DANIELLE MIYUKI GOTO
Projetos de Pesquisa
Unidades Organizacionais
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Aging, Diabetes, and Hypertension Are Associated With Decreased Nasal Mucociliary Clearance(2013) OLIVEIRA-MAUL, Janaina Proenca de; CARVALHO, Heraclito Barbosa de; GOTO, Danielle Miyuki; MAIA, Raphaela Mendonca; FLO, Claudia; BARNABE, Viviane; FRANCO, Denise Reis; BENABOU, Simon; PERRACINI, Monica Rodrigues; JACOB-FILHO, Wilson; SALDIVA, Paulo Hilario Nascimento; LORENZI-FILHO, Geraldo; RUBIN, Bruce K.; NAKAGAWA, Naomi KondoBackground: We showed previously that nasal mucociliary clearance was decreased in critically ill elderly subjects, most of whom had diabetes mellitus (DM) and/or hypertension (HTN). To determine if these changes were due to the effects of aging, disease, or critical illness, we studied nasal mucociliary clearance and mucus properties in an ambulatory population consisting of young, elderly, and healthy subjects and those with DM, HTN, or both. Methods: Of 440 subjects contacted, 252 entered the study. The subjects were divided into the following groups: (1) healthy (n = 79, 18-94 years, 50 men) and (2) DM and/or HTN, of which 37 had DM (14-90 years, 12 men), 52 had HTN (23-90 years, 12 men), and 84 had both DM and HTN (25-82 years, 33 men). Subjects were also grouped by age: < 40 years, 40 to 59 years, and >= 60 years. We assessed demographic and clinical data, quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire, nasal mucociliary clearance using the saccharine transit test (STT), and in vitro mucus properties by examining the sneeze (high airflow) clear-ability and contact angle. A logistic regression analysis for prolonged STT > 12 min was used, and we controlled for age, sex, and diseases. Results: Subjects aged > 60 years reported a decreased SF-36 physical component relative to other age groups. Sex, BMI, BP, heart rate, pulse oximetry, blood glucose level, and mucus properties were not associated with prolonged STT. Aging and DM and/or HTN independently increased the risk of prolonged STT. Conclusions: Aging and DM, HTN, or both diseases are independently associated with decreased nasal mucociliary clearance. This may predispose toward respiratory infections.
- CPAP Has No Effect on Clearance, Sputum Properties, or Expectorated Volume in Cystic Fibrosis(2012) AQUINO, Evanirso Silva; SHIMURA, Francine; SANTOS, Adriana Silveira; GOTO, Danielle Miyuki; COELHO, Cristiane Cenachi; FUCCIO, Marcelo Bicalho de; SALDIVA, Paulo Hilario Nascimento; LORENZI-FILHO, Geraldo; RUBIN, Bruce K.; NAKAGAWA, Naomi KondoBACKGROUND: Positive expiratory pressure (PEP) is used for airway clearance in cystic fibrosis (CF) patients. Hypertonic saline (HTS) aerosol increases sputum expectoration volume and may improve respiratory secretion properties. CPAP may also be used to maintain airway patency and mobilize secretions. To evaluate if CPAP would increase the beneficial clearance effect of HTS in subjects with CF, we investigated the effects of CPAP alone and CPAP followed by HTS on sputum physical properties and expectoration volume in CF subjects. METHODS: In this crossover study, 15 CF subjects (mean age 19 y old) were randomized to interventions, 48 hours apart: directed coughs (control), CPAP at 10 cm H2O, HTS 7%, and both CPAP and HTS (CPAP+HTS). Sputum collection was performed at baseline and after interventions. Expectorated volume was determined and in vitro sputum properties were analyzed for contact angle and cough clearability. RESULTS: There were no significant differences between any treatment in arterial blood pressure, heart rate, or pulse oximetry, between the 2 time points. HTS and CPAP+HTS improved cough clearability by 50% (P = .001) and expectorated volume secretion by 530% (P = .001). However, there were no differences between control and CPAP on sputum contact angle, cough clearability, or volume of expectorated secretion. CONCLUSIONS: CPAP alone had no effect on mucus clearance, sputum properties, or expectorated volume, and did not potentiate the effect of HTS alone in CF subjects.