Consumption, nicotine dependence and motivation for smoke cessation during early stages of COVID-19 pandemic in Brazil: A cross-sectional study.

INTRODUCTION: The COVID-19 pandemic may have changed smoking habits. For the smoking population, information regarding smoking habits and the pandemic could potentially aid COVID-19 prevention and control measures. Our study aimed to analyze the effects of the COVID-19 pandemic on tobacco consumption, nicotine dependence levels, and motivation for smoking cessation. We also collected information from smokers regarding their awareness of the consequences of tobacco use and the increased risks smokers have for severe complications from COVID-19. METHODS: In the survey for this observational cross-sectional study, 122 smokers responded to an online form. The participants provided general data about their smoking history, their smoking habits in the months of April and May 2020, and the effect of the pandemic on their smoking habits. They also completed a Fagerström test and were measured by the Wisconsin Smoking Withdrawal Scale. RESULTS: When compared to pre-pandemic levels, the majority of smokers reported increased tobacco consumption of between 1 and 10 cigarettes per day (37.7%). Their motivation to quit smoking (59.8%) and desire to smoke (53.2%) were unchanged by the pandemic. Most participants demonstrated an awareness of the increased risks smokers have for severe COVID-19-related complications (p<0.001). We identified the following correlations: cigarettes/day before pandemic and motivation for smoking cessation (r=0.19; p=0.030), cigarettes/day and nicotine dependence level (r=0.61; p<0.001), and load consumption and nicotine dependence level (r=0.69; p<0.001). No significant correlations were observed between load consumption and motivation to quit (r=0.13; p=0.120). CONCLUSIONS: Most smokers are well aware of their increased risks for severe COVID-19-related complications. In the early stages of the COVID-19 pandemic in Brazil, most smokers reported increased cigarette consumption. In addition, motivation to quit and desire to smoke were unchanged for the majority of smokers.

Resistance Training With Elastic Tubing Improves Muscle Strength, Exercise Capacity, and Post-Exercise Creatine Kinase Clearance in Subjects With COPD.

BACKGROUND: Among the types of physical exercise, resistance exercises have been gaining significant attention in the COPD population. The aim of this study was to compare effects of conventional resistance training and of training by using elastic tubes on muscle strength, exercise capacity, and creatine kinase clearance in subjects with COPD. METHODS: Twenty-eight subjects with COPD were randomized into the following: resistance training with the elastic tubing group and resistance training with the weight-machine training group (conventional resistance group), performed 3 times a week for 12 weeks. The subjects were submitted to spirometry, functional exercise capacity (the 6-min walk test), muscle strength (dynamometry), and the repetition maximum test. Differences between the initial and final evaluations (Δ) and the (final - initial evaluations)/initial evaluations ×100 (Δ%) of each group were expressed as mean [95% CI]. RESULTS: Nineteen subjects (FEV1 % predicted, 52 ± 18; years, 65 ± 8) completed the training program. Similar improvements were observed in both modalities on muscle strength (knee extension, Δ%18 [6 to 29]; knee flexion, Δ%35 [17 to 54]; elbow flexion, Δ%28 [9 to 48]; shoulder abduction, Δ%41 [25 to 58] and shoulder flexion, Δ%31 [11 to 51] in the weight-machine training group (conventional resistance group); knee extension, Δ%15 [8 to 21]; knee flexion, Δ%28 [15 to 41]; elbow flexion, Δ%36 [22 to 51]; and shoulder abduction, Δ%43 [32 to 55] and shoulder flexion, Δ%43 [25 to 61] in the elastic tubing group, P < .05 for intra-group analysis and P > .05 for between groups analysis), 6-min walk test (baseline 493 ± 67m vs 12 weeks 526 ± 78 in the weight-machine training group (P = .10); baseline 493 ± 71 vs 12 weeks 524 ± 68 in the elastic tubing group (P < .01), P = .88 between groups). The elastic tubing group had lower accumulated creatine kinase levels between 24 and 72 h ((Δ%-24 [-31 to 16] than subjects in the weight-machine training group Δ%3 [-21 to 28], P = .042 between the groups. CONCLUSIONS: Training with elastic resistance provided similar changes in muscle strength and exercise capacity to conventional resistance group in the subjects with COPD. The elastic tubing group had faster creatine kinase clearance after a training session than the weight-machine training group (conventional resistance group). The ease of its application associated with similar training benefits to conventional training supported its application in clinical routine.

Função pulmonar e depuração mucociliar nasal de cortadores de cana-de-açúcar brasileiros expostos à queima de biomassa / Lung function and nasal mucociliary clearance in Brazilian sugarcane cutters exposed to biomass burning

Resumo Objetivos: avaliar a função pulmonar e a depuração mucociliar nasal de cortadores de cana-de-açúcar. Métodos: foram avaliados dezesseis cortadores de cana-de-açúcar em dois períodos: durante o plantio da cana-de-açúcar, em abril/2011, e no final da safra, no período de queima e colheita manual da cana-de-açúcar, outubro/2011. A função pulmonar e a depuração mucociliar foram avaliadas por meio da espirometria e do teste de tempo de trânsito da sacarina (TTS), respectivamente. Resultados: a função pulmonar apresentou diminuição no %FEF25-75 [99,31 (23,79) até 86,36 (27,41); p = 0,001]; %VEF1 [92,19 (13,24) até 90,44 (12,76); p = 0,022] e VEF1/CVF [88,62 (5.68) até 84,90 (6.47); p = 0,004] no período da colheita em comparação ao de plantio. Também houve uma diminuição significativa no resultado do teste do TTS na colheita [3 (1) min] em comparação ao plantio [8 (3) min] (p < 0,001). Conclusão: os cortadores de cana-de-açúcar apresentaram diminuição do %FEF25-75, %VEF1, do índice VEF1/CVF, e aumento da velocidade do transporte mucociliar nasal no final do período de colheita.

Abstract 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 %FEF25-75 [99.31 (23.79) to 86.36 (27.41); p = 0.001]; %FEV1 [92.19 (13.24) to 90.44 (12.76); p = 0.022]; and FEV1/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 %FEF25-75, %FEV1, FEV1/FVC ratio, and increase in nasal mucociliary transport velocity at the end of the harvest season.

Influence of Time and Frequency of Passive Smoking Exposure on Mucociliary Clearance and the Autonomic Nervous System.

BACKGROUND: There are still gaps in the knowledge regarding the damage to mucociliary and autonomous systems from passive exposure to cigarette smoke. Also, the influence of the frequency and duration of exposure on these systems is still unclear. The objective of this work was to verify the effects of passive smoking on mucociliary clearance and adult autonomic nervous systems and investigate the influence of frequency and time of passive exposure on these systems. METHODS: 44 smokers (smoking group), 38 passive smokers (passive smoking group), and 38 healthy individuals (control group) were evaluated. Evaluation of lung function was performed. To analyze the autonomic nervous system, heart rate variability data were collected. Hemodynamic parameters were collected. Mucociliary clearance was evaluated using the saccharin transit time test. RESULTS: The passive smoking group presented reduced lung function (P = .02). Systolic blood pressure was significantly greater in the passive smoking group when compared with the smoking group (P = .02). The passive smoking group presented significantly slower transportability time than the control group. No differences were observed between the groups for the heart rate variability data. There was a significant correlation (P < .05) between the frequency of exposure and diastolic blood pressure, oxygen saturation, and FEF(25-75%). Correlation analyses also demonstrated a reduction of global autonomic activity according to exposure load, in addition to a reduction in vagal activity and an increase in sympathetic activity according to exposure frequency. CONCLUSIONS: Passive smokers presented worse mucociliary clearance, and there was a correlation between passive exposure load and damage to the hemodynamic response, pulmonary function and autonomic nervous system.

Efeito agudo do exercício aeróbio em diferentes intensidades no transporte mucociliar de pacientes com DPOC / Acute effect of aerobic exercise in different intensities in mucociliary clearance of patients with COPD

Experimental. Objetivo(s) do estudo: Analisar o efeito agudo do exercício aeróbio em diferentes intensidades no transporte mucociliar de pacientes com DPOC, bem como investigar possíveis associações do sistema nervoso autônomo nesta resposta. Metodologia: Foram analisados 22 pacientes com DPOC que realizaram avaliação inicial para coleta de dados pessoais e espirometria a fim de avaliar a função pulmonar. Realizou-se um teste progressivo em esteira ergométrica para prescrição do exercício aeróbio. Por fim foram realizadas duas sessões de exercício aeróbio randomizadas em esteira ergométrica com intensidade de 60% e 90% do pico da velocidade atingida no teste incremental(vVO2 pico) com pelo menos 24 horas de descanso entre elas. O transporte mucociliar foi avaliado antes e após realização do exercício por meio do teste do tempo de trânsito da sacarina (TTS). A avaliação da modulação autonômica foi realizada por meio da variabilidade da frequência cardíaca (VFC) a qual prosseguiu durante todo o protocolo. Resultados: Os valores obtidos no teste de TTS dos pacientes com DPOC após exercício aeróbio a 60% da vVO2 pico (9,08 ± 4,96 minutos) foi menor comparado ao TTS antes do exercício (11,96 ± 6,31; p = 0,005). O que também ocorreu após exercício aeróbio a 90% da vVO2pico (8,90 ± 4,21 minutos) quando comparado ao momento basal (12,94 ± 7,22; p = 0,023). As análises de correlação entre os valores finais de TTS e índices da VFC não apontaram diferenças significativas.Conclusões: Pacientes com DPOC apresentaram aceleração da transportabilidade mucociliar frente a uma sessão de exercício aeróbio. Não foi possível observar associação da modulação autonômica nesta resposta após o exercício...

Design of the Study: Clinical Trial. Objective (s): To analyze the acute effect of aerobic exercise at different intensities in mucociliary clearance in patients with COPD, and to investigate possible associations of the autonomic nervous system in this response. Methods: 22 COPD patients underwent an initial evaluation for collecting personal data and spirometry to assess lung function. It was performed a progressive treadmill test for aerobic exercise prescription. Finally two randomized sessions of aerobic exercise with intensity of 60 % and 90 % of peak speed reached during the incremental test ( vVO2 peack ) were performed with at least 24 hours of rest between them. The mucociliary clerance was assessed before and after the exercise sessions by testing the saccharin transit time (STT). Assessment of autonomic modulation was performed by heart rate variability (HRV) which continued throughout the protocol. Results:The values obtained in the STT test after aerobic exercise at 60 % of vVO2 peack (9,08 minutes ± 4,96 ) was lower when compared to the STT before exercise ( 11,96 ± 6,31, p = 0,005 ) . That response also occurred after aerobic exercise at 90% of vVO2 peack ( 8,90 ± 4,21 min ) compared to baseline ( 12,94± 7,22 , p = 0,023 ). Correlation analysis between the final values of STT test and HRV indexes did not show significant differences. Conclusions: Patients with COPD showed acceleration of mucociliary clerance right after a session of aerobic exercise. It was not possible to observe the association of autonomic modulation in this response...

Correlation between heart rate variability indexes and aerobic physiological variables in patients with COPD.

BACKGROUND AND OBJECTIVE: Previous studies have shown a relationship between the level of physical fitness and autonomic variables. However, these relationships have not been investigated in patients with chronic obstructive pulmonary disease (COPD). The objective of this study was to correlate the resting heart rate variability (HRV) indexes with aerobic physiological variables obtained at a maximal exercise test in patients with COPD. METHODS: Thirty-seven patients with COPD (63 (59-70) years; 46 (35.4-63.7) forced expiratory volume in 1 s (FEV1)%) underwent assessment of autonomic modulation at rest for 20 min to determine the HRV indexes in time and frequency domains. Soon after that, the patients performed an incremental exercise test to determine the anaerobic threshold (GET), the peak oxygen uptake (VO 2PEAK) and the velocity corresponding to VO 2PEAK (vVO 2PEAK). RESULTS: The indexes that express parasympathetic component as RMSSD (11.4 [7.5-23.8], HF (ms(2)) (35 [17-195] and SD1 (8.1 [5.3-16.8]), correlated with GET (r = 0.39; r = 0.43; r = 0.39 respectively). The indexes that represent the overall variability, SDNN (19.5 [13.9-28.8]), LF (ms(2)) (111 [38-229]), and SD2 (26.8 [18.6-35.4]) correlated with vVO 2PEAK (r = 0.37; r = 0.38; r = 0.37; r = 0.44; r = 0.43; r = 0.46 respectively). Likewise, the indexes LF (ms(2)), LF (nu) (63.2 [46-77,9]), HF (nu) (36.8 [22.1-54]), and LF/HF (1.7 [0.9-3.5]) correlated with VO 2PEAK (r = 0.35; r = 0.35; r = -0.35; r = 0.40 respectively). CONCLUSIONS: This study demonstrated that HRV indexes at rest may become a predictive tool for aerobic capacity in COPD patients after the development of more consistent methods.