Pub Date : 2017-05-01DOI: 10.1016/j.rppnen.2017.01.001
C. Ribeiro , D. Ferreira , S. Conde , P. Oliveira , W. Windisch
The aim of this study was to develop and validate the professional translation and cultural adaptation of the Portuguese Severe Respiratory Insufficiency (SRI) Questionnaire.
The sample was composed of 93 patients (50 male patients, 53.8%) with a mean age of 66.3 years. The most frequent diagnostic groups were chronic obstructive pulmonary disease, obesity hypoventilation syndrome and restrictive chest wall disorders.
The patients were asked to fill in both the SRI and SF-36 questionnaires. Factor analysis of the SRI questionnaire was performed leading to an explained variance of 73%, and resulted in 13 components. When analyzing the reliability, we obtained values for Cronbach's alpha above 0.70 for most subscales with the reliability of the summary scale being even higher (0.84).
This professional translation and cultural adaptation of the Portuguese SRI Questionnaire has good psychometric properties which are similar, not only to the original, but also to other translations. These characteristics make this questionnaire applicable to the Portuguese population receiving home mechanical ventilation for severe respiratory insufficiency.
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Pub Date : 2017-05-01DOI: 10.1016/j.rppnen.2016.12.005
A. Robalo Nunes , M. Tátá
Introduction
Anaemia is increasingly recognised as an important comorbidity in the context of chronic obstructive pulmonary disease (COPD), but remains undervalued in clinical practice. This review aims to characterise the impact of anaemia and iron deficiency in COPD.
Methods
Literature review of studies exploring the relationship between anaemia/iron deficiency and COPD, based on targeted MEDLINE and Google Scholar queries.
Results
The reported prevalence of anaemia in COPD patients, ranging from 4.9% to 38.0%, has been highly variable, due to different characteristics of study populations and lack of a consensus on the definition of anaemia. Inflammatory processes seem to play an important role in the development of anaemia, but other causes (including nutritional deficiencies) should not be excluded from consideration. Anaemia in COPD has been associated with increased morbidity, mortality, and overall reduced quality of life. The impact of iron deficiency, irrespective of anaemia, is not as well studied, but it might have important implications, since it impacts production of red blood cells and respiratory enzymes. Treatment of anaemia/iron deficiency in COPD remains poorly studied, but it appears reasonable to assume that COPD patients should at least receive the same type of treatment as other patients.
Conclusions
Anaemia and iron deficiency continue to be undervalued in most COPD clinical settings, despite affecting up to one-third of patients and having negative impact on prognosis. Special efforts should be made to improve clinical management of anaemia and iron deficiency in COPD patients as a means of achieving better patient care.
{"title":"The impact of anaemia and iron deficiency in chronic obstructive pulmonary disease: A clinical overview","authors":"A. Robalo Nunes , M. Tátá","doi":"10.1016/j.rppnen.2016.12.005","DOIUrl":"10.1016/j.rppnen.2016.12.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Anaemia is increasingly recognised as an important comorbidity in the context of chronic obstructive pulmonary disease (COPD), but remains undervalued in clinical practice. This review aims to characterise the impact of anaemia and iron deficiency in COPD.</p></div><div><h3>Methods</h3><p>Literature review of studies exploring the relationship between anaemia/iron deficiency and COPD, based on targeted MEDLINE and Google Scholar queries.</p></div><div><h3>Results</h3><p>The reported prevalence of anaemia in COPD patients, ranging from 4.9% to 38.0%, has been highly variable, due to different characteristics of study populations and lack of a consensus on the definition of anaemia. Inflammatory processes seem to play an important role in the development of anaemia, but other causes (including nutritional deficiencies) should not be excluded from consideration. Anaemia in COPD has been associated with increased morbidity, mortality, and overall reduced quality of life. The impact of iron deficiency, irrespective of anaemia, is not as well studied, but it might have important implications, since it impacts production of red blood cells and respiratory enzymes. Treatment of anaemia/iron deficiency in COPD remains poorly studied, but it appears reasonable to assume that COPD patients should at least receive the same type of treatment as other patients.</p></div><div><h3>Conclusions</h3><p>Anaemia and iron deficiency continue to be undervalued in most COPD clinical settings, despite affecting up to one-third of patients and having negative impact on prognosis. Special efforts should be made to improve clinical management of anaemia and iron deficiency in COPD patients as a means of achieving better patient care.</p></div>","PeriodicalId":101122,"journal":{"name":"Revista Portuguesa de Pneumologia (English Edition)","volume":"23 3","pages":"Pages 146-155"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppnen.2016.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34761070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-01DOI: 10.1016/j.rppnen.2017.01.004
B.R.A. Silva , R. Rufino , C.H. Costa , V.S. Vilela , R.A. Levy , A.J. Lopes
Background
Despite the importance of traditional pulmonary function tests (PFTs) in managing systemic sclerosis (SSc), many patients with pulmonary disease diagnosed by computed tomography (CT) present with normal PFTs.
Objective
To evaluate the efficacy of the nitrogen single-breath washout (N2SBW) test in diagnosing SSc and to correlate N2SBW parameters with the PFT indexes used in the follow-up of these patients, clinical data, and CT findings.
Methods
Cross-sectional study in which 52 consecutive SSc patients were subjected to spirometry, body plethysmography, analysis of the diffusing capacity for carbon monoxide (DLCO), analysis of respiratory muscle strength, N2SBW testing, and CT analysis.
Results
Twenty-eight patients had a forced vital capacity (FVC) that was <70% of the predicted value. In the N2SBW test, 44 patients had a phase III slope (Phase III slopeN2SBW) that was >120% of the predicted value, while 15 patients had a closing volume/vital capacity (CV/VC) that was >120% of the predicted value. A significant difference in Phase III slopeN2SBW was observed when the patients with predominant traction bronchiectasis and honeycombing were compared to the patients with other CT patterns (p < 0.0001). The Phase III slopeN2SBW was correlated with FVC (rs = −0.845, p < 0.0001) and DLCO (rs = −0.600, p < 0.0001), and the CV/VC was correlated with FVC (rs = −0.460, p = 0.0006) and residual volume/total lung capacity (rs = 0.328, p = 0.017).
Conclusion
Ventilation heterogeneity is a frequent finding in SSc patients that is associated with restrictive damage, changes in pulmonary diffusion, and CT patterns. In addition, approximately one-third of the patients presented with findings that were compatible with small airway disease.
尽管传统的肺功能检查(PFTs)在治疗系统性硬化症(SSc)中很重要,但许多通过计算机断层扫描(CT)诊断的肺部疾病患者的PFTs正常。目的评价氮单次呼吸冲洗试验(N2SBW)对SSc的诊断效果,并将N2SBW参数与患者随访时使用的PFT指标、临床资料及CT表现进行比较。方法对52例SSc患者进行横断面研究,对其进行肺活量测定、体体积谱、一氧化碳弥散能力(DLCO)分析、呼吸肌力量分析、N2SBW测试和CT分析。结果28例患者用力肺活量(FVC)为预测值的70%。在N2SBW试验中,44例患者的III期斜率(phase III slopeN2SBW)为预测值的120%,而15例患者的闭合容积/生命容量(CV/VC)为预测值的120%。以牵引支气管扩张和蜂窝状为主的患者与其他CT表现的患者相比,III期slopeN2SBW有显著差异(p <0.0001)。III期slopeN2SBW与FVC相关(rs = - 0.845, p <0.0001)和DLCO (rs = - 0.600, p <CV/VC与FVC (rs =−0.460,p = 0.0006)、残气量/总肺活量(rs = 0.328, p = 0.017)相关。结论通气异质性在SSc患者中很常见,与限制性损伤、肺弥散改变和CT表现相关。此外,大约三分之一的患者表现出与小气道疾病相符的结果。
{"title":"Ventilation distribution and small airway function in patients with systemic sclerosis","authors":"B.R.A. Silva , R. Rufino , C.H. Costa , V.S. Vilela , R.A. Levy , A.J. Lopes","doi":"10.1016/j.rppnen.2017.01.004","DOIUrl":"10.1016/j.rppnen.2017.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Despite the importance of traditional pulmonary function tests (PFTs) in managing systemic sclerosis (SSc), many patients with pulmonary disease diagnosed by computed tomography (CT) present with normal PFTs.</p></div><div><h3>Objective</h3><p>To evaluate the efficacy of the nitrogen single-breath washout (N<sub>2</sub>SBW) test in diagnosing SSc and to correlate N<sub>2</sub>SBW parameters with the PFT indexes used in the follow-up of these patients, clinical data, and CT findings.</p></div><div><h3>Methods</h3><p>Cross-sectional study in which 52 consecutive SSc patients were subjected to spirometry, body plethysmography, analysis of the diffusing capacity for carbon monoxide (DLCO), analysis of respiratory muscle strength, N<sub>2</sub>SBW testing, and CT analysis.</p></div><div><h3>Results</h3><p>Twenty-eight patients had a forced vital capacity (FVC) that was <70% of the predicted value. In the N<sub>2</sub>SBW test, 44 patients had a phase III slope (Phase III slope<sub>N2SBW</sub>) that was >120% of the predicted value, while 15 patients had a closing volume/vital capacity (CV/VC) that was >120% of the predicted value. A significant difference in Phase III slope<sub>N2SBW</sub> was observed when the patients with predominant traction bronchiectasis and honeycombing were compared to the patients with other CT patterns (<em>p</em> <!--><<!--> <!-->0.0001). The Phase III slope<sub>N2SBW</sub> was correlated with FVC (<em>r</em><sub>s</sub> <!-->=<!--> <!-->−0.845, <em>p</em> <!--><<!--> <!-->0.0001) and DLCO (<em>r</em><sub>s</sub> <!-->=<!--> <!-->−0.600, <em>p</em> <!--><<!--> <!-->0.0001), and the CV/VC was correlated with FVC (<em>r</em><sub>s</sub> <!-->=<!--> <!-->−0.460, <em>p</em> <!-->=<!--> <!-->0.0006) and residual volume/total lung capacity (<em>r</em><sub>s</sub> <!-->=<!--> <!-->0.328, <em>p</em> <!-->=<!--> <!-->0.017).</p></div><div><h3>Conclusion</h3><p>Ventilation heterogeneity is a frequent finding in SSc patients that is associated with restrictive damage, changes in pulmonary diffusion, and CT patterns. In addition, approximately one-third of the patients presented with findings that were compatible with small airway disease.</p></div>","PeriodicalId":101122,"journal":{"name":"Revista Portuguesa de Pneumologia (English Edition)","volume":"23 3","pages":"Pages 132-138"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rppnen.2017.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34782282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}