RESUMONo âmbito da promoção da saúde, a epidemiologia exerce importante papel ao se preocupar não apenas com o controle de doenças e de seus vetores, mas, sobretudo, com a melhoria da saúde da população. Os estudos que privilegiam temáticas da saúde pública, em geral, estão frequentemente interessados em investigar o modo pelo qual as condições sociais influenciam e determinam o processo saúde-doença das populações, o que tem gerado uma forte articulação entre a epidemiologia e as ciências sociais. É assim que se constrói um ramo epidemiológico denominado por alguns estudiosos como epidemiologia social. A epidemiologia social tem como foco principal o estudo do modo pelo qual a sociedade e os diferentes modos de organização social influenciam a saúde e o bem-estar dos indivíduos e dos grupos sociais, possibilitando a incorporação de suas experiências societárias, para a melhor compreensão de como, onde e porque se dão as desigualdades na saúde. O presente artigo de revisão realiza uma discussão que pretende indicar as contribuições que a abordagem da epidemiologia social pode trazer para os estudos realizados pela pesquisa clínica em doenças infecciosas, de modo a se desenvolver um olhar mais amplo sobre o paciente em conjunto com o seu sistema de relações e de produção do adoecimento e da recuperação da saúde.Palavras-chave: Epidemiologia Social; Pesquisa Clínica; Doenças Infecciosas. ARTIGO DE REVISÃO | REVIEW ARTICLE ABSTRACTIn the context of health promotion, epidemiology plays an important role. It emphasizes not only on control of diseases and their vectors, but also on improving the health of the population. Researches that focus on the themes of public health in general are frequently interested in investigating how social conditions affect and determine the population's health-disease process. This has generated a strong articulation between epidemiology and social sciences, emerging an epidemiological branch named by some scholars as social epidemiology. The focus of social epidemiology is studying how society and the different modes of social organization influence the health and well-being of individuals and social groups, enabling the incorporation of the social experiences to better understand how, where, and why health inequalities occur. This review article discusses and demonstrates the contributions of social epidemiology studies in clinical research studies on infectious diseases in order to develop a broader viewpoint of patients in conjunction with their system of relations and with illness production and health recovery.

Chronic obstructive pulmonary disease (COPD) is a progressive and disabling disease that has been associated with aging. Several factors may potentially impair performance during exercise in elderly patients with COPD. This study was conducted to evaluate what characteristics related to lung function, peripheral muscle strength and endurance can predict the performance of elderly patients with COPD during cardiopulmonary exercise testing (CPET). Forty elderly patients with COPD underwent resting lung function tests, knee isokinetic dynamometry, and CPET. Three models were developed to explain the variability in peak oxygen uptake (VO2 peak) after controlling for age as an independent confounder. The pulmonary function model showed the highest explained variance (65.6 %); in this model, ventilation distribution (p<0.001) and pulmonary diffusion (0.013) were found to be independent predictors. Finally, the models that included the muscle strength and endurance variables presented explained variances of 51 % and 57.4 %, respectively. In these models that involved muscular dysfunction, however, only the endurance variables were found to be independent predictors (p<0.05). In conclusion, ventilation distribution and pulmonary diffusion, but not the degree of airway obstruction, independently predict CPET performance in elderly patients with COPD. In addition, peripheral muscle endurance, but not strength, also predicts CPET performance in these subjects.

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