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Brazilian studies on pulmonary function in COPD patients: what are the gaps?

ABSTRACT: COPD is a major cause of death and morbidity worldwide, and is characterized by persistent airflow obstruction. The evaluation of obstruction is critically dependent on sensitive methods for lung-function testing. A wide body of knowledge has been accumulated in recent years showing that these methods have been significantly refined and seems promising for detection of early disease.This review focuses on research on pulmonary function analysis in COPD performed in Brazil during this century.The literature was searched using a systematic search strategy limited to English language studies that were carried out in Brazil from the year 2000 onward, with study objectives that included a focus on lung function.After we applied our inclusion and exclusion criteria, 94 articles addressed our stated objectives. Among the new methods reviewed are the forced-oscillation technique and the nitrogen-washout test, which may provide information on small-airway abnormalities. Studies investigating the respiratory muscles and thoracoabdominal motion are also discussed, as well as studies on automatic clinical decision-support systems and complexity measurements. We also examined important gaps in the present knowledge and suggested future directions for the cited research fields.There is clear evidence that improvements in lung-function methods allowed us to obtain new pathophysiological information, contributing to improvement in our understanding of COPD. In addition, they may also assist in the diagnosis and prevention of COPD. Further investigations using prospective and longitudinal design may be of interest to elucidate the use of these new methods in the diagnosis and prevention of COPD.

SUBMITTER: Lopes AJ

PROVIDER: S-EPMC4946858 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Brazilian studies on pulmonary function in COPD patients: what are the gaps?

Lopes Agnaldo José AJ de Melo Pedro Lopes PL

International journal of chronic obstructive pulmonary disease 20160711

<h4>Background</h4>COPD is a major cause of death and morbidity worldwide, and is characterized by persistent airflow obstruction. The evaluation of obstruction is critically dependent on sensitive methods for lung-function testing. A wide body of knowledge has been accumulated in recent years showing that these methods have been significantly refined and seems promising for detection of early disease.<h4>Objectives</h4>This review focuses on research on pulmonary function analysis in COPD perfo ...[more]

PMID: 27468230

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Project description:BackgroundIt is not known whether environmental gamma radiation measured in US cities has detectable adverse health effects. We assessed whether short-term exposure to gamma radiation emitted from ambient air particles [gamma particle activity (PRγ)] is associated with reduced pulmonary function in chronic obstructive pulmonary disease (COPD) patients.ObjectiveWe hypothesize that the inhalation of gamma radiation emitted from ambient air particles may be associated with reduced pulmonary function in individuals with COPD.MethodsIn 125 patients with COPD from Eastern Massachusetts who had up to 4 seasonal one-week assessments of particulate matter ≤2.5 μm (PM2.5), black carbon (BC), and sulfur followed by spirometry. The US EPA continuously monitors ambient gamma (γ) radiation including γ released from radionuclides attached to particulate matter that is recorded as 9 γ-energy spectra classes (i = 3-9) in counts per minute (CPMγ) in the Boston area (USA). We analyzed the associations between ambient and indoor PRγi (up to one week) and pre and post-bronchodilator (BD) forced expiratory volume in 1 s (FEV1) and with forced vital capacity (FVC) using mixed-effects regression models. We estimated indoor PRγi using the ratio of the indoor-to-outdoor sulfur in PM2.5 as a proxy for infiltration of ambient radionuclide-associated particles.ResultsOverall, exposures to ambient and indoor PRγi were associated with a similar decrease in pre- and post-BD FEV1 and FVC. For example, ambient PRγ3 exposure averaged from the day of pulmonary function testing through the previous 3 days [IQR of 55.1 counts per minute (CPMγ)] was associated with a decrease in pre-BD FEV1 of 21.0 ml (95%CI: -38.5 to -3.0 ml; p < 0.01) and pre-BD FVC of 27.5 ml [95% confidence interval (CI): -50.7 to -5.0 ml; p < 0.01] with similar effects adjusting for indoor and outdoor BC and PM2.5.ConclusionOur results show that short-term ambient and indoor exposures to environmental gamma radiation associated with particulate matter are associated with reduced pre- and post-BD pulmonary function in patients with COPD.

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Brazilian studies on pulmonary function in COPD patients: what are the gaps?

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Brazilian studies on pulmonary function in COPD patients: what are the gaps?

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