Evaluation of atopy in patients with COPD

Abstract

OBJECTIVE: To determine the prevalence of atopy and to evaluate clinical, laboratory, and radiological profiles in patients with COPD. METHODS: This was a cross-sectional study involving outpatients with stable COPD (defined by the clinical history and a post-bronchodilator FEV1/FVC < 70% of the predicted value). The patients completed a questionnaire regarding clinical characteristics and atopy, after which they underwent nasal lavage cytology, skin prick testing, chest X-rays, arterial blood gas analyses, and determination of total serum IgE. RESULTS: Of the 149 subjects studied, 53 (35.6%), 49 (32.8%), and 88 (59.1%) presented with nasal eosinophilia, a positive skin prick test result, and symptoms of allergic rhinitis, respectively. Correspondence analysis confirmed these findings, showing two distinct patterns of disease expression: atopy in patients with COPD that was less severe; and no evidence of atopy in those with COPD that was more severe (reduced FEV1 and hyperinflation). There was a statistically significant association between nasal eosinophilia and a positive bronchodilator response. CONCLUSIONS: Using simple and reproducible methods, we were able to show that there is a high frequency of atopy in patients with COPD. Monitoring inflammation in the upper airways can be a useful tool for evaluating respiratory diseases in the elderly and in those with concomitant asthma and COPD, a clinical entity not yet fully understood.

The role of fungal sensitisation in clinical presentation in patients with chronic obstructive pulmonary disease

“…In this study, sensitisation to common aeroallergens was noted in 29% of COPD patients. Previously allergic sensitisation has been reported in 25‐41% patients with COPD . Furthermore, fungal sensitisation in this study was 5.4%, which is similar to the prevalence of 8.5% reported by Agarwal et al .…”

“…Previously allergic sensitisation has been reported in 25-41% patients with COPD. 3,14 Furthermore, fungal sensitisation in this study was 5.4%, which is similar to the prevalence of 8.5% reported by Agarwal et al 5 in patients of COPD sensitised to Aspergillus spp. However, it is noteworthy that in the present study, fungal sensitization was not only limited to Aspergillus fumigatus but was also noted against other fungi such as Alternaria alternata, Schizophyllum commune, Aspergillus tamarii and Rhizopus spp.…”

“…Although one may consider that cases of asthma could have been included in the study, the relatively advanced age at presentation, short duration of symptoms, the persistent and progressive nature of the complaints and importantly the strict adherence to the GOLD guidelines in case selection negate this possibility. Also, no significant differences in the severity or airflow limitation or reversibility of the same in either study group were observed which could be attributed to the homogeneity of baseline characteristics in the participants of this study …”

Impacto de uma intervenção educacional de enfermagem em pacientes portadores de DPOC

“…Este fato pode ser justificado pelo aumento do consumo do tabaco entre as mulheres 2 . A média da idade da amostra também está compatível com outros estudos, observando-se o predomínio de pacientes idosos 2,15 O predomínio de ex-tabagistas é similar ao encontrado em outros estudos 2,17 . Os dados sobre tabagismo como tempo médio de fumo e consumo de cigarro e o tempo médio de DPOC também está em consonância com outros estudos 2,17 .…”

“…Quanto à gravidade da DPOC, a maioria foi classificada como grau II (58%) e grau III (22%), ou seja, DPOC moderada e grave respectivamente, similar ao encontrado na literatura. Esse fato talvez possa ser explicado pelas pesquisas terem sido realizadas em ambiente hospitalar e os pacientes que mais apresentam exacerbações e complicações são aqueles que estão nos estágios mais avançados da doença 17,18 .…”