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Background: The transthoracic echocardiogram (TTE) plays a screening role in the diagnostic algorithm of pulmonary hypertension (PH). Studies have shown a significant disagreement between TTE measurements of the systolic pulmonary artery pressure (sPAP) and right atrial pressure (RAP) and those obtained by right heart catheterization (RHC)., Objective: To compare TTE measurements of sPAP and RAP with those obtained by RHC in patients being investigated for PH., Methods: Patients referred to a PH reference center with a high or intermediate TTE probability of PH upon admission were submitted to RHC. The agreement between sPAP and RAP from both procedures was assessed through the Bland-Altman test. Differences of up to 10 mmHg for sPAP and 5 mmHg for RAP were considered within the variability of the test. Receiver Operating Characteristic (ROC) curve was constructed to determine the most accurate sPAP and Tricuspid regurgitation maximal velocity (TRV)values associated with the diagnosis of PH by RHC. The adopted level of statistical significance was 5%., Results: Ninety-five patients were included. The Bland-Altman analysis showed a bias of 8.03 mmHg (95% CI:-34.9-50.9) for sPAP and -3.30 mmHg (95% CI:-15.9-9.3) for RAP. AUC for sPAP and TRV measured by TTE for discrimination of probable PH were 0.936 (95% CI: 0.836-1.0) and 0.919 (95% CI: 0.837-1.0), respectively. However, only 33.4% of the echocardiographic estimate of sPAP and 55.1% of RAP were accurate, as compared to the measurements obtained by RHC., Conclusion: TTE has a high discriminatory power as a screening diagnostic method for PH despite presenting disagreements between sPAP and RAP absolute values when compared to RHC measurements.

Objective: To evaluate respiratory muscle strength and six-minute walk test (6MWT) variables in patients with uncontrolled severe asthma (UCSA)., Methods: This was a cross-sectional study involving UCSA patients followed at a university hospital. The patients underwent 6MWT, spirometry, and measurements of respiratory muscle strength, as well as completing the Asthma Control Test (ACT). The Mann-Whitney test was used in order to analyze 6MWT variables, whereas the Kruskal-Wallis test was used to determine whether there was an association between the use of oral corticosteroids and respiratory muscle strength., Results: We included 25 patients. Mean FEV1 was 58.8 ± 21.8% of predicted, and mean ACT score was 14.0 ± 3.9 points. No significant difference was found between the median six-minute walk distance recorded for the UCSA patients and that predicted for healthy Brazilians (512 m and 534 m, respectively; p = 0.14). During the 6MWT, there was no significant drop in SpO2. Mean MIP and MEP were normal (72.9 ± 15.2% and 67.6 ± 22.2%, respectively). Comparing the patients treated with at least four courses of oral corticosteroids per year and those treated with three or fewer, we found no significant differences in MIP (p = 0.15) or MEP (p = 0.45)., Conclusions: Our findings suggest that UCSA patients are similar to normal subjects in terms of 6MWT variables and respiratory muscle strength. The use of oral corticosteroids has no apparent impact on respiratory muscle strength.

Objective: Increase of the elderly in the Brazilian population demands assessment of aspects that interfere with the retirees' quality of life., Methods: The Brazilian version of SF-36 questionnaire was applied to 87 retirees at their homes. Data on quality of life was associated with demographic data, socioeconomic status, health conditions and life style. Statistical analysis of data was performed using single-variable and multivariate analysis., Results: The mean age was 57.3 years (standard deviation 8.9 years) and the mean retirement time was 7.1 years. Fifty-five percent were early retirements due to disability and 23.4% of those queried were still working when research was carried out. Smokers were 11.5% and 5.7 % were diagnosed as alcohol dependent by CAGE criteria. Depression and arterial systemic hypertension were the most prevalent conditions and 56.3% of the retirees practiced regular physical activity. Multivariate analysis disclosed that regular physical activity and post-retirement occupation were the only variables associated with improved quality of life., Conclusion: The SF-36 questionnaire was a suitable instrument, relatively quick and easy to use. The quality of life was associated with life style, as indicated by the practice of physical activities and post-retirement occupation. Actions are needed to enable retirees to improve their life style after retirement.