Obstructive Respiratory Disorder Research Articles

Analysis of pulmonary function in post-Covid-19 patients at a university hospital

Objective: Evaluate the spirometry pattern of patients who persisted with respiratory symptoms after infection with SARS-Cov-2. Methods: Cross-sectional, observational, retrospective study in a single center, approved by the local Ethics Committee (registration number: 5,120,720). Patients who underwent spirometry due to Post-Covid Syndrome were evaluated to analyze the spirometric pattern presented. The following were collected: exam identification data, sex, age, symptom time, the need for mechanical ventilation, and quality of spirometry, in addition to the following exam parameters: FVC, FEV1, FEV1/FVC, FEV 25-75/FVC, and FEV 75, evaluating the Lower Limit of Normality, pre-bronchodilator and post-bronchodilator values. Results: Data from 72 patients were collected.Of these, 55.5% of patients had spirometry results within normal limits. The most frequent respiratory alteration was obstructive respiratory disorder, present in 29.2% of the patients. Conclusions: The presence of dyspnea in patients with normal spirometry may indicate further evaluation of lung function and other etiologies for dyspnea.

Lung function test in advanced age

Advanced age is not an obstacle to carring out alung function test. In most cases alung function test is necessary due to the fact that about 20% of older persons are affected by an obstructive respiratory disorder. Standard values for the lung function test are available up to advanced ages. The experience of the examiner and a calm environment for the lung function test have an impact on the quality of the measurement results. Severe cognitive impairments and severe immobility make the performance of alung function test impossible. Simple geriatric assessments can help to reliably identify these patients. Alternative lung function test procedures have to be validated in order to adequately diagnose this vulnerable subgroup of patients at risk.

Computed tomographic imaging in chronic obstructive pulmonary disease : What pulmonologists and thoracic surgeons want to know

Chronic obstructive pulmonary disease (COPD) begins with chronic inflammation of the bronchial system and leads to the development of emphysema in many patients. COPD patients are characterized by reduced performance, dyspnea in the context of an obstructive respiratory disorder and increased susceptibility to infections. COPD has amajor impact on public health, as it is very common and many patients die from it. The most important preventable cause of COPD is tobacco smoke inhalation, which is why consistent smoking cessation is the most important component of any COPD treatment. There is no causal therapy, but in severely symptomatic patients with advanced emphysema, respiratory mechanics can be improved by lung volume reduction if all conservative treatment options have been exhausted. Diagnostic imaging is of great importance in the care of COPD patients. This article summarizes which indications warrant the performance of computed tomography (CT) and what we should pay special attention to during image analysis in order to provide optimal advice to our clinical partners.

Importance of the Functional Biomarker FEF 25%-75% in the Evaluation of Children and Adolescents with Asthma Sensibilized to House Dust Mites

Introduction: The GINA and the ATS do not mention that the forced expiratory flow between 25% and 75% of forced vital capacity (FEF 25%-75%) play importance in evaluation of airflow obstruction in asthma. Objectives: To investigate whether the evaluation of the FEF25%-75% in children and adolescents with asthma sensibilized to house dust mites (HDM) plays an important hole in airway obstruction from small airways. Methods. A retrospective study was done in Hospital Municipal Jesus (Rio de Janeiro, Brazil). Thirty-four children and adolescents with asthma were enrolled between January 2016 and December 2019. The FEIA (Immuno CAP®) was used to measure total and specific IgE antibodies to HDM. Standard reference value for small airways diseases with FEF 25%-75% was considered abnormal if below at 65% of predicted with FEV1/FVC ratio above or equal at 80%. Results. There was a significant difference between the mean ages of the sensitized (n=26; 9.8±2.53) and non-sensitized participants (n=8; 7.75±1.28) to HDM (P=0.0353). Male and female sexes were not significant in both groups (P=0.3698 and P=0.3298, respectively). If the FEF 25%-75% (L/s) was not valued in our study, 62% of sensitized participants (44.27±9.26) and 38% not sensitized (56.62±16.56) to HDM would be considered “according to normal reference values” (t=1.86; P=0.0719). Conclusions. The asthma in this study presented an obstructive respiratory disorder of small airways, regardless of a sensitization or a non-sensitization to HDM. The obstructive respiratory disorder of small airways was present, even with normal spirometry in the evaluation of large airways.

Frequency of Living Donors with Comorbidity for Liver Transplantation: Analysis of 337 Cases

Introduction: Living donors for liver transplantation (LT) need to be physically and mentally healthy, but donor candidates sometimes have comorbidities and are forced to evaluate the suitability as donors. We examined the frequency of comorbidities in living liver donors. Patients and methods: Of 337 living donors for LT, except 67 cases with fatty liver, we investigated the preoperative comorbidities and perioperative management in living liver donors. Results: The number of donors with comorbidity was 95 (28%: 95/337), with a median age of 35 (23-57) years, 33 males, and 62 females. Relationships with recipients were 58 mothers, 28 fathers, 2 grandmothers, 2 sons, 5 others. The graft types were 62 lateral segments, 15 left lobes, 6 left lobes with caudate, 6 monosegments, 4 right lobes, and 2 posterior segments. A total of 107 comorbidities was recognized in 95 donors. Twenty-two cases with hepatic comorbidity were positive HBc antibodies, hepatic hemangiomas, drug-induced liver injuries, liver hamartoma, and congenital portosystemic shunt. Extrahepatic comorbidities were plasminogen disorder, obstructive respiratory disorder, lipid metabolism disorder, coagulation factor deficiency, iron deficiency anemia, hypertension, pollinosis, thyroid disease, menstrual abnormalities, postoperative gastrointestinal cancer, metabolic disease, benign ovarian tumor, arrhythmia, pregnancy, and others. We consulted with the department specializing in the comorbidity and closely performed preoperative evaluation and perioperative management according to each comorbidity. No case of complications due to each comorbidity was found. Conclusion: It is important to fully evaluate and determine the suitability of living donor candidates with comorbidities in collaboration with other departments.

Frequency of peripheral blood eosinophilia and obstructive airway disease in sarcoidosis

There is limited information about peripheral blood eosinophilia (PBE) and airway obstruction in sarcoidosis. Since pulmonary sarcoidosis affects the airways, it is often confused with asthma. The aims of the study are to investigate airway obstruction and PBE in sarcoidosis patients and to examine the similarity of clinical presentation with asthma. The patients matching the ATS/ERS/WASOG diagnosis criteria and were between 18 and 80 years of age were included consecutively between 2018 and 2020. Other diseases causing granulomas were excluded. A total of 84 patients were included of which 26 (31%) had a PBE level of ≥300 μL with no significant difference seen between sarcoidosis stage and PBE (p > 0.05). A significant (p < 0.05) decrease was only seen in FEV1 as the stage of sarcoidosis progressed. Respectively 31 (36.9%), 12 (14.3%) and 4 (4.8%) patients had an obstructive, restrictive and mixed respiratory function disorder. Twenty-four (28.6%) subjects with sarcoidosis had history of asthma. Spring fever, eczema, and skin/nose allergy were noticed in 17 (20.2%) of the patients. Mild PBE may be seen in sarcoidosis. Patients applying with PBE, airway obstruction, bronchial hyperreactivity along with spring fever, eczema, skin/nose allergy, wheezing, chest tightness, shortness of breath and cough may be also evaluated in terms of sarcoidosis.

Frequency of peripheral blood eosinophilia and obstructive airway disease in sarcoidosis.

There is limited information about peripheral blood eosinophilia (PBE) and airway obstruction in sarcoidosis. Since pulmonary sarcoidosis affects the airways, it is often confused with asthma. The aims of the study are to investigate airway obstruction and PBE in sarcoidosis patients and to examine the similarity of clinical presentation with asthma. The patients matching the ATS/ERS/WASOG diagnosis criteria and were between 18 and 80 years of age were included consecutively between 2018 and 2020. Other diseases causing granulomas were excluded. A total of 84 patients were included of which 26 (31%) had a PBE level of ≥300 µL with no significant difference seen between sarcoidosis stage and PBE (p > 0.05). A significant (p < 0.05) decrease was only seen in FEV1 as the stage of sarcoidosis progressed. Respectively 31 (36.9%), 12 (14.3%) and 4 (4.8%) patients had an obstructive, restrictive and mixed respiratory function disorder. Twenty-four (28.6%) subjects with sarcoidosis had history of asthma. Spring fever, eczema, and skin/nose allergy were noticed in 17 (20.2%) of the patients. Mild PBE may be seen in sarcoidosis. Patients applying with PBE, airway obstruction, bronchial hyperreactivity along with spring fever, eczema, skin/nose allergy, wheezing, chest tightness, shortness of breath and cough may be also evaluated in terms of sarcoidosis.

436 PRONE THORACOSCOPIC ESOPHAGECTOMY FOR PATIENTS WITH LOW PULMONARY FUNCTION

Abstract Thoracoscopic esophagectomy in the prone position (TEP) for esophageal cancer is reported to have superiority in preserving postoperative respiratory function and reducing postoperative respiratory complications. In Japan, the majority of patients with esophageal cancer are smokers and have obstructive ventilation disorders. But, the feasibirity and safety of TEP for patients with low respiratory function is unclear. Objectives To clarify the feasibirity and safety of TEP for esophageal cancer patients with obstructive respiratory function. Methods The 95 patients with obstructive respiratory disorder who underwent TEP and gastric tube reconstruction via posterior mediastinal route for esophageal cancer from January 2016 to April 2019 were divided into the two groups, low respiratory function (LRF) group and the control group. Short-term outcomes were compared between two groups. Results The control group was 73 cases, and the LRF group was 22 cases. Propensity score matching using age, gender, cT, and cN as covariates was used to identify matched patients (22 per group) in both groups. There were no differences in operation time of overall and intrathoracic part, or blood loss in each group. In the postoperative complications, pneumonia (13.6% vs. 9.1%), recurrent laryngeal palsy (18.2% vs. 22.7%), anastomotic leakage (13.6% vs. 13.6%) and hospital stay (36.3 days vs 27.5 days) were no differences in both groups. Conclusion TEP can be feasible and safe for the patients with obstructive ventilation disorder and low respiratory function.

Effect of Hypercapnia, an Element of Obstructive Respiratory Disorder, on Pancreatic Cancer Chemoresistance and Progression

Chronic obstructive respiratory disorders (ORDs) are linked to increased rates of cancer-related deaths. Little is known about the effects of hypercapnia (elevated CO2) on development of pancreatic ductal adenocarcinoma (PDAC) and drug resistance. Two PDAC cell lines were exposed to normocapnic (5% CO2) and hypercapnic (continuous/intermittent 10% CO2) conditions, physiologically similar to patients with active ORD. Cells were assessed for proliferation rate, colony formation, and chemo-/radiotherapeutic efficacy. In a retrospective clinical study design, patients with PDAC who had undergone pancreatic resection between 2002 and 2014 were reviewed. Active smokers were excluded to remove possible smoking-related protumorigenic influence. Clinical data, pathologic findings, and survival end points were recorded. Kaplan-Meier and Cox regression analyses were performed. Exposure to hypercapnia resulted in increased colony formation and proliferation ratesinvitro in both cell lines (MIA-PaCa-2: 111% increase and Panc-1: 114% increase; p < 0.05). Hypercapnia exposure induced a 2.5-fold increase in oxaliplatin resistance (p<0.05) in both cell lines and increased resistance to ionizing radiation in MIA-PaCa-2 cells (p < 0.05). Five hundred and seventy-eight patients were included (52% were male, median age was 68.7 years [interquartile range 60.6 to 76.8 years]). Cox regression analysis, assessing TNM staging, age, sex, and ORD status, identified ORD as an independent risk factor for both overall survival (hazard ratio 1.64; 95% CI, 1.2 to 2.3; p < 0.05) and disease-free survival (hazard ratio 1.68; 95% CI, 1.06 to 2.67). PDAC cells exposed to hypercapnic environments, which is common in patients with ORD, showed tumor proliferation, radioresistance, and chemoresistance. Patients with a history of ORD had a worse overall prognosis, suggesting that hypercapnic conditions play a role in the development and progression of PDAC and stressing the need for patient-tailored care.

The application of 320-slice CT " double-low" MIP imaging technique in obstructive sleep apnea syndrome with coronary heart disease

Objective To evaluate the value of 320-slice computed tomography (CT) maximum density projection (MIP) imaging protocol (low tube voltage and contrast agent concentration) in obstructive sleep apnea syndrome (OSAS) with coronary heart disease. Methods 40 cases of OSAS with coronary heart disease in our hospital were selected. All patients underwent 320-slice MIP imaging and received conventional coronary angiography (CAG) within 1 month. With reference to CAG examination results, the accuracy of 320-slice double low MIP-imaging technique in diagnosing the Obstructive sleep apnea syndrome with coronary heart disease can be evaluated. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 320-slice CT double-low MIP imaging in the diagnosis of obstructive respiratory sleep disorder with coronary disease were 95.14%, 94.43%, 95.33%, 83.62%, 98.20%. respectively. The heart rate of testers was (65.20±4.79)bpm/min, the dose length product (DLP) was (98.22±32.54)mGy·cm, and the effective radiation dose (ED) was (1.35±0.42)mSv. Conclusions Compared with CAG, the 320-slice MIP imaging technique reduced doses of radiation while maintained the good quality of image. Therefore, this technique has high application value as a clinical diagnosis method to diagnose patients with obstructive respiratory sleep disorder and coronary heart disease. Key words: Sleep apnea, obstructive; Coronary disease; Tomography, X-ray computed

Epidemiologic characteristics of allergic manifestations in food industry sector

Introduction Food industry is a thriving sector in Tunisia, meeting the increasing demand of our population. A variety of substances are used, from organic to chemical, exposing workers in these manufactories to multiple pathologies, essentially allergic and respiratory diseases. The aim of this study was to describe allergic manifestations among food industry employees. Methods A descriptive cross-sectional study including 90 workers in a biscuit factory carried out from January to May 2016. It included workplace description and medical study. The employees answered a standardized questionnaire and benefited from a physical exam followed by a spirometry for all participants. Results The participation rate was 95.5 %. Sex-ratio male/female was 0.18. Average age was 36 ± years old. Smokers represented 49 %. Average professional seniority was 9 ± years. Family atopy was found in 41 %. Collective and individual protective measures at workplace were not satisfactory. Nasal pruritus was reported in 11.6 % and allergic rhinitis in 19 %, ocular pruritus described in 7 %, erythemato-vesicular and pruritic lesions of hands in 10.5 %. Asthma was found in 3.5 % with no significant correlation with age, sex nor professional seniority. Spirometry showed abnormalities in 17.5 % of the participants. An obstructive respiratory disorder was found in 7 %, it was reversible after administration of salbutamol in 50 %. A restrictive respiratory disorder was suspected in 10.5 % and it had a significant link to the existence of allergic rhinitis history (P = 0.05). Conclusion Food industry exposes workers to multiple allergenic high molecular and chemical substances that can be incriminated in allergic manifestations. Periodic medical consultation and adequate preventive measures to reduce allergenic substances concentration are recommanded.

Frequency of Exposure to Secondhand Smoke Outside the Home Is Associated with a Lower FEV1/FVC in Male Workers Regardless of Smoking Status.

Decreased respiratory function associated with aging leads to the onset of chronic obstructive pulmonary disease (COPD) and increased risk of death in the elderly. Prevention of a decline in respiratory function from a young age is important. This study aimed to clarify the factors that affect decreased forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), an index of obstructive respiratory disorder caused by airway obstruction, by considering the influence of body composition and lifestyle. We recruited 262 employed adult men and determined their lifestyle-related factors, including smoking status, past or current secondhand smoke (SHS) exposure, exposure to SHS outside the home, and physical activity (PA). Body composition and respiratory function were also measured. The data were then compared with those of non-smokers using logistic regression analysis, adjusting for age. We also investigated factors influencing FEV1/FVC using multiple regression analysis, adjusting for age, height, smoking status, and lifestyle. Current smokers and heavy smokers exhibited significantly lower amounts of PA and had a higher body fat%, visceral fat area, prevalence of cohabitation with smokers, and frequency of SHS exposure outside the home, and FEV1/FVC was significantly lower in heavy smokers. A multiple regression analysis revealed that FEV1/FVC was associated only with the frequency of SHS exposure outside the home. It is important for occupational health personnel of a company to advise both non-smokers and smokers to avoid SHS to prevent chronic obstructive pulmonary disease onset. This needs to be coupled with encouragement to quit smoking, especially for heavy smokers.

OPPORTUNITIES FOR EARLY OUTPATIENT DIAGNOSTICS OF OBSTRUCTIVE SLEEP DISORDERED BREATHING

Aim. To evaluate the prevalence of possible obstructive respiratory disorder during sleep in outpatients by the data from computed monitoring pulse oxymetry (CPO) and questionnaires.Material and methods. To the open one stage non-randomized comparative study, 175 patients included: 37,1% males, 62,9% females, age 55,1±11,1 y.o., visiting a clinician office at outpatient facility. Sleep disordered breathing of obstructive origin was diagnosed with a survey, modified Stradling questionnaire and CPO; and excessive daytime sleepiness — with Epworth score. For confirmation of obstructive sleep apnea (OSA), a bifunctional monitoring was performed (BM) with further comparison of the data with CPO results.Results. Chronic hypoxemia at night by CPO was found in 71,4% patients, and probability of OSA moderate and severe — in 42,8% patients. By the modified Stradling, OSA was predicted in 57,7%, by Epworth, the daytime sleepiness was found in 11,4%. Mild OSA in BM was found in 8,9%, moderate — 14,7%, severe — 20,6%. The data from CPO matched with BM in 80% patients. Sensitivity of CPO for nocturnal hypoxemia of various severity was 92,4%, specificity — 76,4%; sensitivity of the Stradling questionnaire — 88,9%, specificity — 88,2%. Sensitivity of Epworth score — 27,8%, specificity — 82,4%.Conclusion. Chronic nocturnal hypoxemia was found in 71,4%, and probability of moderate and severe OSA — in 42,8% in outpatients with internal diseases profile. CPO and Stradling questionnaire can be applied as diagnostic instruments for OSA at outpatient stage.

Assessment of ventilatory disorders in artisans exposed to wood dust

Background: Wood dust is produced at virtually all stages of the wood industry. The most important wood-related risks are chemical hazards with the use of toxic, allergenic, and carcinogenic products which may alter respiratory function. Prevalence rates of ventilatory disorders are heterogeneous and no data are available in Senegal. Aims and Objectives: The purpose of our study was to evaluate respiratory function in carpenters. Materials and Methods: A cross-sectional study was conducted from February to July 2017 in 70 male carpenters exclusively, from the city of Thies. Each carpenter received a questionnaire and a spirometry test as a way of establishing a baseline state of all the subjects. The spirometry was subjected to the standardized validation procedure according to the American Thoracic Society/ European Respiratory Society criteria. Results: The average age is 39 years old. Among these carpenters, 14% are active smokers and 17% are former smokers. Seniority ranged from 1 to 48 years. Spirometry revealed a pure obstructive respiratory disorder in 32.85% of cases. The obstruction is classified as mild in 17.14% and moderate in 7.14% of cases. A pure restrictive syndrome is present in 18.57% and a mixed syndrome in 7.14% of cases. Tobacco potentiates the effects of occupational airborne contaminants because smokers have more obstructive syndrome than ex-smokers 50% versus 33.33% (P = 0.02) and more restrictive syndrome than non-smokers 30% versus 14.58% (P = 0.01). Negative correlations between the duration of exposure and forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity, and MEF 25–75% had been found. Conclusion: Exposure to wood dust is implicated in the alteration of various respiratory function parameters.

Efficacy of NPPV for vocal cord abductor paralysis with floppy epiglottis in multiple system atrophy

Background: Multiple system atrophy (MSA) often presents as obstructive breathing disorder, vocal cord abductor paralysis (VCAP) and floppy epiglottis (FE) in an advanced stage. Noninvasive positive-pressure ventilation (NPPV) is known to be effective for VCAP. On the other hand, some reports insist that in the presence of FE, NPPV may worsen obstructive respiratory disorder.

A bench evaluation of fraction of oxygen in air delivery and tidal volume accuracy in home care ventilators available for hospital use.

Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT). We assessed the FIO2 accuracy and the VT delivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000). For assessing FIO2 accuracy, lung model was set to mimic an obstructive lung and HCV were set in volume controlled mode (VC). They supplied with air, 3 or 15 L/min oxygen and FIO2 was measured by using a ventilator tester (Citrex H4TM). For the VT accuracy, the lung model was set in a way to mimic three adult configurations (normal, obstructive, or restrictive respiratory disorder) and one pediatric configuration. Each HCV was set in VC. Two VT (300 and 500 mL) in adult lung configuration and one 50 mL VT in pediatric lung configuration, at two positive end expiratory pressures 5 and 10 cmH2O, were tested. VT accuracy was measured as volume error (the relative difference between set and measured VT). Statistical analysis was performed by suing one-factor ANOVA with a Bonferroni correction for multiple tests. For Astral 150, Elisée 150, Monnal T50 and Trilogy 200, FIO2 averaged 99.2%, 93.7%, 86.3%, and 62.1%, respectively, at 15 L/min oxygen supplementation rate (P<0.001). Volume error was 0.5%±0%, -38%±0%, -9%±0%, -29%±0% and -36%±0% for pediatric lung condition (P<0.001). In adult lung configurations, Monnal T50 systematically over delivered VT and Trilogy 150 was sensitive to lung configuration when VT was set to 300 mL at either positive end-expiratory pressure (PEEP). HCV are different in terms of FIO2 efficiency and VT delivery.

English

BACKGROUND: Occupation exposes an individual to certain hazards which are known as occupational diseases or pneumoconiosis. Carpet weavers are constantly exposed to dust in their workplace environment, posing a threat to their health. Spirometry is a readily available tool to measure pulmonary functions in the high risk group at an early stage which helps to take necessary measures to prevent further damage. AIMS: To study and compare the effects of long term dust exposure on pulmonary functions of carpet weavers with those of healthy subjects unexposed to such dust. MATERIALS AND METHODS: 50 adult female workers from carpet making industry were chosen for our study. 50 age and sex matched healthy subjects who were not exposed to excessive dust, enrolled as the controls. Forced expiratory spirograms were recorded by RMS Medspiror. Parameters such as forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), the ratio of FEV1/FVC, forced expiratory flow in the middle half of FVC (FEF25-75%), peak expiratory flow rate (PEFR) were assessed in both cases and controls. STATISTICAL ANALYSIS: The results were analyzed by using the student's unpaired t-test. RESULTS: Carpet weavers showed deterioration in FVC, FEV1, FEF25-75%, PEFR and FEV1/FVC ratio which was statistically highly significant (P< 0.001), suggestive of obstructive respiratory disorder. CONCLUSION: Weavers are at risk of developing occupational lung disease which can be prevented by taking meticulous measures and

Diffuse panbronchiolitis in a patient with common variable immunodeficiency: a casual association or a pathogenetic correlation?

Diffuse panbronchiolitis (DPB) is an idiopathic inflammatory disease that seems to have an immunological pathogenesis and that causes a severe progressive suppurative and obstructive respiratory disorder. Common variable immunodeficiency (CVID) is the most common serious primary immunodeficiency and it is often associated with respiratory diseases. Herein, we describe a case of DPB in a 41-year-old man affected by CVID. We examined the patient’s lungs, focusing on the characteristics of the inflammatory cells and of the foamy macrophagic nodules typical of DPB. Immunohistochemical typing of the lymphocytic infiltrate showed that B-cells were almost absent, matching the immunological profile of CVID. The case described is the first case reported in the literature of DPB in a patient affected by CVID. Moreover it seems to confirm the correlation between an immunodeficiency status and the development of DPB and provides more information on the accumulation of nodules of foamy macrophages in DPB.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5310709471138338.

Relação entre função pulmonar e as propriedades musculares em pacientes com doença pulmonar obstrutiva crônica

Objetivo: Determinar as interrelações entre função pulmonar e os atributos massa e força muscular em pacientes com doença pulmonar obstrutiva crônica (DPOC). Método: 22 pacientes com DPOC foram submetidos à avaliação espirométrica, à composição corporal por bioimpedância elétrica e de força muscular do quadríceps femoral pela análise da contração voluntária máxima (CVM). Para testar as relações entre os indicadores volume expiratório forçado em um segundo (VEF1), massa magra (MM) e CVM foram realizadas correlações de Pearson. Resultados: Houve relações significantes entre o VEF1 e a MM (r=0,48;p=0,02), VEF1 e a CVM (r=0,45; p=0,05), assim como a MM e a CVM (r=0,67;p=0,002). Conclusão: Os resultados desse estudo demonstram que em pacientes com DPOC estáveis de grau moderado, o distúrbio ventilatório obstrutivo, evidenciado pelo indicador espirométrico VEF1, relacionou-se com os atributos de massa e força muscular periférica, e o declínio da força foi proporcional a massa muscular remanescente.

Effect of poll flexion and dynamic laryngeal collapse on tracheal pressure in Norwegian Coldblooded Trotter racehorses

Dynamic laryngeal collapse (DLC) associated with poll flexion is a newly diagnosed upper respiratory tract obstructive disorder that causes poor racing performance. To determine if Norwegian Coldblooded Trotters (NCTs) affected with DLC associated with poll flexion differ from normal, elite NCTs based on simple airway mechanics measurements. Five normal elite NCTs and 6 NCTs diagnosed previously with DLC underwent treadmill videoendoscopy while tracheal pressures were measured continuously. Alternating head positions were used such that horses were exercised with free head carriage and induced poll flexion at heart rates >200 beats/min. Peak inspiratory tracheal pressures were significantly more negative for horses with DLC compared to the elite horses. This difference was only significant during the exercise phases when the poll region was flexed, P = 0.0015. Head position significantly affected peak inspiratory pressure for both elite and affected horses, P < 0.0001. Induced poll flexion significantly affected peak inspiratory pressure (PIP) in all horses; however, PIPs were significantly more negative in those affected with DLC. Based upon the tracheal pressure measurements recorded in this study, DLC in NCTs is a severe obstructive upper respiratory tract disorder that is induced by poll flexion.