois grupos, o grupo controle que recebeu o tratamento clínico padrão e o grupo de intervenção que realizou o treinamento de exercício físico juntamente com os cuidados clínicos. Os pacientes foram submetidos às seguintes avaliações após 48 horas da hospitalização e após um mês da alta: espirometria, avaliação nutricional, distância percorrida no teste de caminhada de seis minutos (DP6), qualidade de vida, ansiedade e depressão, índice de BODE e intensidade de dispneia. O programa de exercício físico foi composto por treinamento aeróbio em esteira ergométrica, duas vezes ao dia, por 15 minutos cada sessão até o período da alta hospitalar. Resultados: O domínio impacto e o escore total da qualidade de vida apresentaram maior incremento no grupo intervenção em relação ao grupo controle (p < 0,001) quando comparado os momentos. Houve melhora de ambos os grupos após um mês de alta hospitalar no domínio atividade quando comparado ao momento basal, mas sem diferença entre os grupos. Além disso, apenas o grupo de intervenção apresentou...
Abstract: Introduction: Acute Exacerbation (AE) is an important cause of impairment of function in chronic obstructive pulmonary disease (COPD) patients. Negatively affects the quality of life, lung function, muscle weakness, the use of health resources and survival. However, physical exercise performed during the exacerbation can improve the quality of life and the physical capacity of the patient. In this context, this study aims to evaluate the influence of aerobic exercise in hospitalized COPD patients with exacerbation (AECOPD). Objective: To evaluate the effects of short duration aerobic exercise in AECOPD on dyspnea score, quality of life and exercise capacity. Patients and Methods: Twenty-two patients were randomized in two groups; the control group received standard medical treatment and the intervention group that performed aerobic exercise training. All patients performed spirometry, nutritional assessment, distance covered on the six-minute walk test (6MWD), quality of life (Saint George Respiratory Questionnaire- SGRQ), anxiety and depression ( The Hospital Anxiety and Depression Scale), BODE index and intensity of dyspnea (Baseline Dyspnea Index and Modified Medical Research Council Score) after 48 hours of hospitalization and after one month of discharge. The exercise program consisted of aerobic training on a treadmill twice a day for 15 minutes until to the discharge. Results: The impact domain and the total score of quality of life showed a higher increase in the intervention group compared to the control group (p<0.001) when compared to the moments. Both groups showed improvement in the activity domain of SGRQ after one month of hospital discharge, but they did not show difference between groups. Furthermore, only the intervention group showed significant improvement in the symptom domain of SGRQ (p<0.001) and baseline dyspnea index (p=0.006) after one month. 6MWD and BODE did not show difference between ...
Mestre
Liu, Jie. "Novel Bayesian Methods for Disease Mapping: An Application to Chronic Obstructive Pulmonary Disease." Link to electronic thesis, 2002. http://www.wpi.edu/Pubs/ETD/Available/etd-0501102-110350.
Full textKeywords: latent class model; Poisson regression model; Metropolis-Hastings sampler; order restriction; disease mapping. Includes bibliographical references.
Ferrari, Renata [UNESP]. "Evolução da interleucina 6 e da proteína C-Reativa em pacientes com DPOC no período de três anos." Universidade Estadual Paulista (UNESP), 2013. http://hdl.handle.net/11449/102624.
Full textEstudos mostram que os valores médios da Interleucina 6 (IL-6) e Proteína CReativa (PCR) não mudam significativamente em pacientes com DPOC no período de um ano. No entanto, o acompanhamento de longo prazo desses mediadores não está estabelecido. Portanto, o objetivo do atual estudo é verificar a evolução dos marcadores inflamatórios sistêmicos de pacientes com DPOC após três anos e verificar a associação entre eles e os demais marcadores da doença. Uma coorte de 77 pacientes com DPOC estável foi avaliada no momento basal e 53 (VEF1=56±21%) foram incluídos no estudo. Nós avaliamos IL-6, PCR, distância percorrida em seis minutos (DP6) e índice de massa corporal (IMC) no momento basal e após três anos. A concentração plasmática de IL-6 foi avaliada por meio de ensaios imunoenzimáticos (ELISA) ultrassensíveis e a PCR foi obtida por meio de imunonefelometria com uso de kits ultrassensíveis. Os valores da IL-6 aumentaram significativamente após três anos em comparação ao momento basal [0,8 (0,5-1,3) vs 2,4 (1,3-4,4) pg/ml, p <0,001] e foram associados com piora da DP6. Os resultados da análise de regressão de Cox mostraram que os valores aumentados de IL-6 no momento basal foram associados com a mortalidade [Hazard Ratio (95% CI)=2,68 (0,13; 1,84); p=0,02]. Os valores médios da PCR não apresentaram alteração significativa [5 (1,6-7,9) vs 4,7 (1,7-10) mg/ L, p=0,84]; embora, onze pacientes (21%) apresentaram aumento >3 mg/L da PCR no período de três anos. O processo inflamatório sistêmico, avaliado pela IL-6, parece ser persistente e progressivo e associado com mortalidade e piora da performance física em pacientes com DPOC
Past studies have shown that mean values of Interleukin-6 (IL-6) and Creactive protein (CRP) do not change significantly in COPD patients over a one-year period. However, longer period follow-up studies are still lacking. Thus, the aim of this study is to evaluate plasma CRP and IL-6 concentration over three years in COPD patients and to test the association between these inflammatory mediators and disease outcome markers. A cohort of 77 outpatients with stable COPD was evaluated at baseline, and 53 (mean FEV1, 56% predicted) were included in the prospective study. We evaluated IL-6, CRP, six-minute walking distance (6MWD), and body mass index (BMI) at baseline and after three years. Plasma concentration of IL-6 was measured by high sensitivity ELISA, and CRP was obtained by high sensitivity particle-enhanced immunonephelometry. IL-6 increased significantly after 3 years compared to baseline measurements [0.8 (0.5-1.3) vs 2.4 (1.3-4.4) pg/ml; p<0.001] and was associated with worse 6MWD performance. In the Cox regression, increased IL-6 at baseline was associated with mortality [Hazard Ratio (95% CI)=2.68 (0.13, 1.84); p=0.02]. CRP mean values did not change [5 (1.6- 7.9) vs 4.7 (1.7-10) pg/L; p=0.84], although eleven patients (21%) presented with changes >3 mg/L in CRP after 3 years. The systemic inflammatory process, evaluated by IL-6, seems to be persistent, progressive and associated with mortality and worse physical performance in COPD patients
Fung, Yiu-ting Tina, and 馮耀婷. "Evidence-based clinical practice guidelines of smoking cessation programs for COPD patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581856.
Full textFerrari, Renata. "Evolução da interleucina 6 e da proteína C-Reativa em pacientes com DPOC no período de três anos /." Botucatu, 2013. http://hdl.handle.net/11449/102624.
Full textBanca: Suzana Erico Tanni
Banca: Hugo Hyung Bok Yoo
Banca: Oliver Augusto Nascimento
Banca: Marcia Maria Faganello
Resumo: Estudos mostram que os valores médios da Interleucina 6 (IL-6) e Proteína CReativa (PCR) não mudam significativamente em pacientes com DPOC no período de um ano. No entanto, o acompanhamento de longo prazo desses mediadores não está estabelecido. Portanto, o objetivo do atual estudo é verificar a evolução dos marcadores inflamatórios sistêmicos de pacientes com DPOC após três anos e verificar a associação entre eles e os demais marcadores da doença. Uma coorte de 77 pacientes com DPOC estável foi avaliada no momento basal e 53 (VEF1=56±21%) foram incluídos no estudo. Nós avaliamos IL-6, PCR, distância percorrida em seis minutos (DP6) e índice de massa corporal (IMC) no momento basal e após três anos. A concentração plasmática de IL-6 foi avaliada por meio de ensaios imunoenzimáticos (ELISA) ultrassensíveis e a PCR foi obtida por meio de imunonefelometria com uso de kits ultrassensíveis. Os valores da IL-6 aumentaram significativamente após três anos em comparação ao momento basal [0,8 (0,5-1,3) vs 2,4 (1,3-4,4) pg/ml, p <0,001] e foram associados com piora da DP6. Os resultados da análise de regressão de Cox mostraram que os valores aumentados de IL-6 no momento basal foram associados com a mortalidade [Hazard Ratio (95% CI)=2,68 (0,13; 1,84); p=0,02]. Os valores médios da PCR não apresentaram alteração significativa [5 (1,6-7,9) vs 4,7 (1,7-10) mg/ L, p=0,84]; embora, onze pacientes (21%) apresentaram aumento >3 mg/L da PCR no período de três anos. O processo inflamatório sistêmico, avaliado pela IL-6, parece ser persistente e progressivo e associado com mortalidade e piora da performance física em pacientes com DPOC
Abstract: Past studies have shown that mean values of Interleukin-6 (IL-6) and Creactive protein (CRP) do not change significantly in COPD patients over a one-year period. However, longer period follow-up studies are still lacking. Thus, the aim of this study is to evaluate plasma CRP and IL-6 concentration over three years in COPD patients and to test the association between these inflammatory mediators and disease outcome markers. A cohort of 77 outpatients with stable COPD was evaluated at baseline, and 53 (mean FEV1, 56% predicted) were included in the prospective study. We evaluated IL-6, CRP, six-minute walking distance (6MWD), and body mass index (BMI) at baseline and after three years. Plasma concentration of IL-6 was measured by high sensitivity ELISA, and CRP was obtained by high sensitivity particle-enhanced immunonephelometry. IL-6 increased significantly after 3 years compared to baseline measurements [0.8 (0.5-1.3) vs 2.4 (1.3-4.4) pg/ml; p<0.001] and was associated with worse 6MWD performance. In the Cox regression, increased IL-6 at baseline was associated with mortality [Hazard Ratio (95% CI)=2.68 (0.13, 1.84); p=0.02]. CRP mean values did not change [5 (1.6- 7.9) vs 4.7 (1.7-10) pg/L; p=0.84], although eleven patients (21%) presented with changes >3 mg/L in CRP after 3 years. The systemic inflammatory process, evaluated by IL-6, seems to be persistent, progressive and associated with mortality and worse physical performance in COPD patients
Doutor
Mylvaganam, Arunthathi. "Lung cancer risk amongst uranium miners : the Radium Hill study /." Title page, contents and abstract only, 1993. http://web4.library.adelaide.edu.au/theses/09PH/09phm997.pdf.
Full textHe, Yongyi, and 何勇毅. "Evaluation of quality of life in Hong Kong COPD patients using SF-6D." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45172262.
Full textBell, Keisha. "The Role of Spirituality in Ethnic Minority Patients with COPD." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc822782/.
Full textCaram, Laura Miranda de Oliveira [UNESP]. "Associação entre estresse oxidativo, inflamção e manifestações sistêmicas e tabagistas pacientes com DPOC leve e moderada." Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/139337.
Full textFoi realizado estudo transversal para avaliar e comparar a associação entre estresse oxidativo e estado inflamatório e suas relações com a força muscular, a massa muscular sistêmica, a capacidade funcional de exercício e o estado geral de saúde em tabagistas, pacientes com doença pulmonar obstrutiva crônica (DPOC) leve/moderado e controles não tabagistas. Foram avaliados 32 tabagistas ativos (carga tabágica >10 anos/maço) sem DPOC, 32 pacientes com DPOC leve/moderado [tabagistas ativos ou ex-tabagistas (carga tabágica >10 anos/maço)] e 32 indivíduos não tabagistas. Todos os indivíduos foram submetidos à avaliação clínica e do estado tabágico, espirometria pré e pósbroncodilatador, oximetria de pulso e as concentrações de mediadores inflamatórios [proteína C-reativa (PCR), interleucina (IL) 6, receptores do fator de necrose tumoral alfa (TNFR1 e TNFR2)] e indicadores de estresse oxidativo [produtos finais de glicação avançada (AGEs) e receptor solúvel do produto final de glicação (sRAGE)] foram avaliadas no soro. Foi realizada avaliação da composição do corpo por bioimpedância, da força muscular periférica por dinamometria, da capacidade funcional de exercício (distância percorrida em seis minutos) e da avaliação do estado geral de saúde, por meio do Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e da Escala Hospitalar de Ansiedade e Depressão (HAD). Tabagistas (p<0,001) e pacientes com DPOC (p<0,001) apresentaram valores superiores de AGEs quando comparados aos controles. Não houve diferença estatisticamente significante entre tabagistas e pacientes com DPOC. As concentrações de sRAGE não diferiram entre os grupos (p=0,92). Tabagistas (p=0,01) e pacientes com DPOC (p=0,01) apresentaram valores superiores da PCR em comparação aos controles, sem diferenças nas demais comparações. As concentrações de IL6 (p=0,07) e TNFR1 (p=0,07) não diferiram entre os grupos. Os valores...
The aim of this study was to evaluate the association between oxidative stress and inflammatory markers and their relationship with muscle strength, systemic muscle mass, exercise capacity, quality of life in smokers, mild/moderate COPD patients and nonsmokers controls. Were evaluated 32 active smokers (smoking history> 10 pack/years) without COPD, 32 mild/moderate COPD patients [current smokers or former smokers (smoking history> 10 pack/years) and 32 nonsmokers. All individuals underwent to medical and smoking status evaluations, spirometry pre and post-bronchodilator and pulse oximetry. The concentration of inflammatory mediators [C-reactive protein (CRP), interleukin (IL) 6, and tumor necrosis factor-alpha receptors (TNFR1 and TNFR2)] and indicators of oxidative stress [advanced glycation end-products (AGEs) and soluble receptors for advanced glycation end-products (sRAGE)] were measured in serum. We assessed body composition by bioimpedance, peripheral muscle strength by dynamometry, exercise capacity (six minutes walk distance) and the health status through the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HAD). Smokers (p<0.001) and COPD patients (p<0.001) had higher values of AGEs when compared to controls there was no statistically significant difference between smokers and COPD patients. The sRAGE concentrations did not differ between groups (p=0.92). Smokers (p=0.01) and patients with COPD (p=0.01) showed higher values of CRP compared to controls, there was no statistical significant difference between smokers and COPD groups. The concentrations of IL-6 (p=0.07) and TNFR1 (p=0.07) did not differ between groups. Regarding concentrations of TNFR2, COPD patients showed higher values when compared to smokers (p=0.004) and controls (p=0.004). We identified positive association of smoking (p=0.04), CRP (p=0.03) and IL6 (p=0.03) with the concentrations of AGEs. The ...
Caram, Laura Miranda de Oliveira. "Associação entre estresse oxidativo, inflamção e manifestações sistêmicas e tabagistas pacientes com DPOC leve e moderada /." Botucatu, 2015. http://hdl.handle.net/11449/139337.
Full textCoorientador: Susana Erico Tanni Minamoto
Coorientador: Camila Renata Corrêa
Banca: José Antonio Baddini Martinez
Banca: Mariana Gobbo Braz
Banca: Oliver Augusto Nascimento
Banca: Ângela Victoriano de Campos Soares
Resumo: Foi realizado estudo transversal para avaliar e comparar a associação entre estresse oxidativo e estado inflamatório e suas relações com a força muscular, a massa muscular sistêmica, a capacidade funcional de exercício e o estado geral de saúde em tabagistas, pacientes com doença pulmonar obstrutiva crônica (DPOC) leve/moderado e controles não tabagistas. Foram avaliados 32 tabagistas ativos (carga tabágica >10 anos/maço) sem DPOC, 32 pacientes com DPOC leve/moderado [tabagistas ativos ou ex-tabagistas (carga tabágica >10 anos/maço)] e 32 indivíduos não tabagistas. Todos os indivíduos foram submetidos à avaliação clínica e do estado tabágico, espirometria pré e pósbroncodilatador, oximetria de pulso e as concentrações de mediadores inflamatórios [proteína C-reativa (PCR), interleucina (IL) 6, receptores do fator de necrose tumoral alfa (TNFR1 e TNFR2)] e indicadores de estresse oxidativo [produtos finais de glicação avançada (AGEs) e receptor solúvel do produto final de glicação (sRAGE)] foram avaliadas no soro. Foi realizada avaliação da composição do corpo por bioimpedância, da força muscular periférica por dinamometria, da capacidade funcional de exercício (distância percorrida em seis minutos) e da avaliação do estado geral de saúde, por meio do Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e da Escala Hospitalar de Ansiedade e Depressão (HAD). Tabagistas (p<0,001) e pacientes com DPOC (p<0,001) apresentaram valores superiores de AGEs quando comparados aos controles. Não houve diferença estatisticamente significante entre tabagistas e pacientes com DPOC. As concentrações de sRAGE não diferiram entre os grupos (p=0,92). Tabagistas (p=0,01) e pacientes com DPOC (p=0,01) apresentaram valores superiores da PCR em comparação aos controles, sem diferenças nas demais comparações. As concentrações de IL6 (p=0,07) e TNFR1 (p=0,07) não diferiram entre os grupos. Os valores...
Abstract: The aim of this study was to evaluate the association between oxidative stress and inflammatory markers and their relationship with muscle strength, systemic muscle mass, exercise capacity, quality of life in smokers, mild/moderate COPD patients and nonsmokers controls. Were evaluated 32 active smokers (smoking history> 10 pack/years) without COPD, 32 mild/moderate COPD patients [current smokers or former smokers (smoking history> 10 pack/years) and 32 nonsmokers. All individuals underwent to medical and smoking status evaluations, spirometry pre and post-bronchodilator and pulse oximetry. The concentration of inflammatory mediators [C-reactive protein (CRP), interleukin (IL) 6, and tumor necrosis factor-alpha receptors (TNFR1 and TNFR2)] and indicators of oxidative stress [advanced glycation end-products (AGEs) and soluble receptors for advanced glycation end-products (sRAGE)] were measured in serum. We assessed body composition by bioimpedance, peripheral muscle strength by dynamometry, exercise capacity (six minutes walk distance) and the health status through the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HAD). Smokers (p<0.001) and COPD patients (p<0.001) had higher values of AGEs when compared to controls there was no statistically significant difference between smokers and COPD patients. The sRAGE concentrations did not differ between groups (p=0.92). Smokers (p=0.01) and patients with COPD (p=0.01) showed higher values of CRP compared to controls, there was no statistical significant difference between smokers and COPD groups. The concentrations of IL-6 (p=0.07) and TNFR1 (p=0.07) did not differ between groups. Regarding concentrations of TNFR2, COPD patients showed higher values when compared to smokers (p=0.004) and controls (p=0.004). We identified positive association of smoking (p=0.04), CRP (p=0.03) and IL6 (p=0.03) with the concentrations of AGEs. The ...
Doutor
Costa, Gerusa Maritimo da. "Efeito do uso de salbutamol nas propriedades mecânicas do sistema respiratório de indivíduos saudáveis, tabagistas e portadores de doença pulmonar obstrutiva crônica." Universidade do Estado do Rio de Janeiro, 2012. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=6359.
Full textA doença pulmonar obstrução crônica (DPOC) é caracterizada pela limitação de fluxo parcialmente reversível, classificada por níveis de obstrução pós-broncodilatador. Há várias evidências de que o FEV1 sozinho não é capaz de mostrar a broncodilatação de pacientes com DPOC, mesmo naqueles que apresentam melhora clínica. A técnica de oscilações forçadas (TOF) tem mostrado alta sensibilidade na detecção precoce de alterações mecânicas na DPOC, contudo o efeito broncodilatador na impedância respiratória de pacientes com DPOC ainda não está esclarecido. Objetiva avaliar a utilidade da TOF nos diferentes estágios de obstrução das vias aéreas; (2) avaliar a resposta da impedância respiratória ao salbutamol em indivíduos saudáveis ao exame espirométrico e pacientes com DPOC em diferentes graus de gravidade. Foram avaliados 25 indivíduos saudáveis sem história de tabagismo, 24 tabagistas e 151 pacientes com DPOC classificados em graus I, II, III e IV. Todos os sujeitos foram avaliados pela TOF seguida da espirometria, antes e após o uso do salbutamol spray. As curvas de resistência e reatância demonstraram alteração em todos os estágios de obstrução das vias aéreas após o uso do salbutamol. O grupo de risco apresentou alterações mecânicas semelhantes ao grupo leve (p=ns). Os parâmetros R0, Rm, Csr,din e Z4Hz apresentam desempenho diagnóstico adequado (AUC > 0,85) em todos os estágios de gravidade da doença. Todos os parâmetros de TOF e espirometria apresentaram diminuição após uso do salbutamol. Os indivíduos saudáveis apresentaram uma pequena diminuição comparada aos subgrupos de DPOC. A variação em termos absolutos da ΔZ4Hz e das derivadas da resistência, ΔR0, ΔRm, ΔS, apresentaram variação significativa (p<0,0001, p<0,003; p<0,04; p<0,0002, respectivamente) com o aumento da obstrução brônquica. Nas derivadas da reatância o ΔXm aumentou com a gravidade da doença (p<0,0002). Por outro lado, a ΔCrs,dyn não demonstrou diferença significativa com a gravidade da DPOC. Em termos percentuais os parâmetros da TOF apresentaram variação expressiva em ΔRm% (p<0,02), ΔS% (p<0,02) e ΔXm% (p<0,004) com o aumento da obstrução nas vias aéreas. Por outro lado, ΔR0%, ΔCrs,dyn% e ΔZ4Hz% não variaram entre os estágios da DPOC. A associação entre a broncodilatação nas vias aéreas e a impedância pulmonar foi fraca entre ΔXm vs ΔFVC (r=0,32, p<0,0001) e ΔZ4Hz% vs ΔFEV1% vs ΔFVC% (r=0.28, p<0,0005; r=0,29, p<0,0003, respectivamente). A TOF é útil na avaliação das alterações mecânicas nos diferentes níveis de obstrução das vias aéreas na DPOC. Demonstramos o benefício da medicação broncodilatadora, quantificando a melhora da ventilação através da TOF. A impedância respiratória diminui em todos os estágios da DPOC, o estágio leve melhorou tanto quanto o estágio muito grave. Isto sugere que a medida da impedância pulmonar não é dependente do volume como ocorre na espirometria e que a broncodilatação ocorre em todas as fases da progressão da DPOC.
Chronic obstructive pulmonary disease (COPD) is characterized by partially reversible flow limitation, classified by the post-bronchodilator level of airway obstruction. There is abundant evidence that FEV1 alone is not able to show bronchodilation in COPD patients, even in patients with clinical improvement. The forced oscillation technique (FOT) has shown high sensitivity for early detection of mechanical changes in COPD. However, the bronchodilator effect on respiratory impedance is still unclear. Objective to evaluate the utility of FOT in the diagnosis of different stages of airway obstruction, (2) to investigate the response to salbutamol in healthy, smoking and COPD patients in different degrees of severity. We evaluated 25 healthy subjects with no history of smoking, 24 smokers and 151 COPD patients classified into grades I, II, III and IV of severity. All subjects were assessed by the FOT followed by spirometry before and after the use of salbutamol spray. The resistance and reactance curves showed change at all stages of airway obstruction after the use of salbutamol. The smoking group showed similar mechanical changes to the mild group (p=ns). The parameters R0, Rm, Csr,din and Z4Hz presented adequate diagnostic accuracy (AUC>0.85) in all stages of disease severity. All FOT and spirometry parameters showed decreased after salbutamol use. Healthy individuals showed a small decrease compared with the subgroups of COPD. The variations of the impedance module (ΔZ4Hz) and resistance parameters, (ΔR0, ΔRm, Δs) were significant (p<0.0001, p<0.003, p<0.04 and p<0.0002, respectively) with increased bronchial obstruction. Mean reactance (ΔXm) increased with disease severity (p<0.0002). The ΔCrs,dyn showed no significant change with the severity of COPD. In percentage terms, FOT parameters showed significant variation in ΔRm% (p<0.02), Δs (p<0.02) and ΔXm% (p<0.004) with increased airway obstruction. ΔR0% ΔCrs,dyn% and ΔZ4Hz% did not vary between different stages of COPD. The association between bronchodilation in the airways and lung impedance was weak between ΔXm vs ΔFVC (r=0.32, p<0.0001) and ΔZ4Hz% vs ΔFEV1% vs ΔFVC% (r=0.28, p<0.0005, r=0.29, p<0.0003, respectively). The FOT is useful in the evaluation of the mechanical changes at different levels of airway obstruction in COPD. We demonstrate the benefit of a bronchodilator, quantifying the improvement of ventilation through the FOT. The respiratory impedance decreases in all stages of COPD. This suggests that the impedance changes are not dependent on lung volume as in spirometry and that bronchodilation occurs at all stages of the progression of COPD.
Armstrong, Hilary Farrar. "An investigation into the use of selective serotonin reuptake inhibitors for improving low lung function and pulmonary exacerbations." Thesis, 2018. https://doi.org/10.7916/D8CR79GP.
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