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- ItemSomente MetadadadosAir pollution and its relationship to lung function among adolescents from Taubate, Sao Paulo, Brazil(Elsevier Doyma Sl, 2018) Toledo, M. Froio; Saraiva-Romanholo, B. Mangueira; Oliveira, R. Carvalho; Silva, L. Ferraz da; Solé, Dirceu [UNIFESP]Background: This paper sought to evaluate individual exposure to air pollution by quantifying the carbon in alveolar macrophages (AMs) and its relationship to lung function. We also examined the proximity of participants' residences to the Presidente Dutra highway (PDH) in adolescents with asthma from Taubate, Sao Paulo, Brazil. Methods: This descriptive study examined fifty 13- to 14-year-old adolescents with asthma identified by the International Study of Asthma and Allergies in Childhood (ISAAC) in Taubate. These adolescents underwent spirometry and sputum induction via the inhalation of 3% hypertonic saline (HSS). Sputum was collected after each nebulisation, and forced expiratory flow in one second (FEV1) was measured. The collected sputum was stored and transported to the laboratory
- ItemSomente MetadadadosBronchodilator response in wheezing infants assessed by the raised volume rapid thoracic compression technique(W B Saunders Co Ltd, 2016) Lanza, Fernanda Cordoba [UNIFESP]; Wandalsen, Gustavo Falbo [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Solé, Dirceu [UNIFESP]Background: Bronchodilator response (BDR) analyzed by the raised volume rapid thoracic compression (RVRTC) in wheezing infants is not yet well described, although bronchodilators (BD) are routine in the treatment of this population. Objective: To evaluate BDR by RVRTC technique in infants with recurrent wheezing and compare to control group. Method: Cross sectional study, 45 infants, age 56 weeks (38-67 weeks). Two groups: wheezing group (WG: history of recurrent wheezing) and control group (CG). RVRTC was evaluated, FVC, FEV0.5, FEF50, FEF75, FEF85, FEF25-75 were measured. Salbutamol was delivered to infants and RVRTC evaluated again. BDR was determined by the increase greater than two standard deviation from the mean change in the CG. Results: In WG (n = 32) lung function was worse than in CG (n = 13): FEV0.5: 0.0(-0.9-0.9z score) vs 0.8(0.2-1.4z score)
- ItemAcesso aberto (Open Access)Comparação das equações de valores de referência da função pulmonar mais utilizadas no Brasil: impacto no estadiamento da DPOC(Universidade Federal de São Paulo (UNIFESP), 2010-06-30) Pereira, Marcella Cristiane Silveira [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To compare the absolute values of FVC and FEV1 found in a random sample of a Brazilian population over 40 years of age with values of equations most used in Brazil. To compare the values in percentage of predicted of FVC and FEV1 of the selected equations with the PLATINO equation ones. To evaluate the change in COPD staying when using different reference equations. Material and Methods: We conducted a retrospective study from a representative sample of residents in the metropolitan region of Sao Paulo, aged .40 years, from the PLATINO study. For comparison of the FVC and FEV1, were subtracted from the predicted values of each equation the absolute values obtained from each individual, considering the equation inadequate wherever there was a difference of up to 0.15 L as defined by ATS. We also evaluated the difference between the values of FVC and VEF1 in percentage of predicted of the equations with the PLATINO equation, considering as a limit a difference .3% (ATS). The diagnosis of COPD was defined as FEV1/FVC <0.70 after bronchodilator, and the comparison of staging was performed using the FEB1 in percentage of predicted in each equation, with reference to the percentage expected from the PLATINO equation. T-student test, chi-squared and the intraclass correlation coefficient were used to evaluate the performance of FVC and FEV1 in different equations and data are presented as mean, standard deviation, standard error and confidence interval of 95%. Results: After evaluating 178 healthy subjects, we observed that the equations that show less difference between the predicted value and the absolute value for both FEV1 and FVC in both sexes were Roca et al., Pereira et al. 2006, Enright et al. and PLATINO. The Knudson et al. equation underestimated the absolute values for both FVC and FEV1. In comparison with PLATINO equation, the percentage of predicted for FVC and FEV1, the equation showing the lowest difference was NHANES III, except for FVC male, who showed a wide variability. We evaluated 152 patients with COPD, observing staging changes in 29.6% in relation to the difference equations, being Knudson et al. the equation that showed the greatest number of changes. Conclusion: There is a great variability among the reference equations. The equations showing less variability and better intraclass correlation coefficient were Roca et al., Caucasian NHANES III et al., Enright et al. and PLATINO, which are the ones that should be recommended to be used for the Brazilian population. There is a change in the COPD staging when different equations are applied, suggesting that the use of a single equation for the treatment of the patient would avoid possible alterations in treatment.
- ItemAcesso aberto (Open Access)Efeitos agudos da maratona na função pulmonar, mecânica e inflamação(Universidade Federal de São Paulo, 2022-12-20) Gibson-Alves, Thiago Gonçalves [UNIFESP]; Vieira, Rodolfo de Paula [UNIFESP]; http://lattes.cnpq.br/9213556008468472; Universidade Federal de São Paulo (UNIFESP)A maratona tem forte influência nos sistemas respiratório e imunológico. No entanto, nenhum estudo verificou o efeito da maratona na mecânica pulmonar. O presente estudo avaliou a influência da corrida de maratona na função pulmonar, mecânica e inflamação. 29 maratonistas amadores do sexo masculino (42,1 ± 6,2 anos) foram avaliados antes e imediatamente após uma maratona. A função pulmonar e a mecânica foram avaliadas por espirometria e oscilometria de impulso, respectivamente. A inflamação pulmonar foi avaliada por medidas dos níveis de óxido nítrico exalado fracionado (FeNO). E a fadiga muscular respiratória foi avaliada através da manovacuometria. A maratona induziu uma redução significativa na função pulmonar, conforme denotado pela redução: FVC (4,81 ± 0,72 vs 4,67 ± 0,62 p = 0,0095), VC IN (4,81 ± 0,72 vs 4,67 ± 0,62 p = 0,009), FEV1 (3,83 ± 0,62) vs 3,72 ± 0,59 p = 0,0232) e VEF6 (4,87 ± 0,68 vs 4,57 ± 0,63 p = 0,0006). Além disso, um comprometimento da mecânica pulmonar, denotado pela redução da impedância pulmonar (Z5Hz; 2.96±1.36 vs 2.67±1.11; p = 0,0305), resistência de todo o sistema respiratório (R5Hz; 2.76±1.27 vs 2.5±1.08; p = 0,0388), reatância pulmonar (X5Hz; -1.05±0.55 vs -0.91±0.36; p = 0,0101) e da resistência de vias aéreas centrais (R; 1.26±0.73 vs 1.06±0.86; p = 0,0377) após a maratona. Uma diminuição nos níveis de FeNO foi observada imediatamente após a maratona (p = 0,0359). Além disso, as pressões inspiratórias máxima (PImáx; 94.14±41.88 vs 72.52±25.50; p <0,0023) e expiratória (PEmáx; 99.31±31.84 vs 91.29±19.94; p <0,0454) foram comprometidas após a maratona. Em conclusão, a maratona causa um distúrbio agudo na função e mecânica pulmonar, enquanto diminui os níveis pulmonares de óxido nítrico.
- ItemAcesso aberto (Open Access)Efeitos da menopausa sobre a função e mecânica pulmonar e sobre a resposta imunológica pulmonar e sistêmica(Universidade Federal de São Paulo, 2023-05-31) Destefano, Patrícia [UNIFESP]; Vieira, Rodolfo de Paula [UNIFESP]; http://lattes.cnpq.br/9213556008468472; Universidade Federal de São Paulo (UNIFESP)Objetivo: avaliar o impacto da menopausa na função e mecânica pulmonar e sobre a resposta imunológica pulmonar e sistêmica nas mulheres. Métodos: 73 mulheres com idade entre 40 e 56 anos, foram divididas nos grupos pré-menopausa (PRE; n=47) e pós-menopausa (POST; n=26). Critérios de exclusão: uso de reposição ou contraceptivo hormonal, tabagista ou ex-tabagista por período menor que 5 anos, mulheres com histórico com menstruação irregular e sem relação com a menopausa, presença de síndrome do ovário policístico ou endometriose, gravidez e amamentação, e índice de massa corpórea (IMC ≤18,5≥30). Resultados: As medidas de peso corporal, altura, IMC, CC, CQ e RCQ bem como os parâmetros de função pulmonar (CVF%, VEF1%, VEF1/CVF%, PFE% e FEF25-75%) não apresentaram diferença estatística. Foi observado um aumento significatico nos níveis de FeNO [p=0,0088] e redução da reatância do sistema respiratório (X5Hz) [p=0,0098]. Foi encontrado aumento estatisticamente significativo [p<0,05] para os parâmetros RBC, HGB, HCT e LYMPH%, enquanto houve uma redução significativa [p<0,05] nos parâmetros PLT e PCT. No ar condensado foi identificada a redução dos níveis de IL-10 e aumento de TNF-α. [p<0,02] Conclusões: A elastância pulmonar foi encontrada diminuída nas mulheres pós-menopausa, trazendo alterações funcionais discretas dos pulmões. Também foi observado o aumento nos níveis de NO, que é um marcador inflamatório e modulador da função e mecânica pulmonar. Além disso, foi evidenciada a diminuição da capacidade anti-inflamatória do sistema imune pulmonar pela diminuição dos níveis de IL-10 e um aumento da atividade pró-inflamatória pelo aumento nos níveis de TNF-α. Uma redução discreta no nível de Klotho também foi observada, afetando seu papel anti-aging, anti-cancer, anti-inflamatório e anti-fibrótico.
- ItemSomente MetadadadosEffect of time of exposure to environmental risk on the lung function of foundry workers: a cross-sectional study(Soc Physical Therapy Science, 2016) de Moraes, Monica Vasconcelos; Padula, Rosimeire Simprini; Bernardes, Rosane Andrea Bretas; Negreiros, Alexandher; Chiavegato, Luciana Dias [UNIFESP][Purpose] This cross-sectional study aimed to compare foundry workers of the metallurgical industry with high and low exposure time and with a control group. [Subject and Methods] The workers were evaluated for pulmonary function and peak expiratory flow (PEF), respiratory symptoms, smoking habits, and physical activity level. Descriptive statistical analysis and ANOVA one-way test were used. [Results] The mean age was 33.9 +/- 8.25 years (18-59), pulmonary function: FVC: 95 +/- 18% of predicted, FEV1: 95.0 +/- 15.8% of predicted, FEV1/FVC ratio of 0.82 +/- 0.09, and PEF = 499.7 +/- 118.5 l/min. Overall, 85.1% of workers were classified that physically active, 7.93% of workers reported respiratory symptoms, and 14.28% reported being smokers. There was no statistically significant difference between groups for the variables of lung function. [Conclusion] The pulmonary function is preserved in foundry workers independently of exposure time.
- ItemAcesso aberto (Open Access)Effect of time of exposure to environmental risk on the lung function of foundry workers: a cross-sectional study(Soc Physical Therapy Science, 2016) de Moraes, Monica Vasconcelos; Padula, Rosimeire Simprini; Bernardes, Rosane Andrea Bretas; Negreiros, Alexandher; Chiavegato, Luciana Dias [UNIFESP][Purpose] This cross-sectional study aimed to compare foundry workers of the metallurgical industry with high and low exposure time and with a control group. [Subject and Methods] The workers were evaluated for pulmonary function and peak expiratory flow (PEF), respiratory symptoms, smoking habits, and physical activity level. Descriptive statistical analysis and ANOVA one-way test were used. [Results] The mean age was 33.9 +/- 8.25 years (18-59), pulmonary function: FVC: 95 +/- 18% of predicted, FEV1: 95.0 +/- 15.8% of predicted, FEV1/FVC ratio of 0.82 +/- 0.09, and PEF = 499.7 +/- 118.5 l/min. Overall, 85.1% of workers were classified that physically active, 7.93% of workers reported respiratory symptoms, and 14.28% reported being smokers. There was no statistically significant difference between groups for the variables of lung function. [Conclusion] The pulmonary function is preserved in foundry workers independently of exposure time.
- ItemSomente MetadadadosExcess ventilation in COPD: Implications for dyspnoea and tolerance to interval exercise(Elsevier Science Bv, 2018) Bravo, Daniela Manzoli [UNIFESP]; Gimenes, Ana Cristina Oliveira [UNIFESP]; Amorim, Beatriz Cyrillo [UNIFESP]; Alencar, Maria Clara Noman de [UNIFESP]; Berton, Danilo Cortozi [UNIFESP]; O'Donnell, Denis E.; Nery, Luiz Eduardo [UNIFESP]; Neder, Jose Alberto [UNIFESP]Interval exercise delays critical mechanical-ventilatory constraints with positive consequences on Dyspnoea and exercise tolerance in COPD. We hypothesized that those advantages of interval exercise would be partially off-set in patients showing excessive ventilation ((V) over dotE) to metabolic demand ((V) over dotCO(2)). Sixteen men (FEV1 = 42.3 +/- 8.9%) performed, on different days, 30 s and 60 s bouts at 100% peak (on) interspersed by moderate exercise at 40% (off). Nine patients did not sustain exercise for 30 min irrespective of on duration. They presented with higher (V) over dotE/(V) over dotCO(2) nadir (35 +/- 3 vs. 30 +/- 5) and dead space/tidal volume (0.39 +/- 0.05 vs. 0.34 +/- 0.06) compared to their counterparts (p < 0.05). [Lactate], operating lung volumes and symptom burden (dyspnoea and leg effort) were also higher (p < 0.05). Unloading off decreased the metabolic-ventilatory demands, thereby allowing 7/9 patients to exercise for 30 min. Increased wasted ventilation accelerates the rate at which critical mechanical constraints and limiting dyspnoea are reached during interval exercise in patients with COPD.
- ItemSomente MetadadadosFunctional aerobic exercise capacity limitation in adolescent idiopathic scoliosis(Elsevier B.V., 2014-10-01) Sperandio, Evandro Fornias [UNIFESP]; Alexandre, Anderson Sales [UNIFESP]; Yi, Liu Chiao [UNIFESP]; Poletto, Patrícia Rios [UNIFESP]; Gotfryd, Alberto O.; Vidotto, Milena Carlos [UNIFESP]; Dourado, Victor Zuniga [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Santa Casa da Misericordia Santos HospBACKGROUND CONTEXT: Exercise limitation has been described in patients with adolescent idiopathic scoliosis (AIS); however, whether the walking performance is impaired in these patients should be elucidated.PURPOSE: Thus, we aimed to evaluate the physiologic responses to the incremental shuttle walk test (ISWT) in patients with AIS.STUDY DESIGN/SETTING: Cross-sectional study.PATIENT SAMPLE: Twenty-nine patients with AIS and 20 healthy adolescents aged between 11 and 18 years old.OUTCOME MEASURES: Oxygen uptake (VO2), incremental shuttle walk distance (ISWD), Delta VO2/Delta walking velocity, Delta HR/Delta VO2, Delta VE/Delta VCO2, and linearized Delta tidal volume (VT)/Delta lnVE, forced expiratory volume in the first second of expiration (FEV1), and forced vital capacity (FVC).METHODS: We performed two ISWTs, and the data used were acquired in the second test. We also evaluated the lung function and respiratory muscle strength through spirometry test and manovacuometry, respectively. All authors confirm that there are no conflicts of interest. To compare the means or medians of variables between patients and healthy subjects, we used the unpaired t test or Mann-Whitney U test, respectively. the correlations were assessed by Pearson or Spearman coefficients according to the distribution of the studied variables. the probability of alpha error was set at 5% for all analyses.RESULTS: Adolescent idiopathic scoliosis patients showed significant lower values of ISWD, VO2, and ventilation at the end of the ISWT, as well as lower FEV1 and FVC; they also presented significantly shallower slope of Delta VT/Delta lnVE, whereas VO2 related significantly with ISWD (r = 0.80), FVC (r = 0.78), FEV1 (r = 0.73), and Delta VT/Delta lnVE (r = 0.58).CONCLUSIONS: Adolescent idiopathic scoliosis correlated to walking limitation and was associated to reduced pulmonary function and worse breathing pattern during exercise. Our results suggest that walking-based aerobic exercises should be encouraged in these patients. (C) 2014 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosIntervenção da fisioterapia respiratória na função pulmonar de indivíduos obesos submetidos a cirurgia bariátrica. Uma revisão(Soc Portuguesa Pneumologia, 2010-03-01) Tenorio, Luis Henrique Sarmento; Lima, Anna Myrna Jaguaribe de; Brasileiro-Santos, Maria do Socorro [UNIFESP]; Universidade Federal de Pernambuco (UFPE); Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Paraíba (UFPB)Introduction: Obesity, considered a new worldwide epidemic, is characterised by excess adipose tissue and contributes to a series of chronic diseases and increased mortality. Obesity associated to surgical procedure in these patients makes respiratory physiotherapy a must to recover lung function and prevent postoperative pulmonary complications. Aims: To assess the effects of respiratory physiotherapy on the lung function of obese patients undergoing weight loss surgery. Material and methods: We conducted a literature review October 2008-June 2009 of data which had been published over the last thirty years and which was available on the Medline, Pubmed ans Scielo databases. Conclusion: Pre- and postoperative respiratory physiotherapy is vital for patients undergoing weight loss surgery irrespective of technique used, as it can prevent pulmonary complications inherent in the surgical procedure and aid lung function recovery.
- ItemSomente MetadadadosPulmonary complications in patients with antibody deficiency(Elsevier B.V., 2011-05-01) Costa-Carvalho, Beatriz T. [UNIFESP]; Wandalsen, Gustavo F. [UNIFESP]; Pulici, Guilherme [UNIFESP]; Aranda, Carolina Sanchez [UNIFESP]; Sole, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: the aim of this study was to evaluate pulmonary complications in patients with primary antibody deficiency (X-linked agammaglobulinaemia [XLA] and common variable immunodeficiency [CVID]).Methods: Thirty patients over six years of age regularly followed in a reference out-patient clinic on primary immunodeficiency were studied. All of them have been treated with intravenous immunoglobulin (IVIG) replacement therapy. Pulmonary complications were evaluated analysing clinical data (medical records review), lung function test (spirometry) and pulmonary imaging (chest computed tomography [CCT]).Results: Patients with normal CCT (N=14) and those with abnormal CCT (N=16) have shown no differences regarding the age at onset of symptoms, age of diagnosis, and duration of IVIG treatment. the mean number of pneumonia episodes before IVIG replacement was significantly higher among patients with abnormal CCT (4 vs 7 episodes, p=0.008). CCT abnormalities observed in 16 patients were: bronchiectasis (12/16); peribronchial thickening (3/16); air trapping (5/16); lung volume reduction (4/16); atelectasis (2/16), follicular bronchiolitis and ground-glass abnormality (2/16) and parenchyma nodule (1/16). Lung function tests showed ventilatory disturbance in 18/30: obstructive pattern in 38.8%, restrictive pattern in 44.4%, and mix pattern in 16.7%. There were no significant differences in lung function between those with and without CCT abnormalities. Negative significant correlations were observed between lung function and number of episodes of pneumonia. Chronic persistent cough was associated with a reduction in lung function.Conclusions: Pulmonary complications are not rare in patients with antibody deficiencies and they must be monitored. (C) 2010 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.
- ItemAcesso aberto (Open Access)Reduction in the Leptin Concentration as a Predictor of Improvement in Lung Function in Obese Adolescents(Karger, 2012-12-01) Silva, Patricia Leão [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Cheik, Nadia Carla; Sanches, Priscila de Lima [UNIFESP]; Campos, Raquel Munhoz da Silveira [UNIFESP]; Carnier, June [UNIFESP]; Inoue, Daniela Sayuri [UNIFESP]; Nascimento, Claudia Maria da Penha Oller do [UNIFESP]; Oyama, Lila Missae [UNIFESP]; Tock, Lian [UNIFESP]; Tufik, Sergio [UNIFESP]; Dâmaso, Ana Raimunda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Uberlândia (UFU)Objective: To assess the effects of weight loss on adipokines, asthma-related symptoms, exercise-induced bronchospasm (EIB) and lung function, and to evaluate the role of leptin and adiponectin levels on lung function after treatment in obese adolescents. Methods: 84 postpubertal obese adolescents were enrolled and distributed in quartiles according to weight loss (low (<2.5 kg), low to moderate (>2.5 and <8 kg), moderate (<8 and <14 kg) and massive (<14 kg)). Body composition was measured by plethysmography, and visceral and subcutaneous fat were detected by ultrasound. Serum levels of adiponectin and leptin were analyzed. Lung function, asthma and EIB were evaluated according to the American Thoracic Society criteria. Patients were submitted to 1 year of interdisciplinary intervention consisting of physiotherapy, medical, nutritional, exercise, and psychological therapy. Results: After treatment the moderate and massive weight loss promoted an increase in adiponectin and adiponectin/leptin (A/L) ratio as well as a decrease in leptin levels and a reduction in EIB frequency and asthma-related symptoms. Furthermore, the reduction in leptin levels was a predictor factor to improvement in lung function. Conclusion: Interdisciplinary therapy was able to decrease EIB and asthma-related symptoms and to improve pro/anti-inflammatory adipokines. Additionally, the leptin concentration was a predictor factor to explain changes in lung function. Copyright (C) 2012 S. Karger AG, Basel
- ItemAcesso aberto (Open Access)Repercussões da suplementação com vitamina D sobre a função pulmonar de mulheres pós-menopausadas submetidas a um programa de exercícios aquáticos(Universidade Federal de São Paulo (UNIFESP), 2017-12-21) Santos, Rodrigo Nolasco dos [UNIFESP]; Castro, Marise Lazaretti [UNIFESP]; http://lattes.cnpq.br/8253870907570489; http://lattes.cnpq.br/4942502375632992; Universidade Federal de São Paulo (UNIFESP)A vitamina D tem sido envolvida em diversos processos biológicos, incluindo o metabolismo ósseo. Alguns trabalhos sugerem um efeito sobre a musculatura estriada e sobre a função respiratória. Desta forma, o objetivo desse estudo foi investigar os efeitos da suplementação de vitamina D e exercícios aquáticos, sobre a função pulmonar de mulheres pós-menopausadas. Métodos: Este estudo prospectivo e controlado, envolveu 104 mulheres (62 ± 6,5 anos), divididas em três grupos: controle sem suplementação de vitamina D (GC; n=17), controle com suplementação de vitamina D (GCD, n=33) e grupo treinado, submetidas a exercícios aquáticos três vezes por semana, com suplementação de vitamina D (GTD, n=54). Foram analisados antes e depois de seis meses do estudo: a 25-hidroxivitamina D (25OHD) sérica, o pico de fluxo expiratório (PFE), a capacidade vital forçada (CVF), o volume expiratório forçado no 1º segundo (VEF1) e a cirtometria. Os três grupos eram semelhantes no momento inicial. Os resultados são expressos em média ± erro padrão, e a significância estatística (p<0,05) verificada pelo teste “t” de Student e Anova One-way com post-hoc de Tukey. Resultados: Ao final do estudo foram observados aumentos significativos nas concentrações de 25(OH)D nos grupos GCD (antes: 52,9±2,4; depois: 69,1±2,2; nmol/L) e GTD (Antes: 55,5±3, Depois: 71,5±3; nmol/L). O PFE aumentou 7+2% no GCD e 11+2% no GTD, a CVF aumentou 7+2% no GCD e 10+2% no GTD, que não diferiram entre si. A variação percentual da cirtometria do grupo GTD (43±3%) foi significativamente (p<0,0001) maior que o grupo GC (-4±8 %) e GCD (4±9 %) que não diferiram entre si. Conclusão: A suplementação de vitamina D melhorou os parâmetros da função pulmonar em mulheres na pós-menopausa, mesmo sem a prática de atividade física regular. Além disso, o programa de exercícios aquáticos induziu a um aumento na expansibilidade do tórax.