RESUMEN
AIM: To assess prospectively the effects of a controlled program of inspiratory muscle training program and nutritional support in patients with chronic obstructive lung disease (COPD). PATIENTS AND METHODS: Twenty-three patients with COPD were randomly assigned into four groups. Group I received a 1000 kcal/day nutritional supplement, given as a casein based enteral nutritional formula; group III was subjected to inspiratory muscle training, using an inexpensive pressure threshold load valve constructed according to the Appropriate Technology principles of the WHO, adjusted at 30% of Maximal Inspiratory Mouth Pressure and received also the nutritional supplement; group IV was trained but did not receive the nutritional supplement and group II was not trained nor supplemented. Patients were studied during three months and monthly, inspiratory muscle function, exercise capacity and anthropometry were measured. RESULTS: A significant improvement in exercise capacity, maximal inspiratory pressure and inspiratory muscle endurance was observed in the four groups throughout the study. Trained subjects had greater improvement in their inspiratory muscle endurance, compared to untrained subjects. Nutritional support had no effect in inspiratory muscle function or exercise capacity. No changes in anthropometric measures were observed. CONCLUSIONS: The pressure threshold load valve used in this study, improved inspiratory muscle endurance and nutritional support had no effect in patients with COPD.
Asunto(s)
Enfermedades Pulmonares Obstructivas/terapia , Músculos Respiratorios/fisiopatología , Terapia Respiratoria/métodos , Anciano , Análisis de Varianza , Ejercicios Respiratorios , Terapia Combinada , Nutrición Enteral , Femenino , Humanos , Capacidad Inspiratoria/fisiología , Masculino , Ventilación Voluntaria Máxima , Persona de Mediana Edad , Fatiga Muscular/fisiología , Estado Nutricional , Apoyo Nutricional , Distribución Aleatoria , Pruebas de Función Respiratoria , Factores Socioeconómicos , Caminata/fisiologíaRESUMEN
Hepatitis C virus antibodies were studied in sera coming from 39 patients with porphyria (cutanea tarda in 17, variegate in 8, intermittent acute in 4, coproporphyria in 2 and protoporphyria in 8). Nine of 17 patients with porphyria cutanea tarda had positive antibodies, but none of the patients with other types of porphyria. All subjects with porphyria cutanea tarda had histological or laboratory liver abnormalities. There was no relationship between the presence of antibodies and frequency of alcoholism, diabetes, or carbohydrate intolerance. Family background of porphyria was significantly less frequent among patients with positive hepatitis C virus antibodies. In 13 patients, a liver biopsy was performed, always showing signs of chronic hepatitis, whose magnitude was higher in those with positive antibodies. It is concluded that, as reported previously, hepatitis C virus may be an activating factor for porphyria cutanea tarda or may potentiate its accompanying liver disease.