Papers by Alejandro Castro
Revista Portuguesa de Pneumologia, 2014
Background: Chronic Obstructive Pulmonary Disease (COPD) will be the 5th leading cause of disabil... more Background: Chronic Obstructive Pulmonary Disease (COPD) will be the 5th leading cause of disability (DALYs) and the 4th leading cause of death by 2030. Measuring the real impact of COPD using CAT (''COPD Assessment Test'') can complement BODE index, an indicator of mortality. Aims: To assess correlation between CAT and BODE index in COPD patients. Materials and methods: A retrospective study was conducted in a population of patients with COPD in a Respiratory Rehabilitation program. We analyzed demographic variables, variables in respiratory function-6 min walking test (6MWT), post-BD forced expiratory volume in 1st second (FEV1%); dyspnea by mMRC scale; BODE Index and CAT. Results: The study included 50 patients-GOLD stage I (7), II (25), III (14) and IV (4), 48 men; mean age 62.6 years (±9.5), average BMI 25.8 kg/m 2 (±4.8) and FEV1 57.1% (±19.6); 6MWT of 443.3 m (±61.6); 46% patients in classes 2 and 3 of mMRC scale; 84% were class 2 in BODE Index. About 80% reported slight to medium impact in CAT. CAT score and impact were correlated with BODE index score: R = 0.475, p < 0.01, and R = 0.377, p = 0.004, and BODE index class: R = 0.357, p = 0.011, and R = 0.326, p = 0.021. Abbreviations: BMI, body mass index; BODE, body mass index, airflow limitation (forced expiratory volume in one second), dyspnoea and 6-min walk distance; FEV1, forced expiratory volume in one second; CAT, COPD assessment Test; CCQ, Clinical COPD questionnnaire; COPD, chronic obstructive pulmonary disease; FEV1%predicted, forced expiratory volume in one second in percent of the predicted value; mMRC, Modified Medical Research Council dyspnoea scale; GOLD, global initiative for chronic obstructive lung disease; SGRQ, St. George's Respiratory Questionnaire; 6MWT, 6-min walking test.
American Journal of Kidney Diseases, 2009
Surveillance for chronic kidney disease (CKD) using nationally representative samples of the US p... more Surveillance for chronic kidney disease (CKD) using nationally representative samples of the US population is central in providing information on the magnitude and trends in CKD burden that will guide disease management and prevention planning for clinicians and public health authorities. We used a cross-sectional study design to estimate the change in prevalence of CKD over time using National Health and Nutrition Examination Survey (NHANES) data. NHANES III (1988-1994) included 15,488 participants and NHANES rounds 1999-2004 included 13,233 participants over the age of 20 years with serum creatinine measurements who were examined in a mobile examination center. Early stages of CKD were defined by glomerular filtration rate (GFR) as estimated by the Modification of Diet in Renal Disease (MDRD) Study equation and urinary albumin-to-creatinine ratio (ACR) following the classification system established by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative. Moderately reduced GFR increased in prevalence from 5.4% to 7.7% (P<0.001) and severely reduced GFR increased from 0.21% to 0.35% (P=0.02) from 1988-1994 to 1999-2004. Within CKD stage 3, 18.6 % (SE 1.6%) of individuals should be referred to a nephrologist following a proposed set of criteria for referral; referral rates were highest for individuals with diabetes and lower among whites compared to other race-ethnicity groups. These survey data suggest that the prevalence of CKD has increased between the years of 1988-1994 and 1999-2004. Surveillance for early stages of CKD (CKD stages 1-4) should monitor these and other trends.
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Papers by Alejandro Castro