Navegando por Palavras-chave "pulmonary function"
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- ItemSomente MetadadadosExhaled nitric oxide for monitoring childhood asthma inflammation compared to sputum analysis, serum interleukins and pulmonary function(Wiley-Blackwell, 2008-02-01) Paro-Heitor, Maria Luisa Z.; Bussamra, Maria Helena C. F.; Saraiva-Romanholo, Beatriz M.; Martins, Milton A.; Okay, Thelma Suely; Rodrigues, Joaquim Carlos; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)The level of fractional exhaled nitric oxide (FENO) is significantly elevated in uncontrolled asthma and decreases after anti-inflammatory therapy the aim of this prospective study was to analyze the behavior of FENO in the follow-up and management of the inflammation in asthmatic pediatric patients treated with inhaled corticosteroids (ICS), compared to sputum cellularity, serum interleukins (IL), and pulmonary function. Twenty-six clinically stable asthmatic children aged from 6 to 18 years, previously treated or not with ICS were included. Following an international consensus (GINA), the patients were submitted to standard treatment with inhaled fluticasone for 3 months according to the severity of the disease. During this period, each patient underwent three assessments at intervals of approximately 6 weeks: Each evaluation consisted of the measurement of FENO, determination of serum interleukins IL-5, IL-10, IL-13, and interferon gamma (INF-gamma), spirometry and cytological analysis of spontaneous or induced sputum. A significant reduction in mean FENO and IL-5, without concomitant changes in FEV1, was observed along the study. There was no significant correlation between FeNO and FEV1 in the three assessments. A significant correlation between FeNO and IL-5 levels was only observed in the third assessment (r = 0.499, P=0.025). in most patients, serum IL-10, IL-13, and INF-gamma concentrations were undetectable throughout the study Sputum samples were obtained spontaneously in 11 occasions and in 56 by induction with 3% hypertonic saline solution (success rate: 50.8%), with 39 (69.9%) of them adequate for analysis. Only two of the 26 patients produced adequate samples in the three consecutive evaluations, which impaired the determination of a potential association between sputum cellularity and FeNO levels throughout the study. in conclusion, among the parameters of this study, it was difficult to perform and to interpret the serial analysis of spontaneous or induced sputum. Serum interleukins, which remained at very low or undetectable levels in most patients, were not found to be useful for therapeutic monitoring, except for IL-5 that seems to present some correlation with levels of FeNO exhaled. Monitoring of the mean FEV1 indicated no significant variations during the treatment, demonstrating that functional stability or the absence of obstruction may not reflect the adequate management of asthma. Serial measurement of FeNO seemed to best reflect the progressive anti-inflammatory action of ICS in asthma.
- ItemAcesso aberto (Open Access)Função pulmonar em pacientes asmáticos com Síndrome da Apneia Obstrutiva do Sono: um estudo observacional transversal(Universidade Federal de São Paulo (UNIFESP), 2016-12-21) Fransolin, Carolina [UNIFESP]; Carvalho, Luciane Bizari Coin de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Context. Asthma and Obstructive Sleep Apnea Syndrome are diseases which compromise respiratory function and interfere in lung mechanics as well as the quality of sleep. OSAS is a major factor in asthma exacerbations, it is necessary to investigate the relationship between asthma and OSA through examinations which assess and promote effective responses to questions. Objective. To evaluate and compare the pulmonary functional impairment through the variables Peak Expiratory Flow (PEF), Forced Expiratory Volume in the first second (FEV1), and Forced Vital Capacity (FVC). To evaluate and compare the daytime sleepiness in a sample of patients with asthma attack with OSAS and without OSAS in the emergency room and after 7 days of treatment. Methods. Sixty patients in asthma attacks moderate or severe, we included 24 patients who sought the emergency and emergency service of the São Paulo Hospital of the Escola Paulista de Medicina of the Federal University of São Paulo. Initially, PEF values less than 50% of the product according to age, height and sex were indispensable for the insertion of the patients in the research. Subsequently, all patients underwent pulmonary function tests in the initial 30 minutes in the emergency room after 4 hours and on return after 7 days. Sleepiness scales (Stanford Sleepiness Scale - SSS and Epworth Sleepiness Scale - ESS) were filled at the initial care and at 7-day follow-up. The polysomnography to diagnose the presence of OSAS was performed after 15 days of treatment. Results. The values of PEF, FEV1 and FVC of asthmatic patients with OSAS were lower when compared to asthmatic patients without OSAS at the initial evaluation (emergency room) and after seven days of follow-up (p <0.05). Patients with OSAS did not improve drowsiness after 7 days, but after the same period, patients without OSAS presented improvement in sleepiness, as measured by the Stanford scale. Asthmatic patients with OSAS were older than asthmatic patients without OSAS Conclusion. Asthmatic patients with OSA have greater impairment of lung function than asthmatic patients without OSA. Patients with OSA did not improvement in sleepiness after 7 days of treatment. Patients with OSA is older than patients without OSA.
- ItemAcesso aberto (Open Access)Miniesternotomia na cirurgia de revascularização miocárdica preserva função pulmonar pós-operatória(Sociedade Brasileira de Cardiologia - SBC, 2010-10-01) Guizilini, Solange [UNIFESP]; Bolzan, Douglas Willian [UNIFESP]; Faresin, Sonia M. [UNIFESP]; Alves, Francisco A. [UNIFESP]; Gomes, Walter José [UNIFESP]; OSS-SPDM Hospital Geral de Pirajussara; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: In coronary artery bypass graft (CABG) surgery, the need to perform a midsternotomy has been considered a factor for the decrease in postoperative pulmonary function. OBJECTIVE: To prospectively evaluate early postoperative (PO) pulmonary function in patients submitted to off-pump CABG, comparing the conventional midsternotomy with the ministernotomy approach. METHODS: A total of 18 patients were evaluated and assigned to the two groups: Group Conventional Midsternotomy (CMS, n=10) and Group Ministernotomy (MS, n=8). Spirometric results of the forced vital capacity (FVC) and the Forced Expiratory Volume in one second (FEV1) were obtained on the 1st, 3rd and 5th PO days and the arterial gasometry was obtained before and on the 1st PO day. The pulmonary shunt percentage and the pain score were also assessed. RESULTS: When compared in terms of percentage of the preoperative value, the FVC was higher in the MS group than in the CMS group on the 1st, 3rd and 5th PO days (p<0.001). Similar results were obtained for FEV1. The recovery of the FVC between the 1st and the 5th PO days was higher in the MS than in the CMS group (p=0,043). The PaO2 decreased on the 1st PO day in both groups (p<0.05), with a higher decrease in the CMS group (p=0.002). The shunt increased in the two groups on the 1st PO day (p<0.05); however, it was lower in the MS group (p=0.02). The reported pain score was lower and the duration of the hospital stay was shorter in the MS group. CONCLUSION: Patients submitted to CABG by MS present better preservation and recovery of pulmonary function than those submitted to CMS.
- ItemAcesso aberto (Open Access)Pulmonary emphysema induced by passive smoking: an experimental study in rats(Associação Brasileira de Divulgação Científica, 1997-10-01) Cendon Filha, Sônia Perez [UNIFESP]; Battlehner, Claudia; Lorenzi-Filho, Geraldo; Dohlnikoff, Marisa; Pereira, Patricia M [UNIFESP]; Conceição, Gleice M S [UNIFESP]; Beppu, Osvaldo Shigueomi [UNIFESP]; Saldiva, Paulo Hilário Nascimento; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)We describe a short time model for inducing experimental emphysema in rats by chronic tobacco smoke inhalation. Three groups of male Wistar rats (6 months old) were studied: controls (N = 8), rats intoxicated for 45 days (s-45, N = 7) or for 90 days (s-90, N = 8). The exposed animals were intoxicated 3 times a day (10 cigarettes per exposure period), 5 days a week. Pulmonary damage was assessed by means of functional tests and quantitative pathological examination of the airways and lung parenchyma. The s-45 and s-90 animals were similar in terms of functional residual capacity (FRC) corrected for body weight (FRC/kg) but both groups of smoking rats exhibited significantly higher FRC/kg values than the controls (s-45 = 6.33; s-90 = 6.46; controls = 3.78; P<0.05). When the two groups of smoking rats were pooled together and compared to controls, they showed decreased lung elastance (1.6 vs 2.19; P = 0.046) and increased mean linear intercept (Lm) (85.14 vs 66.44; P = 0.025). The s-90 animals presented higher inflammation and muscular hypertrophy at the level of the axial bronchus than the controls (P<0.05). When smoking groups were pooled and compared to controls, they presented significantly higher inflammation at the lateral level (P = 0.028), as well as airway secretory hyperplasia (P = 0.024) and smooth muscle hypertrophy (P = 0.005) at the axial level. Due to its simplicity, low cost and short duration, this technique may be a useful model to obtain new information about airspace remodeling due to chronic tobacco consumption
- ItemSomente MetadadadosRelationship between induced sputum cytology and inflammatory status with lung structural and functional abnormalities in asbestosis(Wiley-Blackwell, 2008-03-01) Setta, Jose Henrique [UNIFESP]; Neder, Jose Alberto [UNIFESP]; Bagatin, Ericson; Terra-Filho, Mario; Napolis, Lara Maris [UNIFESP]; Dal Corso, Simone [UNIFESP]; Amorin, Maria Marta Ferreira [UNIFESP]; Rodrigues, Reynaldo Tavares [UNIFESP]; Fernandes, Ana Luisa Godoy [UNIFESP]; Nery, Luiz Eduardo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Med Sch Jundiai; Universidade Estadual de Campinas (UNICAMP); Universidade de São Paulo (USP); Ctr Univ Nove JulhoBackground Asbestosis is associated with lung cellular and immunological abnormalities. Induced sputum cytology and local and systemic markers of inflammation may be helpful to characterize disease status and progression in these patients.Methods Thirty-nine ex-workers with asbestosis on high-resolution CT (HRCT) and 21 non-exposed controls were evaluated. Sputum cytology and IL-8 in serum and sputum were related to lung function impairment.Results Subjects with asbestosis had reduced sputum cellularity but higher macrophagel neutrophil ratio and % macrophage as compared with controls. Sputum and serum IL-8 were also higher in patients with asbestosis (P < 0.05). in addition, evidence of lung architectural distorption on HRCT was associated with increased levels of serum IL-8. Interestingly, absolute macrophage number was negatively correlated with total lung capacity (r = -0.40; P = 0.04) and serum IL-8 to lung diffiusing capacity (r = -0.45; P = 0.01).Conclusions Occupationally exposed subjects with asbestosis on HRCT have cytologic abnormalities in induced sputum and increased local and systemic pro-inflammatory status which are correlated to functional impairment.
- ItemSomente MetadadadosSafety and cardiovascular behavior during pulmonary function in patients with Marfan syndrome(Wiley-Blackwell, 2010-07-01) Cipriano, G. F. B. [UNIFESP]; Peres, P. A. T.; Cipriano Junior, Gerson [UNIFESP]; Arena, R.; Carvalho, A. C.; Universidade Federal de São Paulo (UNIFESP); Virginia Commonwealth UnivMarfan syndrome (MS) is a dominant autosomal connective tissue disease that impacts multiple systems, such as the cardiovascular system, tissue viscoelastic properties, bone calcification matrix and, most specific to the present investigation, pulmonary parenchyma. the aim of the present study was to evaluate pulmonary function (PF) in patients with MS and relate it to thoracic cage abnormalities (TCA) and the occurrence of cardiac arrhythmias during the spirometric exam (SE). A sample of 75 subjects (46 with MS) underwent clinical, anthropometric, echocardiographic, radiographic and PF evaluation; 51 subjects (33 with MS) had their electrocardiogram (ECG) information evaluated during PF. These individuals were matched and compared with a healthy control group (CG). Forced vital capacity (FVC) and forced expiratory volume (FEV) in the first second (FEV(1)) in the patients with MS were significantly lower in comparison with the CG (p = 0.012 and 0.0006) and predicted values (p = 0.04 and 0.003). Subgroup analysis based on TCA revealed differences between patients with MS with two combined abnormalities (scoliosis + pectus) in comparison with both the CG (p = 0.012 and 0.002) and patients without abnormalities (p = 0.05 and 0.006). There were no differences regarding the occurrence of arrhythmia during exertion on the SE. There was a correlation between clinical history, cardiovascular behavior and PF. PF is reduced in patients with MS, and deformities in the thoracic cage appear to contribute to this reduction. Despite the apparent structural alterations in the cardiovascular system in this population, exertion during the SE appears to be safe.