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Physiotherapy: functionality and biomolecular and cellular study in the treatment of patients with cardiorespiratory dysfunctions

Grant number: 13/13598-1
Support type:Regular Research Grants
Duration: June 01, 2014 - May 31, 2017
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Naomi Kondo Nakagawa
Grantee:Naomi Kondo Nakagawa
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Assoc. researchers: Dalmo Antonio Ribeiro Moreira ; Ernani Pinto Junior ; Geraldo Lorenzi Filho ; Henrique Takachi Moriya ; Heraclito Barbosa de Carvalho ; Iracema Ioco Kikuchi Umeda ; Mario Hiroyuki Hirata ; Paula Helena Ortiz Lima ; Paulo Hilário Nascimento Saldiva ; Pedro Rodrigues Genta ; Sandra Helena Poliselli Farsky ; Ubiratan de Paula Santos

Abstract

PROJECT 1: Heart failure is a clinical syndrom that is the common end of several cardiac diseases with symptoms such as muscle fatigue, dispnea and reduction of quality of life. To improve respiratory and functional capacity of these patients, there are strategies that can be used such as inspiratory muscle training and peripheric muscle training by dynamic resistance training. Objective: To assess the effects of a combined program of inspiratory muscle and peripheric muscle training on functionality and quality of life in patients with severe heart failure and assessment of oxidative stress, inflammation and DNA and RNA changes. Population: 50 patients with severe heart failure (functional class from NYHA III and IV) will be included in this study. PROJECT 2: The obstructive sleep apnea (OSA) affects between 10% to 25% of the adults. Continuous positive airway pressure (CPAP) is the chosen treatment in moderate and severe OSA. However, the adherence to CPAP varies, and the interface between patient and the CPAP may interfere with adherence, comfort and efficiency. Objectives: (1) to determine which is the preferred airway flow, (2) to analyze the effects of nasal and oronasal respiration on the nasal mucosa and the airways, (3) the effects of each interface (nasal and orofacial masks) on the nasal epithelum and airways in these patients under CPAP, and (3) to assess the oxidative stress, inflammation and DNA and RNA changes. Population: 40 patients with moderate and severe OSA recruted at Sleep Laboratory of Heart Institute - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. PROJECT 3: Inhalation of cigarette smoke is deleterious to the respiratory epithelium, it changes the ciliary beating and also production and mucus composition. All together induces morphological alterations in the respiratory tract epithelium and also to loss of cilia, metaplasia, keratinization of goblet cells followed by respiratory epithelium thickening as well as submucosa inflammation. Objective: To assess the effects of smoking and smoking cessation on (1) the airways defense mechanisms and (2) to assess the oxidative stress, inflammation and DNA and RNA changes. Population: Smokers, non-smokers and quitters of both genders, aged between 18-70 years old will be recruted at Faculdade de Medicina da Universidade de São Paulo. METHODS AND INSTRUMENTS OF ANALYSIS: Maximal respiratory pressures by manovacuometer, Lung function by spirometry, functional capacity by 6 minutes walk test, peripheric muscle strength by dynamometer, Quality of life by questionnaires (Minnesota, SF-36, Epworth, Pittsburgh, SNOT20, IPAQ), physical activity classification by accelerometers, Heart rate variability and cardiac events by electrophysiological study, nasal mucociliary clearance by saccharine transit time test, mucus physical properties by contac angle por cough transportability, nasal and the airways inflammation by nasal lavage total cells and pH, pH in exhaled breath condensate. Systemic oxidative stress, inflammation by antioxidants, oxidants and cytokines in peripheric blood, and changes in DNA and RNA miRNA by PCR-microarray. (AU)

Scientific publications (7)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
NASCIMENTO, JULIANA A.; GENTA, PEDRO R.; FERNANDES, PAULO H. S.; BARROSO, LUCIA P.; CARVALHO, TOMAS S.; MORIYA, HENRIQUE T.; MADEIRO, FERNANDA; LORENZI-FILHO, GERALDO; NAKAGAWA, NAOMI KONDO. Predictors of oronasal breathing among obstructive sleep apnea patients and controls. Journal of Applied Physiology, v. 127, n. 6, p. 1579-1585, DEC 2019. Web of Science Citations: 1.
KAWAUCHI, TATIANA SATIE; KIKUCHI UMEDA, IRACEMA IOCO; BRAGA, LAYS MAGALHAES; MANSUR, ANTONIO DE PADUA; ROSSI-NETO, JOAO MANOEL; DE MORAES REGO SOUSA, AMANDA GUERRA; HIRATA, MARIO HIROYUKI; CAHALIN, LAWRENCE P.; NAKAGAWA, NAOMI KONDO. Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial. Clinical Research in Cardiology, v. 106, n. 9, p. 676-685, SEP 2017. Web of Science Citations: 9.
BRAGA, LAYS MAGALHAES; PRADO, GUSTAVO FAIBISCHEW; KIKUCHI UMEDA, IRACEMA IOCO; KAWAUCHI, TATIANA SATIE; FROES TABOADA, ADRIANA MARQUES; AZEVEDO, RAYMUNDO SOARES; PEREIRA FILHO, HORACIO GOMES; GRUPI, CESAR JOSE; CAVENAGUE SOUZA, HAYALA CRISTINA; RIBEIRO MOREIRA, DALMO ANTONIO; NAKAGAWA, NAOMI KONDO. Reproducibility for Heart Rate Variability Analysis during 6-Min Walk Test in Patients with Heart Failure and Agreement between Devices. PLoS One, v. 11, n. 12 DEC 9 2016. Web of Science Citations: 1.
DE SA, MATHEUS CAVALCANTE; NAKAGAWA, NAOMI KONDO; SALDIVA DE ANDRE, CARMEN DIVA; CARVALHO-OLIVEIRA, REGIANI; CARVALHO, TAMAS DE SANTANA; NICOLA, MARINA LAZZARI; DE ANDRE, PAULO AFONSO; NASCIMENTO SALDIVA, PAULO HILARIO; VAISBERG, MAURO. Aerobic exercise in polluted urban environments: effects on airway defense mechanisms in young healthy amateur runners. JOURNAL OF BREATH RESEARCH, v. 10, n. 4 DEC 2016. Web of Science Citations: 3.
FRANCHINI, MICHELLE LISIDATI; ATHANAZIO, RODRIGO; AMATO-LOURENCO, LUIS FERNANDO; CARREIRAO-NETO, WALDIR; NASCIMENTO SALDIVA, PAULO HILARIO; LORENZI-FILHO, GERALDO; RUBIN, BRUCE K.; NAKAGAWA, NAOMI KONDO. Oxygen With Cold Bubble Humidification Is No Better Than Dry Oxygen in Preventing Mucus Dehydration, Decreased Mucociliary Clearance, and Decline in Pulmonary Function. CHEST, v. 150, n. 2, p. 407-414, AUG 2016. Web of Science Citations: 5.
ODAGIRI UTIYAMA, DANIELA MITIYO; YOSHIDA, CAROLINA TIEKO; GOTO, DANIELLE MIYUKI; CARVALHO, TOMAS DE SANTANA; SANTOS, UBIRATAN DE PAULA; KOCZULLA, ANDREAS REMBERT; NASCIMENTO SALDIVA, PAULO HILARIO; NAKAGAWA, NAOMI KONDO. The effects of smoking and smoking cessation on nasal mucociliary clearance, mucus properties and inflammation. Clinics, v. 71, n. 6, p. 344-350, JUN 2016. Web of Science Citations: 4.
NICOLA, MARINA LAZZARI; DE CARVALHO, HERACLITO BARBOSA; YOSHIDA, CAROLINA TIEKO; DOS ANJOS, FABYANA MARIA; NAKAO, MAYUMI; SANTOS, UBIRATAN DE PAULA; MORAIS CARDOZO, KARINA HELENA; CARVALHO, VALDEMIR MELECHCO; PINTO, ERNANI; POLISELLI FARSKY, SANDRA HELENA; SALDIVA, HILARIO NASCIMENTO; RUBIN, BRUCE K.; NAKAGAWA, NAOMI KONDO. Young ``Healthy{''} Smokers Have Functional and Inflammatory Changes in the Nasal and the Lower Airways. CHEST, v. 145, n. 5, p. 998-1005, MAY 2014. Web of Science Citations: 26.

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