Efficacy of speech therapy in post-intubation patients with oropharyngeal dysphagia: a randomized controlled trial.

Purpose: to verify the efficacy of speech therapy in the early return of oral intake in patients with post-orotracheal intubation dysphagia.

Methods: It was a double-blinded randomized controlled trial for two years with patients of intensive care units of a hospital. Study inclusion criteria were orotracheal intubation>48hours, age≥18 years old, clinical stability, and dysphagia.

Risk factors for asthma in schoolchildren in Southern Brazil.

Background: Due to the high prevalence of recurrent wheezing in the pediatric population, it is important to be able to identify environmental risk factors that may affect the etiology of asthma in several regions.

Objective: to identify possible risk factors associated with asthma in children (9-12 years old) in Passo Fundo, Rio Grande do Sul, Brazil.

Material And Methods: A total of 1003 school-age children were selected for the cross-sectional study by applying a standardized written questionnaire from the International Study of Asthma and Allergy, and a supplementary questionnaire (ISAAC phase II) was added to address personal, family and environmental factors.

Effects of positive expiratory pressure on pulmonary clearance of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid in healthy individuals.

Objective:: To evaluate the effects of positive expiratory pressure (PEP) on pulmonary epithelial membrane permeability in healthy subjects.

Methods:: We evaluated a cohort of 30 healthy subjects (15 males and 15 females) with a mean age of 28.3 ± 5.

Pulmonary hypertension as estimated by Doppler echocardiography in adolescent and adult patients with cystic fibrosis and their relationship with clinical, lung function and sleep findings.

Background: In cystic fibrosis (CF) patients, end stage of pulmonary disease is characterized by pulmonary hypertension (PH), hypoxemia, decrease in exercise tolerance, and sleep quality.

Objective: To evaluate the association between clinical, lung function, sleep quality, and polysomnographic variables with PH in CF patients aged 16 years or older.

Methods: In a cross-sectional study, 51 clinically stable CF patients underwent a clinical evaluation, an overnight polysomnography and answered sleep questionnaires (Pittsburgh Sleep Quality Index and Epworth sleepiness scale).

Noninvasive ventilation in status asthmaticus in children: levels of evidence.

Objective: To evaluate the quality of available evidence to establish guidelines for the use of noninvasive ventilation for the management of status asthmaticus in children unresponsive to standard treatment.

Methods: Search, selection and analysis of all original articles on asthma and noninvasive ventilation in children, published until September 1, 2014 in all languages in the electronic databases PubMed, Web of Science, Cochrane Library, Scopus and SciELO, located using the search terms: "asthma", "status asthmaticus", "noninvasive ventilation", "Bronchospasm", "continuous positive airway pressure", "child", "infant", "pediatrics", "hypercapnia", "respiratory failure" and the keywords "BIPAP", "CPAP", "Bilevel", "acute asthma" and "near fatal asthma". The articles were assessed based on the levels of evidence of the GRADE system.

Clinical Outcomes and Prognostic Factors in a Cohort of Adults With Cystic Fibrosis: A 7-Year Follow-Up Study.

Background: Due to the heterogeneity of cystic fibrosis (CF), the longer survival observed in cohorts of adult subjects, and inter-population variations, there is a clear need to seek further information about clinical outcomes and prognostic factors in different cohorts of subjects with CF. Our objectives were to evaluate clinical outcomes and prognostic factors in a cohort of adult subjects with CF after a 7-y follow-up period and investigate longitudinal changes in clinical scores, spirometry, 6-min walk test performance, and pulmonary artery systolic pressure as assessed by Doppler echocardiography.

Methods: A cohort of clinically stable subjects (≥16 y old) who were enrolled in an adult CF program in 2004-2005 underwent clinical evaluation.

High frequency hearing thresholds and product distortion otoacoustic emissions in cystic fibrosis patients.

Introduction: The treatment of patients with cystic fibrosis involves the use of ototoxic drugs, mainly aminoglycoside antibiotics. Due to the use of these drugs, fibrocystic patients are at risk of developing hearing loss.

Objective: To evaluate the hearing of patients with cystic fibrosis by High Frequency Audiometry and Distortion Product Otoacoustic Emissions.

Exercise programme in patients with cystic fibrosis: a randomized controlled trial.

Objectives: Assess the effects of a home exercise programme, based on aerobic training and muscle strength training, in patients with cystic fibrosis (CF), for a period of 3 months.

Methods: Randomised controlled clinical experiment, with an analysis of intention to treat including clinically stable patients with CF and of age ≥ 16. Assessments include: a 6 min walk test (6 MWT), one-repetition maximum strength test (1 RM), spirometry and quality of life questionnaires.

Post-traumatic stress symptoms and exacerbations in COPD patients.

Background: Post-Traumatic Stress Disorder (PTSD) is a common psychological consequence of exposure to traumatic stressful life events. During COPD exacerbations dyspnea can be considered a near-death experience that may induce post-traumatic stress symptoms. The aim of this study was to evaluate the relationship between COPD exacerbations and PTSD- related symptoms.

Can the single-breath helium dilution method predict lung volumes as measured by whole-body plethysmography?

Objective: To compare TLC and RV values obtained by the single-breath helium dilution (SBHD) method with those obtained by whole-body plethysmography (WBP) in patients with normal lung function, patients with obstructive lung disease (OLD), and patients with restrictive lung disease (RLD), varying in severity, and to devise equations to estimate the SBHD results.

Methods: This was a retrospective cross-sectional study involving 169 individuals, of whom 93 and 49 presented with OLD and RLD, respectively, the remaining 27 having normal lung function. All patients underwent spirometry and lung volume measurement by both methods.

A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country.

Objective: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE).

Methods: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil.

Activity level predicts 6-minute walk distance in healthy older females: an observational study.

Background: The 6-minute walk test (6MWT) is widely used in clinical practice and research. Few studies have investigated activity level as a predictor of 6-minute walk distance (6MWD), and existing predictive models do not allow for activity level.

Objectives: To evaluate if knowledge of the level of physical activity enhanced the ability to predict 6MWD, and if the inclusion of activity level added to the predictive accuracy of existing models for the 6MWT in healthy older women; and to validate existent predictive models for 6MWD in a new sample.

Six-minute walk distance is not related to quality of life in patients with non-cystic fibrosis bronchiectasis.

Objective: To evaluate physical performance on the six-minute walk test (6MWT) in patients with non-cystic fibrosis bronchiectasis and to investigate its relationship with quality of life (QoL). To identify predictors of exercise performance, we also investigated whether six-minute walk distance (6MWD) is associated with clinical and spirometric findings.

Methods: This was a cross-sectional study involving patients with non-cystic fibrosis bronchiectasis (age, > 18 years), with at least one respiratory symptom for > 2 years and an FEV1 < 70% of predicted.

D-dimer levels in stable COPD patients: a case-control study.

Background: High D-dimer levels have been detected in patients with chronic obstructive pulmonary disease (COPD) exacerbation, irrespective of presence of venous thromboembolism. On the other hand, there is a continuing debate about the diagnostic efficiency of D-dimer tests in patients with stable COPD.

Objectives: We aimed to investigate if basic laboratory investigations suggest hypercoagulability state in stable COPD patients, and if there is an association with D-dimer levels and pulmonary function tests.

Effects of expiratory positive airway pressure on dynamic hyperinflation during exercise in patients with COPD.

Background: Expiratory positive airway pressure (EPAP) is a form of noninvasive positive-pressure ventilatory support that, in spite of not unloading respiratory muscles during inspiration, may reduce the inspiratory threshold load and attenuate expiratory dynamic airway compression, contributing to reduced expiratory air-flow limitation in patients with COPD. We sought to determine the effects of EPAP on operational lung volumes during exercise in COPD patients.

Methods: This was a nonrandomized, experimental comparison of 2 exercise conditions (with and without EPAP); subjects completed a treadmill exercise test and performed, before and immediately after exercise, lung volume measurements.

Bronchodilator effect on maximal breath-hold time in patients with obstructive lung disease.

Objective: To identify the role of bronchodilators in the maximal breath-hold time in patients with obstructive lung disease (OLD).

Methods: We conducted a case-control study including patients with OLD and a control group. Spirometric tests were performed prior to and after the use of a bronchodilator, as were breath-hold tests, using an electronic microprocessor and a pneumotachograph as a flow transducer.

Venous thromboembolism prophylaxis in a general hospital.

Objective: To evaluate the use of venous thromboembolism (VTE) prophylaxis in a general hospital.

Methods: A cross-sectional cohort study at the Hospital Nossa Senhora da Conceição, located in the city of Porto Alegre, Brazil, involving a random sample of patients admitted between October of 2008 and February of 2009. We included patients over 18 years of age and hospitalized for more than 48 h.

A new approach to the determination of airway resistance: interrupter technique vs. plethysmography.

Objective: To determine the agreement between interrupter resistance (Rint) and airway resistance (Raw) by plethysmography in order to verify the clinical applicability of the interrupter technique.

Methods: The Rint technique was performed with the patients in a sitting position, during exhalation, with a nose clip and cheek support. Plethysmography was carried out in accordance with standard protocols.

Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index.

Introduction: The Pittsburgh Sleep Quality Index (PSQI) is a questionnaire that assesses sleep quality and disturbances over a 1-month period. It is a valuable tool for research purposes. The aim of this study was to validate a Brazilian Portuguese version of the PSQI.

Predictors of physical and mental health-related quality of life in patients with interstitial lung disease: a multifactorial analysis.

Objective: To determine predictors of health-related quality of life (HRQoL) in patients with interstitial lung disease (ILD).

Methods: A cross-sectional study comprising 63 patients, all of whom underwent lung function testing and the six-minute walk test. The following instruments were used: the Medical Outcomes Study 36-item Shortform Survey (SF-36), the Saint George's Respiratory Questionnaire (SGRQ), the Beck Anxiety Inventory, the Beck Depression Inventory, and the Modified Medical Research Council Dyspnea Scale.

Poor perception of dyspnea following methacholine challenge test in patients with asthma.

Objective: To determine the proportion of asthma patients with a poor perception of dyspnea, correlating the level of that perception with the severity of acute bronchoconstriction, bronchial hyperresponsiveness, use of maintenance medication, and asthma control.

Methods: Uncontrolled clinical trial involving asthma patients treated at the Pulmonology Outpatient Clinic of the São Lucas Hospital, in Porto Alegre , Brazil. Methacholine challenge testing was performed using a five-breath dosimeter protocol.

[Recommendations for the management of pulmonary thromboembolism, 2010].

Pulmonary thromboembolism and deep vein thrombosis together constitute a condition designated venous thromboembolism. Despite the advances, the morbidity and the mortality attributed to this condition are still high, because the patients present with more complex diseases, are submitted to a greater number of invasive procedures and survive longer. Although there are various international guidelines available, we decided to write these recommendations for their application in medical practice in Brazil.

Incentive spirometry with expiratory positive airway pressure brings benefits after myocardial revascularization.

Background: Patients undergoing coronary artery bypass graft (CABG) surgery have higher risk to develop pulmonary complications (PCs) such as atelectasis, pneumonia and pleural effusion. These complications could increase the length of hospital stay, resources utilization and also are associated with reduced quality of life and functional capacity a long term.

Objective: To test if the use of incentive spirometry (IS) associated with expiratory positive airway pressure (EPAP), after CABG surgery improves dyspnea, effort perceived and quality of life 18 months after CABG.

The role of the FEF50%/0.5FVC ratio in the diagnosis of obstructive lung diseases.

Objective: To evaluate the contribution of a new coefficient, the FEF50%/0.5FVC ratio, obtained from the maximal expiratory flow-volume curve, to the diagnosis of obstructive lung disease (OLD); to test this coefficient in differentiating among patients considered normal, those with OLD and those with restrictive lung disease (RLD); and to determine cut-off points for each functional diagnosis, as well as the probability for each diagnosis based on individual values.

Methods: A prospective, cross-sectional study analyzing the pulmonary function of patients referred to the Porto Alegre Hospital de Clínicas, in Porto Alegre, Brazil, between January and December of 2003.