Andréa Lúcia Gonçalves da Silva

Evaluation of DNA damage in COPD patients and its correlation with polymorphisms in repair genes

BackgroundWe investigated a potential link between genetic polymorphisms in genes XRCC1 (Arg399Gln), OGG1 (Ser326Cys), XRCC3 (Thr241Met), and XRCC4 (Ile401Thr) with the level of DNA damage and repair, accessed by comet and micronucleus test, in 51 COPD patients and 51 controls.MethodsPeripheral blood was used to perform the alkaline and neutral comet assay; and genetic polymorphisms by PCR/RFLP. To assess the susceptibility to exogenous DNA damage, the cells were treated with methyl methanesulphonate for 1-h or 3-h. After 3-h treatment the % residual damage was calculated assuming the value of 1-h treatment as 100%. The cytogenetic damage was evaluated by buccal micronucleus cytome assay (BMCyt).ResultsCOPD patients with the risk allele XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) showed higher DNA damage by comet assay. The residual damage was higher for COPD with risk allele in the four genes. In COPD patients was showed negative correlation between BMCyt (binucleated, nuclear bud, condensed chromatin and karyorrhexic cells) with pulmonary function and some variant genotypes.ConclusionOur results suggest a possible association between variant genotypes in XRCC1 (Arg399Gln), OGG1 (Ser326Cys), XRCC3 (Thr241Met), and XRCC4 (Ile401Thr), DNA damage and progression of COPD.

Is cardiac autonomic modulation during upper limb isometric contraction and Valsalva maneuver impaired in COPD patients

Purpose To evaluate the heart rate variability (HRV) indices and heart rate (HR) responses during isometric contraction (IC) and Valsalva maneuver (VM) in COPD patients. Methods Twenty-two stable moderate to severe COPD patients were evaluated. R-R intervals were recorded (monitor Polar® S810i) during dominant upper limb IC (2 minutes). Stable signals were analyzed by Kubios HRV® software. Indices of HRV were computed in the time domain (mean HR; square root of the mean squared differences of successive RR intervals [RMSSD] and HRV triangular index [RR tri index]) and in the frequency domain (high frequency [HF]; low frequency [LF] and LF/HF ratio). The HR responses were evaluated at rest, at the peak and at the nadir of the VM (15 seconds). The Valsalva index was also calculated. Results During IC: time domain indices (mean HR increased [P=0.001], RMSSD, and RR tri index decreased [P=0.005 and P=0.005, respectively]); frequency domain indices (LF increased [P=0.033] and HF decreased [P=0.002]); associations were found between forced expiratory volume in 1 second (FEV1) vs RMSSD (P=0.04; r=−0.55), FEV1 vs HR (P=0.04; r=−0.48), forced vital capacity (FVC) vs RMSSD (P=0.05; r=−0.62), maximum inspiratory pressure (MIP) vs HF (P=0.02; r=0.68). FEV1 and FVC justified 30% of mean HR. During VM: HR increased (P=0.01); the nadir showed normal bradycardic response; the Valsalva index was =0.7. Conclusion COPD patients responded properly to the upper limb IC and to the VM; however, HR recovery during VM was impaired in these patients. The severity of the disease and MIP were associated with increased parasympathetic modulation and higher chronotropic response.

Respiratory muscle strength effect on linear and nonlinear heart rate variability parameters in COPD patients

Introduction Chronic obstructive pulmonary disease (COPD) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities, including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders. We investigated whether alterations in respiratory muscle strength (RMS) would affect cardiac autonomic modulation in COPD patients. Methods This study was a cross-sectional study done in ten COPD patients affected by moderate to very severe disease. The heart rate variability (HRV) signal was recorded using a Polar cardiofrequencimeter at rest in the sitting position (10 minutes) and during a respiratory sinus arrhythmia maneuver (RSA-M; 4 minutes). Linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals. RMS was assessed using a digital manometer, which provided the maximum inspiratory pressure (PImax) and the maximum expiratory pressure (PEmax). Results During the RSA-M, patients presented an HRV power increase in the low-frequency band (LFnu) (46.9±23.7 vs 75.8±27.2; P=0.01) and a decrease in the high-frequency band (HFnu) (52.8±23.5 vs 24.0±27.0; P=0.01) when compared to the resting condition. Significant associations were found between RMS and HRV spectral indices: PImax and LFnu (r=−0.74; P=0.01); PImax and HFnu (r=0.74; P=0.01); PEmax and LFnu (r=−0.66; P=0.01); PEmax and HFnu (r=0.66; P=0.03); between PEmax and sample entropy (r=0.83; P<0.01) and between PEmax and approximate entropy (r=0.74; P=0.01). Using a linear regression model, we found that PImax explained 44% of LFnu behavior during the RSA-M. Conclusion COPD patients with impaired RMS presented altered cardiac autonomic control, characterized by marked sympathetic modulation and a reduced parasympathetic response; reduced HRV complexity was observed during the RSA-M.

DNA damage and cellular abnormalities in tuberculosis, lung cancer and chronic obstructive pulmonary disease

BackgroundTuberculosis (TB), Lung Cancer (LC) and Chronic Obstructive Pulmonary Diseases (COPD) affect millions of individuals worldwide. Monitoring of DNA damage in pathological situations has been investigated because it can add a new dimension to clinical expression and may represent a potential target for therapeutic intervention. The aim of this study was to evaluate DNA damage and the frequency of cellular abnormalities in TB, LC and COPD patients by comparing them to healthy subjects.MethodsThe detection of DNA damage by a buccal micronucleus cytome assay was investigated in patients with COPD (n = 28), LC (n = 18) and TB (n = 22) and compared to control individuals (n = 17).ResultsThe COPD group had a higher frequency of apoptotic cells compared to TB and LC group. The TB group showed a higher frequency of DNA damage, defect in cytokinesis, apoptotic and necrotic cells. Patients with LC had low frequency of chromosomal aberrations than TB and COPD patients.ConclusionCOPD patients showed cellular abnormalities that corresponded to cell death by apoptosis and necrosis, while patients with TB presented defects in cytokinesis and dysfunctions in DNA repair that resulted in the formation of micronucleus (MN) besides apoptotic and necrotic cells. Patients with COPD, TB and LC had a low frequency of permanent DNA damage.

Effect of Physical Exercise on the Level of DNA Damage in Chronic Obstructive Pulmonary Disease Patients

This study assessed the chronic effects of physical exercise on the level of DNA damage and the susceptibility to exogenous mutagens in peripheral blood cells of chronic obstructive pulmonary disease (COPD) patients. The case-control study enrolled COPD patients separated into two groups (group of physical exercise (PE-COPD; ); group of nonphysical exercise (COPD; )) and 51 controls. Peripheral blood was used to evaluate DNA damage by comet assay and lipid peroxidation by measurement of thiobarbituric acid reactive species (TBARS). The cytogenetic damage was evaluated by the buccal micronucleus cytome assay. The results showed that the TBARS values were significantly lower in PE-COPD than in COPD group. The residual DNA damage (induced by methyl methanesulphonate alkylating agent) in PE-COPD was similar to the controls group, in contrast to COPD group where it was significantly elevated. COPD group showed elevated frequency of nuclear buds (BUD) and condensed chromatin (CC) in relation to PE-COPD and control groups, which could indicate a deficiency in DNA repair and early apoptosis of the damaged cells. We concluded that the physical exercise for COPD patients leads to significant decrease of lipid peroxidation in blood plasma, decrease of susceptibility to exogenous mutagenic, and better efficiency in DNA repair.

Análise da marcha em portadores de doença pulmonar obstrutiva crônica

INTRODUCTION: Knowledge about gait functional in COPD patients and the identification of the associated variables in these characteristics can support the development of specific approaches in rehabilitation with the objective to maintain the autonomy. OBJECTIVE: To evaluate the gait pattern adopted by COPD patients using a bidimensional analysis. METHOD: Transversal delineation, study of cases, carried through with six patients of COPD, the masculine sex, 64,00 ± 8,07 years of age, index of corporal mass (IMC) 22,28 ± 2,46 kg/m2, forced expiratory volume in the first second (VEF1) 35.17 ± 25.79% predicted, vital capacity forced (CVF) 64.83 ± 17.84% predicted. For kinematic data, we used bidimensional videography Simi Motion, connected was used the camera of digital video. The registers in 60 frames for second and time of acquisition of march cycle. RESULTS: The kinematic data had met varied, since each individual presented overlapping peculiarities the basic standards. One strong negative correlation between cadence and PImax (p = 0,002 and r = - 0,96), between length of step and PEmax was observed (p = 0,007 and r = - 0,93). For the quality of life (SGQR), direct associations had been found, quality of total life (QVT) and percentage of the support phase (p = 0,086 and r = 0,75), and also quality of life impact (QVI) and percentage of the support phase (p = 0,09 and r = 0,74). CONCLUSION: To evaluate the standard of march the DPOC carrier, made possible in them to infer objective on this, possible to delineate therapeutically interventions. The benefits waited with such research, as much for the individual as for the society, it was in a new way to evaluate and to develop the march, basic element for maintenance of functional independence and quality of life.

Fisioterapia na UTI neonatal: as razões médicas utilizadas para prescrição de fisioterapia

Aim: To investigate the criteria by which doctors in a Neonatal Intensive Care Unit prescribe physiotherapy to patients in their care. Methods: Cross-sectional study conducted together with the medical intensive care unit of Hospital Santa Cruz through the application of a structured questionnaire. Results: 8 physicians participated in the study, 06 female and 2 with professional expertise in intensive care. Clinical experience and evidence in the literature were the criteria used for prescribing physiotherapy and respiratory changes the main reason for prescription, followed by motor stimulation. Conclusions: The criteria for prescribing physiotherapy consolidate both in clinical practice and the evidence in the literature, persisting specific clear criteria in neonatal intensive care.

FREQUÊNCIA DE EXACERBAÇÃO EM PACIENTES PORTADORES DE DPOC SUBMETIDOS A UM PROGRAMA DE REABILITAÇÃO PULMONAR

O objetivo deste estudo foi avaliar a frequencia de exacerbacao em pacientes diagnosticados com Doenca Pulmonar Obstrutiva Cronica (DPOC) submetidos em Programa de Reabilitacao Pulmonar (PRP) em hospital de ensino no interior do Rio Grande do Sul. Estudo transversal com 32 pacientes. A coleta de dados ocorreu em outubro de 2015, atraves do sistema computadorizado do hospital e banco de dados do PRP. A amostra foi estratificada em grupos, conforme o tempo de permanencia no PRP: menos de dois meses (G1), de dois a 12 meses (G2) e mais de 12 meses (G3).Verificou-se que 59,4% eram do sexo masculino com idade media de 63,5 anos (± 6,9). No G1, 50% dos pacientes exacerbaram, no G2, 65% e no G3, 37,5%. Os resultados demonstraram que portadores de DPOC que frequentaram o PRP por tempo superior a 12 meses apresentaram menor frequencia e menor intensidade de exacerbacao da doenca. Descritores: Reabilitacao; Doenca Pulmonar Obstrutiva Cronica; Exacerbacao dos Sintomas.

Does peripheral arterial occlusive disease influence muscle strength and exercise capacity in COPD patients

Abstract Background The pathophysiology of chronic obstructive pulmonary disease (COPD) is complex and understanding of it has been changing in recent years, with regard to its multisystemic manifestations, especially peripheral dysfunction and its influence on intolerance to exercise. Objectives To evaluate the relationship between peripheral arterial occlusive disease (PAOD) and peripheral muscle strength and exercise capacity in COPD patients. Methods We conducted a cross-sectional study of 35 patients with COPD who were evaluated with the Ankle-Brachial Index, handgrip strength test, 1 repetition maximum (1RM) of knee extensors and flexors, and distance covered in the incremental shuttle walking test (dISWT). Results COPD patients with coexisting PAOD had lower dominant handgrip strength test results (33.00 vs. 26.66 kgf, p = 0.02) and worse performance in the dISWT (297.32 vs. 219.41 m, p = 0.02) when compared to the COPD patients without PAOD. Strong correlations were found between the result of the handgrip strength test and both the dISWT (r = 0.78; p < 0.001) and the 1RM/knee extension (r = 0.71; p = 0.03); and also between the dISWT and both the 1RM/knee extension (r = 0.72; p = 0.02) and the 1RM/knee flexion (r = 0.92; p < 0.001). The linear regression model showed that the dISWT variable alone explains 15.3% of the Ankle-Brachial Index result (p = 0.01). Conclusion COPD patients with PAOD exhibit reduced muscle strength and lower exercise capacity than COPD patients without PAOD.