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Gastroesophageal reflux disease (GERD) is associated with different pulmonary diseases, including chronic obstructive pulmonary disease (COPD). Whether GERD is contributory to COPD severity remains unclear. This study aims to evaluate the contribution of GERD to the clinical manifestation of COPD based on ventilatory parameters and yearly clinical exacerbations. We studied 48 patients (56% females, age 66 years) with COPD. All patients underwent high-resolution manometry and esophageal pH monitoring. The patients were separated into two groups according to the presence of GERD. GERD was present in 21 (44%) patients. GERD + and GERD – groups did not differ in regard to gender, age, and body mass index. Pulmonary parameters were not different in the absence or presence of GERD. The number of yearly exacerbations was higher in patients GERD1. The severity of GERD (as measured by DeMeester score) correlated with the number of exacerbations. Our results show the following: 1) GERD does not influence pulmonary parameters and 2) GERD is associated with a higher number of annual clinical exacerbations. We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation.

In conclusion, inhaled beta agonist bronchodilators not only increase the thoracic pressure but also lead to an increased abdominal pressure favoring GERD by affecting the esophagogastric barrier.

Objetivo: Caracterizar pacientes portadores de bronquiectasias acompanhados em um ambulatório de pneumologia na cidade de São Paulo. Método: Trata-se de um estudo clínico descritivo, retrospectivo do tipo série de casos, no qual foram estudados sujeitos portadores de bronquiectasias, atendidos entre 2004 e 2011 no Ambulatório Multiprofissional de Bronquiectasias da Universidade Federal de São Paulo. Resultados: A amostra foi constituída de 194 pacientes, sendo 103 (53%) do sexo feminino, media de idade de 53,3 ± 18,3 anos e índice de massa corpórea de 23,4 ± 4,5 Kg/m2. Os sintomas predominantes foram tosse (93,8%), expectoração (89,2%) e dispneia (76,3%), sendo as maiores causadoras da doença a sequela de tuberculose pulmonar (37,15%), seguida de etiologia pós-infecciosa (33,5%) e causas idiopáticas (23,7%). As comorbidades mais encontradas foram hiper-reatividade brônquica (66%) e doenças cardiovasculares (44%). Conclusão: Foi delineado o perfil clínico de pacientes portadores de bronquiectasias caracterizados por baixa escolaridade, múltiplas comorbidades e presença acentuada de tosse, expectoração e dispneia.

INTRODUCTION: Bronchiectasis is a chronic disorder characterized by permanent dilation of the bronchi and bronchioles accompanied by inflammatory changes in the walls of these structures and adjacent lung parenchyma. OBJECTIVE: The aim of the present study was to perform a clinical and functional characterization of adult patients with non-cystic fibrosis bronchiectasis. METHODS: A clinical, descriptive, retrospective, case-series study was carried out involving 232 patients with non-cystic fibrosis bronchiectasis treated at a lung ambulatory between 2004 and 2012. RESULTS: The sample consisted of 232 patients (134 females; mean age: 52.9 years ± 17.7; body mass index: 23.5 kg/m² ± 4.4). The predominant symptoms were cough (91.4%), expectoration (85.8%) and dyspnea (76.3%). The majority of cases were of a non-tuberculosis etiology (64.7%). Regarding lung function, the obstructive breathing pattern was predominant (43.5%). The most common comorbidities were of a cardiovascular origin (51.0%). CONCLUSIONS: Adult patients with non-cystic fibrosis bronchiectasis (mainly post-infection or post-tuberculosis in origin) are characterized by a low educational level, excessive cough, sputum, dyspnea, muscle fatigue, an obstructive breathing pattern with frequent hypoxemia and multiple comorbidities, mainly of a cardiovascular origin. However, our patients have a low index of exacerbations and hospitalizations that can be assigned to a clinical protocol for monitoring.

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