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de Censo CM, Passini VV, Verri BATA, Xavier RF, Carvalho-Pinto RM, Lorenzi-Filho G, Carvalho CR. Postural balance in COPD with obstructive sleep apnoea: a cross-sectional study. ERJ Open Res 2024; 10:00948-2023. [PMID: 38623312 PMCID: PMC11017103 DOI: 10.1183/23120541.00948-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/05/2024] [Indexed: 04/17/2024] Open
Abstract
Objective The aim of this study was to assess the postural balance in COPD patients with obstructive sleep apnoea (OSA). Physical activity, anxiety and depression symptoms, mood, and falls were also assessed in this population. Methods Moderate to severe COPD patients were assessed for laboratory and clinical postural balance (force platform and mini-balance evaluation systems test (Mini-BESTest)), physical activity (accelerometry), OSA (polysomnography), sleep quality (Pittsburgh Sleep Quality Index), sleepiness (Epworth Sleepiness Scale), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), dyspnoea (modified Medical Research Council), clinical status (COPD Assessment Test) and mood (Brunel Mood Scale). Self-reported falls were recorded for 6 months via phone calls. Results COPD patients (n=70) were divided according to the polysomnography findings into the no OSA (n=30), mild OSA (n=25), and moderate to severe OSA (n=15) groups. Compared to patients with no OSA, those with moderate to severe OSA (msOSA group) presented median (interquartile range) increased path length (30.5 (23.9-34.5) cm versus 39.0 (30.6-52.6) cm, anteroposterior displacement (1.89 (1.39-2.31) cm versus 2.54 (2.06-2.83) cm and postural adjustment velocity (1.02 (0.80-1.15) cm·s-1 versus 1.30 (1.02-1.76) cm·s-1) (p<0.05). No differences were observed in the Mini-BESTest scores among the groups. The msOSA group presented a greater number of recurrent fallers in the first follow-up trimester. No association was observed between postural balance and age and pulmonary function. Conclusion Individuals with COPD and moderate to severe OSA present changes in postural balance, including broader oscillation, faster postural adjustments and a greater risk of falls than those with no OSA. Physical activity, anxiety and depression symptoms, and mood are similar between COPD patients with and without OSA.
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Affiliation(s)
| | - Viviane Vieira Passini
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Regina Maria Carvalho-Pinto
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Geraldo Lorenzi-Filho
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Celso R.F. Carvalho
- Departament of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Santos EAD, Pinto TF, Xavier RF, Stelmach R, Carvalho-Pinto RM, Carvalho CRFD. Elastic tape reduces dyspnea and improves health status in the short term in nonobese COPD males: A randomized controlled trial. Respir Med 2024; 221:107459. [PMID: 37944827 DOI: 10.1016/j.rmed.2023.107459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION AND OBJECTIVES The elastic tape (ET) is a novel intervention that acutely improves exercise capacity in laboratory tests; however, its effect on a patient's daily life remains unknown. This randomized controlled trial evaluated the effects of ET on daily life physical activity (DLPA), dyspnea symptoms, health status, and health-related quality of life (HRQoL) in individuals with COPD. METHODS Fifty males with moderate to very severe COPD were randomly assigned to an intervention group (ETG, n = 25), receiving ET on the chest wall and abdomen, or a control group (CG, n = 25). The intervention was for 14 days. DLPA (accelerometry; steps per day, and sedentary time), dyspnea symptoms (transition dyspnea index, TDI; and modified Medical Research Council, mMRC), health status (COPD assessment test, CAT), and health-related quality of life (HRQoL, CRQ) were evaluated at baseline and on Day 21 after the intervention. RESULTS No change in the DLPA was observed in between-group comparison. CG presented a reduction in step counts after 21days (-707,p <0.05) while ETG. maintained (-114,p > 0.94). However, ET reduced dyspnea symptoms in all TDI domains (functional, task, and effort) and on the mMRC scale after 14 days compared with CG (p < 0.01). Also, the ETG improved CAT score compared to the CG, reaching minimal clinical important difference (MCID) (-4.4 score, p <0.01). The ETG also improved in most CRQ domains reaching MCID after 21 days. CONCLUSIONS ET does not modify DLPA but reduces dyspnea and improves health status and HRQoL in nonobese males with moderate to very severe COPD in the short term. This novel and low-cost intervention improves COPD symptoms.
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Affiliation(s)
| | - Thiago Fernandes Pinto
- Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Regina Maria Carvalho-Pinto
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Silva STC, Freitas PD, Lunardi AC, Xavier RF, Barbosa RCC, Stelmach R, Carvalho CRF. Association between illness perception and clinical control, quality of life, physical activity, and psychosocial status in subjects with moderate to severe asthma: a cluster analysis. J Asthma 2023; 60:115-122. [PMID: 35060439 DOI: 10.1080/02770903.2022.2032136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Illness perception (IP) is a psychosocial factor involved in several chronic diseases and is associated with relevant clinical outcomes. However, the relationship between IP and health-related quality of life (HRQoL), psychosocial status, and physical activity in daily life (PADL) in subjects with asthma is poorly understood.Objective: To identify groups of subjects with asthma based on their IPs and to assess their association with clinical control, HRQoL, psychosocial disturbances, and PADL.Methods: This cross-sectional study included 149 subjects with moderate to severe asthma. IP, anthropometric data, Asthma Control Questionnaire-7, Asthma Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, PADL (accelerometry), and general self-efficacy (GSE) were assessed. Cluster analysis was performed to identify clusters with similar profiles and investigate their characteristics and differences. Pearson's correlation coefficient was used to test the associations between IP and other variables.Results: Statistical analyses identified two clusters of subjects with asthma based on IP. Cluster 1 presented worse IP in seven out of eight domains than Cluster 2. Cluster 1 had more negative consequences of the disease, worse understanding, and a high emotional representation of the disease than Cluster 2. Cluster 1 also had a greater extent of asthma symptoms, poor clinical control, worse HRQoL, and more symptoms of anxiety and depression. No difference between clusters was found for PADL or self-efficacy.Conclusion: Subjects with asthma who have worse IP have more negative symptoms, worse clinical control, HRQoL, and symptoms of anxiety and depression.
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Affiliation(s)
- Simone T Camargo Silva
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patrícia Duarte Freitas
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Adriana Claudia Lunardi
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Renata Cleia C Barbosa
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rafael Stelmach
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.,Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
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Cunha MCA, Schardong J, Righi NC, Lunardi AC, Sant'Anna GND, Isensee LP, Xavier RF, Brambatti KR, Pompeu JE, Frâncio F, Faria LM, Cardoso RA, Silva AMVD, Dorneles CDC, Werle RW, Ferreira JC, Plentz RDM, Carvalho CRF. Impact of prone positioning on patients with COVID-19 and ARDS on invasive mechanical ventilation: a multicenter cohort study. J Bras Pneumol 2022; 48:e20210374. [PMID: 35475866 PMCID: PMC9064626 DOI: 10.36416/1806-3756/e20210374] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/19/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To identify factors that lead to a positive oxygenation response and predictive factors of mortality after prone positioning. METHODS This was a retrospective, multicenter, cohort study involving seven hospitals in Brazil. Inclusion criteria were being > 18 years of age with a suspected or confirmed diagnosis of COVID-19, being on invasive mechanical ventilation, having a PaO2/FIO2 ratio < 150 mmHg, and being submitted to prone positioning. After the first prone positioning session, a 20 mmHg improvement in the PaO2/FIO2 ratio was defined as a positive response. RESULTS The study involved 574 patients, 412 (72%) of whom responded positively to the first prone positioning session. Multiple logistic regression showed that responders had lower Simplified Acute Physiology Score III (SAPS III)/SOFA scores and lower D-dimer levels (p = 0.01; p = 0.04; and p = 0.04, respectively). It was suggested that initial SAPS III and initial PaO2/FIO2 were predictors of oxygenation response. The mortality rate was 69.3%. Increased risk of mortality was associated with age (OR = 1.04 [95 CI: 1.01-1.06]), time to first prone positioning session (OR = 1.18 [95 CI: 1.06-1.31]), number of sessions (OR = 1.31 [95% CI: 1.00-1.72]), proportion of pulmonary impairment (OR = 1.55 [95% CI: 1.02-2.35]), and immunosuppression (OR = 3.83 [95% CI: 1.35-10.86]). CONCLUSIONS Our results show that most patients in our sample had a positive oxygenation response after the first prone positioning session. However, the mortality rate was high, probably due to the health status and the number of comorbidities of the patients, as well as the severity of their disease. Our results also suggest that SAPS III and the initial PaO2/FIO2 predict the oxygenation response; in addition, age, time to first prone positioning, number of sessions, pulmonary impairment, and immunosuppression can predict mortality.
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Affiliation(s)
- Marieta C A Cunha
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Natiele Camponogara Righi
- . Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS) Brasil
| | - Adriana Claudia Lunardi
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Larissa Padrão Isensee
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rafaella Fagundes Xavier
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Kaciane Roberta Brambatti
- . Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - José Eduardo Pompeu
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Luiza Martins Faria
- . Departamento de Fisioterapia, Hospital Universitário Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Rozana Astolfi Cardoso
- . Departamento de Fisioterapia, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte (MG) Brasil
| | | | | | - Roberta Weber Werle
- . Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria, Santa Maria (RS) Brasil
| | - Juliana Carvalho Ferreira
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rodrigo Della Méa Plentz
- . Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS) Brasil
| | - Celso R F Carvalho
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Pinto TF, Fagundes Xavier R, Lunardi AC, Marques da Silva CCB, Moriya HT, Lima Vitorasso R, Torsani V, Amato MBP, Stelmach R, Salge JM, Carvalho-Pinto RM, Carvalho CR. Effects of elastic tape on thoracoabdominal mechanics, dyspnea, exercise capacity, and physical activity level in nonobese male subjects with COPD. J Appl Physiol (1985) 2020; 129:492-499. [DOI: 10.1152/japplphysiol.00690.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Elastic tape can be used as a new and low-cost intervention to reduce thoracoabdominal asynchrony and sedentary behavior as well as improve exercise capacity and physical activity level in nonobese male subjects with severe-to-very severe chronic obstructive pulmonary disease.
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Affiliation(s)
- Thiago Fernandes Pinto
- Department of Physical Therapy, Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Henrique Takachi Moriya
- Biomedical Engineering Laboratory, Escola Politécnica, University of São Paulo, São Paulo, Brazil
| | - Renato Lima Vitorasso
- Biomedical Engineering Laboratory, Escola Politécnica, University of São Paulo, São Paulo, Brazil
| | - Vinicius Torsani
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcelo Brito Passos Amato
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, Medical School, University of São Paulo, São Paulo, Brazil
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, Medical School, University of São Paulo, São Paulo, Brazil
| | - João Marcos Salge
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, Medical School, University of São Paulo, São Paulo, Brazil
| | - Regina Maria Carvalho-Pinto
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, Medical School, University of São Paulo, São Paulo, Brazil
| | - Celso R.F. Carvalho
- Department of Physical Therapy, Medical School, University of São Paulo, São Paulo, Brazil
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Boffino CC, Pereira ACAC, Coelho DB, Xavier RF, Berto CC, Da Silva M, Tanaka C, Ramos RT, Yamaguti WP, Carvalho CRF. Age and Disease have a Distinct Influence on Postural Balance of Patients with COPD. COPD 2019; 16:246-253. [PMID: 31328579 DOI: 10.1080/15412555.2019.1634683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The postural imbalance is an extra-pulmonary condition, associated with chronic obstructive pulmonary disease (COPD). COPD affects older individuals and it is unclear whether balance abnormalities can be described as pathophysiological mechanism or aging. The present study aimed to evaluate the influence of age or disease on postural balance of patients with COPD. Patients with COPD over 50 years old were compared with age- and sex-matched healthy adults, and with sex-matched younger healthy adults (n = 30 in each group). The Modified Sensory Organization Test (mSOT) was performed in four different conditions fixed or sway-referenced surface both either with full or no vision. It was analyzed the center of pressure (CoP) variables: amplitude, velocity, root-mean-square and load asymmetry. Three-way ANOVA and post hoc analysis were performed been represented of age (older or COPD compared with younger healthy adults) or disease influences (COPD compared with older healthy groups). Main results were as follows: The CoP excursion was faster, with higher amplitude and variability progressively from COPD vs. older healthy vs. younger healthy adults (p < 0.05) showing age and disease influences (p < 0.05). Age and disease influences were also observed in the sway-referenced surface in both vision conditions. Impairment in postural balance was found related to aging and disease in patients with COPD older than 50 years.
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Affiliation(s)
- Catarina Costa Boffino
- LIM 23 do Instituto de Psiquiatria do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo , São Paulo , Brazil.,LIM 44 do Departamento de Radiologia do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo , São Paulo , Brazil.,Divisão de Fisioterapia do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo , São Paulo , Brazil
| | | | - Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo , Brazil
| | | | | | - Marques Da Silva
- Physical Therapy Department, School of Medicine, University of São Paulo , São Paulo , Brazil
| | - Clarice Tanaka
- Physical Therapy Department, School of Medicine, University of São Paulo , São Paulo , Brazil
| | - Renato Teodoro Ramos
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto , Canada
| | | | - Celso R F Carvalho
- Physical Therapy Department, School of Medicine, University of São Paulo , São Paulo , Brazil
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Rodrigues FMM, Ramos D, Xavier RF, Ito JT, Souza APD, Fernandes RA, Cecchini R, Rossi e Silva RC, Macchione M, Toledo-Arruda ACD, Guarnier FA, Ramos EMC. Nasal and systemic inflammatory profile after short term smoking cessation. Respir Med 2014; 108:999-1006. [PMID: 24863424 DOI: 10.1016/j.rmed.2014.04.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 04/23/2014] [Accepted: 04/26/2014] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Smoking cessation promotes health benefits and, despite cigarette smoking be an important pro inflammatory stimulus, there are few studies concerning the nasal and systemic inflammation; as well as the mucociliary clearance behavior in smokers after short period of smoking cessation. AIM To evaluate the nasal and systemic inflammatory markers and mucociliary clearance behavior after 30 days of cigarette smoking abstinence. METHODS Twenty-five smokers were included and divided into two groups: abstinent smokers (n = 14) and current smokers (n = 11). Tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-8 and IL-10 were measured on nasal lavage and blood serum samples by ELISA at baseline and after 30 days. The mucociliary clearance, exhaled carbon monoxide (exCO) and carboxyhemoglobin (HbCO) were also measured at the same moments. RESULTS There was a decrease of TNF-α level only in blood serum at 30 days of abstinence compared to current smokers. The mucociliary clearance improved and there was a reduction in exCO and HbCO (p < 0.05 for all) after 30 days of smoking cessation. CONCLUSION The short term smoking abstinence decreased systemic inflammation and improved nasal mucociliary clearance, despite not having changed the nasal inflammation.
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Affiliation(s)
| | - Dionei Ramos
- Department of Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | | | - Juliana Tiyaki Ito
- Department of Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Alcirene Policarpo de Souza
- Department of Physics, Chemistry and Biology, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Rômulo Araújo Fernandes
- Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Rubens Cecchini
- Department of Pathological Sciences, State University of Londrina (UEL), Londrina, Brazil
| | | | | | - Alessandra Choqueta de Toledo-Arruda
- Department of Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, Brazil; Department of Clinical Medicine (LIM-20), University of São Paulo (USP), Brazil
| | | | - Ercy Mara Cipulo Ramos
- Department of Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, Brazil.
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Xavier RF, Ramos D, Ito JT, Rodrigues FMM, Bertolini GN, Macchione M, de Toledo AC, Ramos EMC. Effects of cigarette smoking intensity on the mucociliary clearance of active smokers. ACTA ACUST UNITED AC 2013; 86:479-85. [PMID: 23615315 DOI: 10.1159/000348398] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 01/24/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Smoking impairs mucociliary clearance and increases respiratory infection frequency and severity in subjects with and without smoking-related chronic lung diseases. OBJECTIVE This study evaluated the effects of smoking intensity on mucociliary clearance in active smokers. METHODS Seventy-five active smokers were grouped into light (1-10 cigarettes/day; n = 14), moderate (11-20 cigarettes/day; n = 34) and heavy smokers (≥21 cigarettes/day; n = 27) before starting a smoking cessation programme. Smoking behaviour, nicotine dependence, pulmonary function, carbon monoxide in exhaled air (exCO), carboxyhaemoglobin (COHb) and mucociliary clearance measured by the saccharin transit time (STT) test were all evaluated. An age-matched non-smoker group (n = 24) was assessed using the same tests. RESULTS Moderate (49 ± 7 years) and heavy smokers (46 ± 8 years) had higher STT (p = 0.0001), exCO (p < 0.0001) and COHb (p < 0.0001) levels compared with light smokers (51 ± 15 years) and non-smokers (50 ± 11 years). A positive correlation was observed between STT and exCO (r = 0.4; p < 0.0001), STT and cigarettes/day (r = 0.3, p = 0.02) and exCO and cigarettes/day (r = 0.3, p < 0.01). CONCLUSION Smoking impairs mucociliary clearance and is associated with cigarette smoking intensity.
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Ramos EMC, De Toledo AC, Xavier RF, Fosco LC, Vieira RP, Ramos D, Jardim JR. Reversibility of impaired nasal mucociliary clearance in smokers following a smoking cessation programme. Respirology 2011; 16:849-55. [PMID: 21545372 DOI: 10.1111/j.1440-1843.2011.01985.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Smoking cessation (SC) is recognized as reducing tobacco-associated mortality and morbidity. The effect of SC on nasal mucociliary clearance (MC) in smokers was evaluated during a 180-day period. METHODS Thirty-three current smokers enrolled in a SC intervention programme were evaluated after they had stopped smoking. Smoking history, Fagerström's test, lung function, exhaled carbon monoxide (eCO), carboxyhaemoglobin (COHb) and nasal MC as assessed by the saccharin transit time (STT) test were evaluated. All parameters were also measured at baseline in 33 matched non-smokers. RESULTS Smokers (mean age 49 ± 12 years, mean pack-year index 44 ± 25) were enrolled in a SC intervention and 27% (n = 9) abstained for 180 days, 30% (n = 11) for 120 days, 49.5% (n = 15) for 90 days or 60 days, 62.7% (n = 19) for 30 days and 75.9% (n = 23) for 15 days. A moderate degree of nicotine dependence, higher education levels and less use of bupropion were associated with the capacity to stop smoking (P < 0.05). The STT was prolonged in smokers compared with non-smokers (P = 0.002) and dysfunction of MC was present at baseline both in smokers who had abstained and those who had not abstained for 180 days. eCO and COHb were also significantly increased in smokers compared with non-smokers. STT values decreased to within the normal range on day 15 after SC (P < 0.01), and remained in the normal range until the end of the study period. Similarly, eCO values were reduced from the seventh day after SC. CONCLUSIONS A SC programme contributed to improvement in MC among smokers from the 15th day after cessation of smoking, and these beneficial effects persisted for 180 days.
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Affiliation(s)
- Ercy Mara Cipulo Ramos
- Department of Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil.
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Ferreira-Ceccato AD, Ramos EMC, de Carvalho LCS, Xavier RF, Teixeira MFDS, Raymundo-Pereira PA, Proença CDA, de Toledo AC, Ramos D. Short-term effects of air pollution from biomass burning in mucociliary clearance of Brazilian sugarcane cutters. Respir Med 2011; 105:1766-8. [PMID: 21855310 DOI: 10.1016/j.rmed.2011.08.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 07/31/2011] [Accepted: 08/02/2011] [Indexed: 10/17/2022]
Abstract
Nasal mucociliary system is the first line of defense of the upper airways and may be affected acutely by exposure to particulate matter (PM) from biomass burning. Several epidemiologic studies have demonstrated a consistent association between levels of air pollution from biomass burning with increases in hospitalization for respiratory diseases and mortality. To determine the acute effects of exposure to particulate matter from biomass burning in nasal mucociliary transport by saccharin transit time (STT) test, we studied thirty-three non-smokers and twelve light smokers sugarcane cutters in two periods: pre-harvest season and 4 h after harvest at the first day after biomass burning. Lung function, exhaled carbon monoxide (CO), nasal symptoms questionnaire and mucociliary clearance (MC) were assessed. Exhaled CO was increased in smokers compared to non-smokers but did not change significantly after harvest. In contrast, STT was similar between smokers and non-smokers and decreased significantly after harvest in both groups (p < 0.001). Exposure to PM from biomass burning did not influence nasal symptoms. Our results suggest that acute exposure to particulate matter from sugarcane burned affects mucociliary clearance in smokers and non-smokers workers in the absence of symptoms.
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Abstract
This work presents a novel approach to develop dedicated transverse gradient coils for head imaging. The proposed coil design is based on the stochastic optimization of an asymmetrical stream function and improves the matching between the region-of-interest and the homogeneous gradient volume. Additionally, the electric field produced by these asymmetrical coils is 30% lower than that produced by standard symmetrical designs, which minimizes the risk of magnetostimulation of nerves in fast imaging techniques. A prototype of the asymmetrical gradient coil was built to test the method and magnetic field produced by the prototype was measured. Magnetic field measurements and electrical parameters of coils are in good agreement with theoretical calculations.
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Affiliation(s)
- D Tomasi
- Medical Department, Brookhaven National Laboratory, Upton, New York 11973, USA.
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