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

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)

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Scientific publications (12)
(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)
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; et al. Young ``Healthy{''} Smokers Have Functional and Inflammatory Changes in the Nasal and the Lower Airways. CHEST, v. 145, n. 5, p. 998-1005, . (13/13598-1, 13/11401-6)
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, . (13/13598-1)
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; et al. Young "Healthy" Smokers Have Functional and Inflammatory Changes in the Nasal and the Lower Airways. CHEST, v. 145, n. 5, p. 8-pg., . (13/11401-6, 13/13598-1)
NAKAGAWA, NAOMI KONDO; DIZ, MARIANA ABREU; KAWAUCHI, TATIANA SATIE; DE ANDRADE, GEISA NASCIMENTO; KIKUCHI UMEDA, IRACEMA IOCO; MURAKAMI, FERNANDA MURATA; OLIVEIRA-MAUL, JANAINA PROENCA; NASCIMENTO, JULIANA ARAUJO; NUNES, NEWTON; TAKADA, JULIO YOSHIO; et al. Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure. Respiratory Care, v. 65, n. 4, p. 507-516, . (13/13598-1)
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, . (13/13598-1)
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, . (13/13598-1)
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, . (13/13598-1)
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; et al. 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, . (13/13598-1)
ANDRADE, G. N.; RODRIGUES, T.; TAKADA, J. Y.; BRAGA, L. M.; UMEDA, I. I. K.; NASCIMENTO, J. A.; PEREIRA-FILHO, H. G.; GRUPI, C. J.; SALEMI, V. M. C.; JACOB-FILHO, W.; et al. Prolonged heart rate recovery time after 6-minute walk test is an independent risk factor for cardiac events in heart failure: A prospective cohort study. PHYSIOTHERAPY, v. 114, p. 8-pg., . (19/02880-4, 17/21264-7, 13/13598-1)
ARCAS, CAMILA DOS SANTOS; LIN-WANG, HUI TZU; KIKUCHI UMEDA, IRACEMA IOCO; DE SOUSA, MARCIO GONCALVES; ODAGIRI UTIYAMA, DANIELA MITIYO; MANSUR, ANTONIO DE PADUA; MACCHIONE, MARIANGELA; HIRATA, MARIO HIROYUKI; NAKAGAWA, NAOMI KONDO. Smoking load reduction is insufficient to downregulate miR-301b, a lung cancer promoter. SCIENTIFIC REPORTS, v. 10, n. 1, . (17/21264-7, 13/13598-1)
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, . (17/10372-3, 13/13598-1)
GEISA NASCIMENTO DE ANDRADE; IRACEMA IOCO KIKUCHI UMEDA; ANGELA RUBIA CAVALCANTI NEVES FUCHS; LUIZ EDUARDO MASTROCOLA; JOÃO MANOEL ROSSI-NETO; DALMO ANTONIO RIBEIRO MOREIRA; PATRICIA ALVES DE OLIVEIRA; CARMEN DIVA SALDIVA DE ANDRÉ; LAWRENCE PATRICK CAHALIN; NAOMI KONDO NAKAGAWA. Home-based training program in patients with chronic heart failure and reduced ejection fraction: a randomized pilot study. Clinics, v. 76, . (13/13598-1, 17/21264-7)

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