Mucociliary clearance

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Lung function and nasal mucociliary clearance in Brazilian sugarcane cutters exposed to biomass burning

Lung function and nasal mucociliary clearance in Brazilian sugarcane cutters exposed to biomass burning

Objective: to evaluate the effects of sugarcane burning on lung function and mucociliary clearance in sugarcane workers. Methods: sixteen sugarcane workers were evaluated in two sequential periods: during the non-harvest season, in April/2011, and during the sugarcane burning harvest season, in October/2011. Mean values (standard deviation) of lung function and mucociliary clearance were evaluated through spirometry and the saccharin transit time (STT) test, respectively. Results: lung function decreased %FEF 25-75 [99.31 (23.79) to 86.36 (27.41); p = 0.001]; %FEV 1 [92.19 (13.24) to 90.44 (12.76); p = 0.022]; and FEV 1 /FVC [88.62 (5.68) to 84.90 (6.47); p = 0.004] during the harvest season compared with the non-harvest season. A significant decrease was found in saccharin transit time during the harvest [3 (1) min] season compared with the non-harvest season [8 (3) min] (p < 0.001). Conclusion: sugarcane workers present a decrease in %FEF 25-75 , %FEV 1 , FEV 1 /FVC ratio, and increase in nasal mucociliary transport velocity at the end of the harvest season.
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Lung function and nasal mucociliary clearance in Brazilian sugarcane cutters exposed to biomass burning

Lung function and nasal mucociliary clearance in Brazilian sugarcane cutters exposed to biomass burning

Objective: to evaluate the effects of sugarcane burning on lung function and mucociliary clearance in sugarcane workers. Methods: sixteen sugarcane workers were evaluated in two sequential periods: during the non-harvest season, in April/2011, and during the sugarcane burning harvest season, in October/2011. Mean values (standard deviation) of lung function and mucociliary clearance were evaluated through spirometry and the saccharin transit time (STT) test, respectively. Results: lung function decreased %FEF 25-75 [99.31 (23.79) to 86.36 (27.41); p = 0.001]; %FEV 1 [92.19 (13.24) to 90.44 (12.76); p = 0.022]; and FEV 1 /FVC [88.62 (5.68) to 84.90 (6.47); p = 0.004] during the harvest season compared with the non-harvest season. A significant decrease was found in saccharin transit time during the harvest [3 (1) min] season compared with the non-harvest season [8 (3) min] (p < 0.001). Conclusion: sugarcane workers present a decrease in %FEF 25-75 , %FEV 1 , FEV 1 /FVC ratio, and increase in nasal mucociliary transport velocity at the end of the harvest season.
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Clinics  vol.69 número12

Clinics vol.69 número12

OBJECTIVES: There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution. METHODS: In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO 2 ) concentration-
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Int. Arch. .  vol.21 número3

Int. Arch. . vol.21 número3

The interruption of airflow in the nasal cavity leads to changes in endonasal temperature, 19 an increase in humidity, 20 and changes in mucus consistency. Such changes give rise to the formation of a hyper-secretory phase and mucociliary clear- ance increases 21 in the early term, depending on the loss of nasal cycle, and a slowing down of the endonasal blood flow. 22 We also determined in our study prolonged mucociliary clear- ance time in patients who underwent total laryngectomy at least two years ago. None of the studied cases presented mucociliary clearance time within pathological limits. The average mucociliary clearance time was 16.95  2.47 minutes in the patient group; whereas in the control group, that average was 11.04  2.71 minutes. Mucociliary clearance time of the patient group was significantly higher than the control group in our statistics (p < 0.01). We found that nasal mucociliary clearance slowed down in the later term, which is different from the results of previous studies conducted early (< 2 years) in patients with total laryngectomy. It is possible that there was damage to patients’ nasal mucociliary clearance due to the disabling of the upper airway after total laryngectomy because of tracheostomy and due to atrophy of the nasal mucosa in the late stages. Mucociliary clearance time is prolonged because of the changes in the nasal mucosa in the chronic term. Moreover, such changes create conditions that favor secondary infections from saprophytic bacteria and cause atrophy in nasal mucosa, reduction in humidity, and a decrease in endonasal temperature.
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Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation

Effects of intravenous furosemide on mucociliary transport and rheological properties of patients under mechanical ventilation

activity in cultured human airway epithelium [10]. The effects of inhaled furosemide have also been investigated. Inhaled furosemide prevents exercise-induced bronchoconstriction in asthmatic patients [11]. Hasani et al. [12] reported that inhaled furosemide had no effects on mucociliary clearance in humans. However, the primary site of furosemide action is the basolateral membrane of the airway, where it inhibits the NaK(Cl) 2 co-transporter. Therefore the effects of the drug on the respiratory epithelium might depend on the route of administration. The aim of the present study was to investi- gate the effects of IV furosemide on the transportability and rheological properties of mucus in patients under MV.
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Análise do clearance mucociliar nasal e dos efeitos adversos do uso de CPAP nasal em pacientes com SAHOS

Análise do clearance mucociliar nasal e dos efeitos adversos do uso de CPAP nasal em pacientes com SAHOS

S ince 1981 the use of positive airway pressure through the nasal CPAP has been considered the main clinical treatment of the SAOS- sleep obstructive apnea syndrome, despite its low adhesion on a long- term. Some authors report that the nasal complaints from the continuous positive airway pressure in the nasal cavity are the main causes for the therapy discontinuance. This would probably occur because the treatment would lead to epithelium alterations and changes in the mucociliarytransport and hence, a greater number of upper respiratory infections. Aim: To evaluate the nasal mucociliary clearance in patients with SAHOS under nasal CPAP use through saccharin test, and correlate the adverse effects of this therapy with the treatment endurance and the pressure level used in it. Study design: Clinical study case-control. Material and Method: Twenty five patients, carriers of SAHOS – between their 18 and 70 – submitted to nasal CPAP use for one month, were followed-up at the Instituto do Sono (UNIFESP-EPM) and subjected to the saccharin test. The results were compared to a group of 25 normal individuals. Results: There was no statistical difference among the groups regarding the saccharin test. The adverse effects were present in 84% of the sample, being 60% for nasal dryness and 36% for nasal obstruction. Conclusions: The mucociliary transport stays normal in the SAHOS group submitted to nasal CPAP use and the nasal obstruction and nasal dryness do not present correlation with the treatment time and pressure level used by the device.
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Braz. j. .  vol.82 número2

Braz. j. . vol.82 número2

mucociliary clearance and nasal patency in 22 healthy vol- unteers, each of them serving as self-control, with the use of 3% or 0.9% saline; and concluded that both saline solu- tions improved nasal clearance; but with the use of 3% saline the clearance was faster, with no change in nasal patency as measured by acoustic rhinometry. In animal studies, there is also controversy about the effects of dif- ferent concentrations of saline solutions on the mucosa and ciliary beating. 13,14,31 Alzérreca et al., 15 reviewing the

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Clinics  vol.62 número3

Clinics vol.62 número3

22. Rubin BK, Ramirez O, King M. Mucus-depleted frog palate as a model for the study of mucociliary clearance. J Appl Physiol. 1990;69:424-9. 23. Mowry RW. Alcian blue techniques for histochemical study of acidic carbohydrates. J Histochem Cytochem. 1956;4:407. Apud Harkema JR, Plopper CG, Hyde DM, St George JA. Regional differences in quantities of histochemically detectable mucosubstances in nasal, paranasal, and nasopharyngeal epithelium of the bonnet monkey. J Histochem Cytochem. 1987;35:279-86.

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O efeito da eltgol sobre a depuração mucociliar em pacientes com doença pulmonar obstrutiva crônica

O efeito da eltgol sobre a depuração mucociliar em pacientes com doença pulmonar obstrutiva crônica

chest physiotherapy technique used to remove lung secretions. The aim this study was to evaluate the effect of the ELTGOL on the mucociliary clearance in patients with chronic obstructive pulmonary disease (COPD). Methods: Twelve patients, mean age 61.76 ± 8.13 (SD) years, with COPD, mild to moderate airflow limitation were studied through ventilatory scintigraphy, using 99m Tc-DTPA. Six posterior scintigraphy images (T0, T1, T2, T3, T4, T5 ) were taken. The study was carried out in two phases (control and experimental) on a randomized order. ELTGOL was performed with the right lung in infralateral posture, after T0. The right and left lungs were studied in interest areas (total, peripheral, intermediate and central). Statistical analysis was performed by paired t test. Results: On right lung during ELTGOL phase it was observed a significant increase in mucociliary clearance in peripheral area in all times, except in T1 . For Intermediate at T1 and T2 and for central area, increases were found at T1, T2, T3 and T4. On total area of the right lund a significant increase in mucociliary clearance was observed in all times of comparisons. On left lung no significant changes were observed on peripheral area in all times studied. In intermediate and central area results were similar to right lung. Considering the total area significant increase in mucociliary clearance was found at T1 and T2. Conclusions: Our results show that ELTGOL was an effective technique to improve secretion removal from peripheral area of dependent lung in patients with COPD.
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Clinics  vol.71 número6

Clinics vol.71 número6

OBJECTIVE: The aim of the present study was to assess nasal mucociliary clearance, mucus properties and inflammation in smokers and subjects enrolled in a Smoking Cessation Program (referred to as quitters). METHOD: A total of 33 subjects with a median (IQR) smoking history of 34 (20-58) pack years were examined for nasal mucociliary clearance using a saccharine transit test, mucus properties using contact angle and sneeze clearability tests, and quantification of inflammatory and epithelial cells, IL-6 and IL-8 concentrations in nasal lavage fluid. Twenty quitters (mean age: 51 years, 9 male) were assessed at baseline, 1 month, 3 months and 12 months after smoking cessation, and 13 smokers (mean age: 52 years, 6 male) were assessed at baseline and after 12 months. Clinicaltrials.gov: NCT02136550.
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Como escolher os alvos terapêuticos para melhorar a perfusão tecidual no choque séptico.

Como escolher os alvos terapêuticos para melhorar a perfusão tecidual no choque séptico.

A otimização precoce da oxigenação tecidual é manda- tória na ressuscitação dos pacientes com sepse grave e choque séptico. A utilização de um protocolo de ressus- citação precoce guiado por metas, que inclua a satura- ção venosa central de oxigênio ou o clearance de lactato como parâmetros de adequação do fluxo sanguíneo e, consequentemente, da oferta de oxigênio a demanda metabólica, é altamente recomendada pelas diretrizes que norteiam a ressuscitação de pacientes com sepse grave e choque séptico.

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Farmacocinética enantiosseletiva da ciclofosfamida em pacientes com câncer de m...

Farmacocinética enantiosseletiva da ciclofosfamida em pacientes com câncer de m...

Segundo Williams et al. (1999 b), existe uma grande variabilidade interindividual nos efeitos clínicos da CPA em função de diferenças inter-pacientes na velocidade e extensão da absorção, distribuição, metabolismo e eliminação. A bioativação da ciclofosfamida em humanos é dependente do CYP2B6, CYP3A4 e CYP2C9, sendo que o CYP3A4 também catalisa a reação de N-descloroetilação da CPA (WILLIAMS et al., 1999; BODDY; YULE, 2000). Visto que a atividade do CYP3A envolvido no metabolismo da CPA exibe um amplo grau de variabilidade interindividual, diferenças na atividade desta isoforma podem ser responsáveis pela variação na eficácia terapêutica e toxicidade observada entre pacientes submetidos à terapia com CPA (WILLIAMS et al., 1999; NELSON et al., 1996). Petros et al (2005) apontaram que polimorfismos no CYP3A4 e CYP3A5 estão associados com uma redução no clearance sistêmico da CPA e uma fraca resposta clínica, sugerindo, assim, um importante papel do CYP3A na ativação da CPA. De acordo com Petros et al. (2005), variantes alélicas do CYP3A são relativamente incomuns em brancos, mas encontram-se em aproximadamente 50% dos afro-americanas. Segundo os autores, essas variantes podem ser parcialmente responsáveis pela diminuição da eficácia da CPA em afro-americanas.
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Marcadores práticos de função renal em pacientes com cistinose.

Marcadores práticos de função renal em pacientes com cistinose.

reoideana normal ou sob terapia de reposição hormonal, equilibrados metabólica e eletroliticamente, recebendo bitartrato de cisteamina e aderentes ao tratamento de acordo com a presença aos exames e consultas, e avalia- mos os seguintes parâmetros: creatinina sérica, cistatina C e clearance de creatinina pela Fórmula de Schwartz.

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Correlação entre a cistatina C sérica e marcadores de aterosclerose subclínica em pacientes hipertensos.

Correlação entre a cistatina C sérica e marcadores de aterosclerose subclínica em pacientes hipertensos.

Amostras de sangue venoso, em jejum (12 horas), foram coletadas e os parâmetros bioquímicos foram determinados por analisador automático. As seguintes medidas foram obtidas: glicose, ureia, creatinina, potássio, colesterol total, colesterol HDL, colesterol LDL, triglicerídeos, contagem de leucócitos, ácido úrico, proteína C-reativa de alta sensibilidade, fibrinogênio e s-CC. Cada participante coletou a própria urina durante 24 horas para determinação de microalbuminúria e depuração de creatinina. A proteína C-reativa de alta sensibilidade e a microalbuminúria foram determinadas por imunoturbidimetria. O clearance de creatinina medido ajustado para a superfície corporal foi usado como índice da taxa de filtração glomerular, a qual foi considerada baixa quando < 60 mL/min/1,73m 2 . O clearance de creatinina
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Regulação da apoptose por hormonas sexuais no plexo coroide : implicações na clearance do B-amiloide

Regulação da apoptose por hormonas sexuais no plexo coroide : implicações na clearance do B-amiloide

A deficiência hormonal ovárica após a menopausa é um fator de risco significativo para o desenvolvimento da doença de Alzheimer em mulheres (Paganini-Hill and Henderson 1994; Tang et al. 1996) que tem sido atribuída, principalmente, à depleção dos níveis de estrogénios. Os estrogénios podem impedir a patogénese da AD a vários níveis: 1) protegendo contra a morte celular induzida pelo a-beta, reduzindo a produção e melhorando a clearance do péptido amiloide (Chen et al. 2006); 2) agindo como regulador endógeno de fatores relacionados com a apoptose, pois aumenta a expressão de Bcl-xL e diminui a proteólise mediada por caspases e morte celular induzida por a-beta (Pike 2001); 3) influenciando a função cerebral, pois atravessam facilmente a barreira hematoencefálica, onde podem interagir tanto com os recetores estrogénicos nucleares como com os recetores membranares (Kawata 1995); 4) promovendo o crescimento de neurites e suprimento vascular para o cérebro (Belfort et al. 1995), de forma a aumentar a regeneração e reparação neuronais; 5) promovendo a quebra da proteína precursora amiloide a fragmentos menos suscetíveis de acumular o péptido β-amiloide (Henderson 1997); 6) enfraquecendo os efeitos neurotóxicos do β-amiloide, devido às propriedades antioxidantes (Mukai et al. 1990; Niki and Nakano 1990; Mooradian 1993); 7) aumentando o catabolismo e reduz os níveis plasmáticos da ApoE (Applebaum-Bowden et al. 1989; Kushwaha et al. 1991); e 8) através de efeitos protetores na função e/ou estabilidade mitocondriais (Simpkins and Dykens 2008).
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Spontaneous clearance of Mycobacterium ulcerans in a case of Buruli ulcer.

Spontaneous clearance of Mycobacterium ulcerans in a case of Buruli ulcer.

This report of spontaneous clearance of M. ulcerans from a small but clinically apparent BU confirms previous anecdotal and some systematic field observations in patients likely to have BU, but from whom definitive laboratory confirmation was not available [17]. For example, Revill et al. reported that 29% of patients with small nodular lesions diagnosed clinically healed spontaneously while receiving placebo

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J. bras. pneumol.  vol.34 número5 en v34n5a05

J. bras. pneumol. vol.34 número5 en v34n5a05

drugs used for immunosuppression present a series of side effects, such as nephrotoxicity and hepato- toxicity, we raised the hypothesis that such drugs have a deleterious effect on the airway epithelial tissue as well. Since azathioprine is one of the drugs most commonly used by patients after transplant, and since its direct effect on the mucociliary system is not clearly known, it was chosen as the drug to be tested in this study.

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PDF EN Jornal Brasileiro de Pneumologia 5 5 english

PDF EN Jornal Brasileiro de Pneumologia 5 5 english

drugs used for immunosuppression present a series of side effects, such as nephrotoxicity and hepato- toxicity, we raised the hypothesis that such drugs have a deleterious effect on the airway epithelial tissue as well. Since azathioprine is one of the drugs most commonly used by patients after transplant, and since its direct effect on the mucociliary system is not clearly known, it was chosen as the drug to be tested in this study.

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Perfil de segurança de medicamentos antidiabéticos para uso em pacientes idosos com doença renal crônica

Perfil de segurança de medicamentos antidiabéticos para uso em pacientes idosos com doença renal crônica

Glibenclamida e glimepirida são metabolizadas pelo fígado em metabó- litos ativos e são eliminadas pelos rins, dessa forma, há uma maior chance de acúmulo desses metabólitos no organis- mo na vigência da DRC. A monitorização glicêmica torna-se necessária devido ao risco de hipoglicemia em idosos (GAME, 2014; NEVES et al., 2009). Pode haver necessidade de redução da dose desses medicamentos de acordo com o valor do clearance de cada paciente e quando o valor de creatinina for > 2 mg/dL (MI- CROMEDEX ® , 2015).

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Avaliação da função renal de cães sob dois protocolos para administração da cisplatina.

Avaliação da função renal de cães sob dois protocolos para administração da cisplatina.

tenham se mantido dentro da normalidade para a espécie em estudo, a concentração sérica de creatinina sofreu aumento significativo e o clearance de creatinina dimi- nuiu significativamente na terceira sessão de quimiotera- pia em relação à primeira sessão no grurpo que não recebeu furosemida. Estes achados podem ser indicati- vos de um possível efeito protetor adicional conferido pela furosemida.

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