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Original Papers

The relevance of the 6 minutes walking test and of dyspnoea measured with mMRC scale in evaluating COPD severity

Veronica Mănescu
Spitalul Clinic de Pneumoftiziologie Constanţa
The 6 minutes walking test (6MW) and the measurement of dyspnoea using Medical Research Council modified scale (mMRC ) for Chronic Obstructive Pulmonary Disease (COPD) allow an integrated diagnostic of severity, deficiencies and disability of active age, stable COPD patient, assisting the physician to create an adequate rehabilitation programme. The descriptive and prospective study that covered the period January 2008 - October 2010 aimed to determinethe existing relationship between the dyspnoea degree, the 6 minutes walking test and the degree of severity of COPD patients, evaluated against GOLD stages. Method and subjects: in a sample of 105 eligible COPD patients, aged 44 to 65, we measured the degree of severity of COPD using GOLD staging, mMRC dyspnea scale and 6MWT. Results. The GOLD stages have a very strong correlation to dyspnoea degree measured by mMRC scale. The GOLD stages are moderately correlated with the distance covered in 6MWT. The dyspnoea degrees are strongly correlated with the distance covered in the 6MWT. Conclusions. The dyspnoea degree measured by the mMRC scale allows the evaluation of the severity and also the disability of the COPD patient. The 6MWT allows the measurement of the disease severity and prognosis by the distance covered and also the effort endurance revealing the disability degree.
Keywords: COPD, GOLD stages, dyspnoea degree, 6 minutes walking test

High sensitive C-reactive protein for prediction of adverse outcome in acute exacerbation of chronic obstructive pulmonary disease

Fatmeh Tofan1, Mohammad Hossein Rahimi-Rad1, Yosef Rasmi2, Shagayeg Rahimirad3
1. Internal Medicine Dept., Faculty of Medicine, Urmia University of Medical Sciences, Urmia, 2. Dept. of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, 3. Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran


Hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with a high risk of mortality and complications. The goal of the study is to assess the clinical utility of serum high sensitive C-reactive protein (hs-CRP) at admission in predicting outcome in hospitalized patients with AECOPD. Methods: Consecutive patients with AECOPD admitted to a public teaching hospital were studied prospectively. The adverse outcome defined occurrence of one or more of: (1) death in hospital or within 30 days after discharge, (2) transfer to the intensive care unit, or (3) intubation and mechanical ventilation. The correlation of hs-CRP with duration of hospitalization and FEV1% of predicted is also calculated. Results: Of 60 patients, 22 had adverse outcome and 38 good outcomes. There were no significant differences between two group for mean age, gender, smoking status, and previous hospitalizations (p>0.05). The adverse outcome rate was 56.5% in those with serum hs-CRP equal or more than 100 mg/ml versus 24.3% in patients with hs-CRP less 100 mg/ml (p=0.01). Conclusions: Serum hs-CRP at admission is a predictor of outcome in AECOPD. Admission hs-CRP higher than 100 mg/ml was associated with near fourfold increased probability of adverse outcome.

Keywords: Chronic obstructive pulmonary disease, exacerbation, outcome, prediction, hs-CRP

Non-cystic bronchectasis: pathogenic correlations between the parameters of body composition, systemic inflammation and respiratory function

Adina M. Țurcanu, Traian Mihăescu
Universitatea de Medicină și Farmacie „Grigore T. Popa” Iași, Facultatea de Medicină Generală, Disciplina de Pneumologie


Non-cystic bronchectasis: pathogenic correlations between the parameters of body composition, systemic inflammation and respiratory function The causes of bronchiectasis may be idiopathic or secondary to pulmonary diseases. The consequences determined by this pathology are found on different levels. Aim. To determine the relationships between the parameters of body mass composition, chronic systemic inflammatory syndrome and lung function in patients with bronchiectasis. Method. 35 patients with bronchiectasis diagnosed through HRCT (High Resolution Computer Tomography) and 35 patients with COPD were enrolled in the study. The protocol included the testing of all subjects, not in an acute period, to determine body mass composition, lung function and systemic inflammation. Results. Modified parameters of body mass composition significantly correlated with those determined by the presence of inflammatory syndrome and alteration of lung function mainly for patients with bronchiectasis compared with patients with COPD. Conclusions. There is an important relationship between the parameters that were studied and this call for an individualized and targeted treatment that will lead to significant improvement of the general status of patients with bronchiectasis.

Keywords: bronchiectasis, body mass composition, inflammation, respiratory function