OBJETIVOS: Estudar a relação entre nível de atividade física na vida diária (AFVD) e gravidade da Doença Pulmonar Obstrutiva Crônica (DPOC) avaliada pelo índice BODE. MÉTODOS: Sessenta e sete pacientes com DPOC (36 homens), com volume expiratório forçado no primeiro segundo (VEF1) 39(27-47)%previsto, e 66(61-72)anos foram submetidos a avaliações de espirometria, grau de dispneia (Medical Research Council scale, MRC) e teste de caminhada de 6 minutos (TC6). O índice BODE foi calculado com base no índice de massa corpórea (peso/estatura²), VEF1, MRC e TC6, e os pacientes foram subdivididos em quatro quartis de acordo com sua pontuação no BODE (quartil I: 0 a 2 pontos, n=15; quartil II: 3 a 4 pontos, n=20; quartil III: 5 a 6 pontos, n=23; quartil IV: 7 a 10 pontos, n=9). O nível de AFVD foi avaliado por dois monitores de atividade física (DynaPort® e SenseWear®). Os testes de Kruskal-Wallis (pós-teste Dunns), Mann-Whitney e Coeficiente de Correlação de Spearman foram utilizados na análise estatística. RESULTADOS: Houve correlação modesta entre os escores do índice BODE e o tempo gasto andando/dia, gasto energético total e tempo gasto/dia em atividades moderadas e vigorosas (-0,32< r <-0,47; p<0.01 para todos). Quando comparados os quartis agrupados I+II com III+IV, houve diferença significante entre o tempo gasto andando/dia, gasto energético total e tempo gasto em atividades moderadas (p<0,05). CONCLUSÃO: O nível de AFVD apresenta correlação modesta com a classificação da gravidade da DPOC dada pelo índice BODE, refletindo apenas diferenças entre pacientes com doença leve-moderada e grave-muito grave.

OBJECTIVES: To study the relationship between the level of physical activity in daily life and disease severity assessed by the BODE index in patients with chronic obstructive pulmonary disease (COPD). METHODS: Sixty-seven patients with COPD (36 men) with forced expiratory volume in the first second (FEV1) of 39 (27-47)% predicted and age of 66 (61-72) years old were evaluated by spirometry, dyspnea levels (measured by the Medical Research Council scale, MRC) and by the 6-minute walking test (6MWT). The BODE index was calculated based on the body mass index (weight/height²), FEV1, MRC and 6MWT, and then the patients were divided in four quartiles according to their scores (Quartile I: 0 to 2 points, n=15; Quartile II: 3 to 4 points, n=20; Quartile III: 5 to 6 points, n=23; Quartile IV: 7 to 10 points, n=9). Two activity monitors (DynaPort® and SenseWear®) were used to evaluate the level of physical activity in daily life. The Kruskal-Wallis test (Dunns's post-hoc test), the Mann-Whitney test and the Spearman Correlation Coefficient were used for statistical analysis. RESULTS: There were modest correlation between the BODE index and the time spent walking per day, the total daily energy expenditure and the time spent in moderate and vigorous activities per day (-0.32 < r <- 0.47; p<0.01 for all variables). When comparing the pooled quartiles I+II with III+IV, there were significant difference between the time spent walking per day, the total daily energy expenditure and the time spent in moderate activities per day (p<0.05). CONCLUSION: The level of physical activity in daily life has a modest correlation with the classification of COPD severity assessed by the BODE index, reflecting only differences between patients with classified as mild-moderate and severe-very severe COPD.

Introduction New medical therapies and technical advances, as well as the increased experience in interventional cardiology, made it necessary to carry out this new registry, the CONAREC XIV protocol, on the use of percutaneous coronary intervention (PCI), a procedure that is safe and effective for the treatment of coronary disease. Objective To evaluate the characteristics of patients, indications, and results of PCI in our country. Material and Methods A prospective consecutive registry was performed during 6 months in patients that underwent PCI at centers that had a Residency in Cardiology. Background, clinical condition upon admission, therapy, results and in-hospital complications were assessed. Results The recorded patients were 1,500. The average age was 62,8 ± 10,8 years and 78,3% were males. Background: 72% arterial hypertension, 56,6% dyslipemia, 19,2% diabetes and 22,4% smokers. Clinical conditions were: 20% asymptomatic, 16,2% stable chronic angina, 45% non ST segment elevation acute coronary syndrome (NSTE-ACS), 19% ST elevation acute coronary syndrome (STE-ACS). In 74,7% of the cases PCI was performed in one of the vessels. Stents were used in 94,5% of the cases and in 18,7%, drug eluting stents were used. The use of functional tests previous to PCI in stable patients was of 53,9%, whereas in STE-ACS was of 31,6%. The median evolution time up to PCI in the STEACS was 1 day with 25-75% (ICR) interquartile range of 0 to 3. In ST-AMI, the door-to-balloon time was 60 minutes (ICR 40-105) and mortality was 8%. Conclusions PCI is used mainly in the treatment of acute coronary syndromes. High use rate of stents and drug eluting stents was evident. The use of functional tests was low. The complications rate was similar to those shown in international registries.

Introducción Los nuevos tratamientos médicos y los avances técnicos, junto con la mayor experiencia adquirida en cardiología intervencionista, hicieron necesaria la realización de este nuevo registro, el protocolo CONAREC XIV, sobre empleo de angioplastia coronaria (ATC), un procedimiento que es seguro y eficaz para el tratamiento de la enfermedad coronaria. Objetivo Evaluar las características de los pacientes, las indicaciones y los resultados de la ATC en nuestro país. Material y métodos Se realizó un registro prospectivo y consecutivo durante 6 meses de pacientes tratados con ATC en centros con residencia de cardiología. Se determinaron antecedentes, cuadro clínico de ingreso, tratamiento, resultados y complicaciones intrahospitalarias. Resultados Se registraron 1.500 pacientes. La edad promedio fue de 62,8 ± 10,8 años y el 78,3% eran hombres. Antecedentes: 72% hipertensión arterial, 56,6% dislipidemia, 19,2% diabetes y 22,4% tabaquismo. Los cuadros clínicos de presentación fueron: 20% asintomáticos, 16,2% angina crónica estable, 45% síndrome coronario agudo sin supradesnivel del ST (SCA-SST), 19% síndrome coronario agudo con supradesnivel del ST (IAM-ST). En el 74,7% de los casos se realizó ATC de un vaso. Se utilizaron stents en el 94,5% de los casos y en el 18,7%, stents liberadores de drogas. El uso de pruebas funcionales previas a la ATC en cuadros estables fue del 53,9%, mientras que en el SCA-SST fue del 31,6%. La mediana de tiempo de evolución hasta la ATC en el SCA-SST fue de 1 día con un rango intercuartil 25-75% (RIC) de 0 a 3. En el IAM-ST, el tiempo puerta-balón fue de 60 minutos (RIC 40-105) y la mortalidad fue del 8%. Conclusiones La ATC se utiliza principalmente para el tratamiento de síndromes coronarios agudos. Se evidenció una tasa alta de uso de stents y de stents liberadores de drogas. El empleo de pruebas funcionales fue bajo. La tasa de complicaciones fue similar a la de los registros internacionales.

The reverse transcription-polymerase chain reaction (RT-PCR) is the most sensitive method used to evaluate gene expression. Although many advances have been made since quantitative RT-PCR was first described, few reports deal with the mathematical bases of this technique. The aim of the present study was to develop and standardize a competitive PCR method using standard-curves to quantify transcripts of the myogenic regulatory factors MyoD, Myf-5, Myogenin and MRF4 in chicken embryos. Competitor cDNA molecules were constructed for each gene under study using deletion primers, which were designed to maintain the anchorage sites for the primers used to amplify target cDNAs. Standard-curves were prepared by co-amplification of different amounts of target cDNA with a constant amount of competitor. The content of specific mRNAs in embryo cDNAs was determined after PCR with a known amount of competitor and comparison to standard-curves. Transcripts of the housekeeping ß-actin gene were measured to normalize the results. As predicted by the model, most of the standard-curves showed a slope close to 1, while intercepts varied depending on the relative efficiency of competitor amplification. The sensitivity of the RT-PCR method permitted the detection of as few as 60 MyoD/Myf-5 molecules per reaction but approximately 600 molecules of MRF4/Myogenin mRNAS were necessary to produce a measurable signal. A coefficient of variation of 6 to 19% was estimated for the different genes analyzed (6 to 9 repetitions). The competitive RT-PCR assay described here is sensitive, precise and allows quantification of up to 9 transcripts from a single cDNA sample.