Drug combinations identified by high-throughput screening promote cell cycle transition and upregulate Smad pathways in myeloma.

Drug resistance and disease progression are common in multiple myeloma (MM) patients, underscoring the need for new therapeutic combinations. A high-throughput drug screen in 47 MM cell lines and in silico Huber robust regression analysis of drug responses revealed 43 potentially synergistic combinations. We hypothesized that effective combinations would reduce MYC expression and enhance p16 activity. Six combinations cooperatively reduced MYC protein, frequently over-expressed in MM and also cooperatively increased p16 expression, frequently downregulated in MM. Synergistic reductions in viability were observed with top combinations in proteasome inhibitor-resistant and sensitive MM cell lines, while sparing fibroblasts. Three combinations significantly prolonged survival in a transplantable Ras-driven allograft model of advanced MM closely recapitulating high-risk/refractory myeloma in humans and reduced viability of ex vivo treated patient cells. Common genetic pathways similarly downregulated by these combinations promoted cell cycle transition, whereas pathways most upregulated were involved in TGFß/SMAD signaling. These preclinical data identify potentially useful drug combinations for evaluation in drug-resistant MM and reveal potential mechanisms of combined drug sensitivity.

Morphology of coat and skin of small ruminants reared in the Brazilian semi-arid region.

The structure of the coat and integument of small ruminants reared in semi-arid regions have valuable characteristics that favor their adaptation to the region. The objective of this study was to evaluate the structural characteristics of the coat and integument and sweating capacity of goats and sheep in the Brazilian semi-arid region, using 20 animals, 10 of each breed, 5 males and 5 females of each species, grouped in a completely randomized design in a 2 x 2 factorial scheme (2 species and 2 genders) with 5 replicates. The animals were already being kept under the influence of high temperatures and levels of direct solar radiation before the day of the collections. At the time of the evaluations, ambient temperature was high, with low relative humidity. The pattern of epidermal thickness and sweat glands per body region was superior in sheep (P < 0.05), and the number of hair follicles and sweat rate were similar (P > 0.05) between the species. There was no difference (P > 0.05) in the evaluated characteristics between the genders, showing that they are not influenced by hormones. The morphology of the coat and skin of these animals showed a superiority of goats compared to sheep.

Modeling the resilience of urban mobility when exposed to the COVID-19 pandemic: A qualitative system dynamics approach.

In December 2019, coronavirus disease (COVID-19) was detected in Wuhan, China. Due to the rapid spread of the disease, containment measures were adopted, which caused unprecedent shifts in individual mobility. Although some studies explored the impacts of the COVID-19 pandemic on travel patterns and resilience of transport systems based on different analysis techniques, there is a lack of studies addressing the impacts of the pandemic on the sustainability and resilience of urban mobility systems using in-depth and holistic methods, such as system dynamics. This research aims to characterize the dynamics present in urban mobility systems when exposed to pandemics and analyze the changes needed for systems to increase their resilience to pandemics using qualitative system dynamics modeling. The framework comprises the characterization of cause-and-effect relationships and the creation of systems' causal loop diagrams (CLD) in their basic state of functionality, when affected by pandemics, and still operating owing to its resilience. Our findings indicated that the CLD of a resilient system is driven by strategic preparedness and response plans, as well as research and development, which balance the spread of the pandemic and increase support on technological strengths and the activities performed from home.

Cyclists' noise exposure in a Brazilian medium-sized city. / Exposição de ciclistas ao ruído em uma cidade média brasileira.

This study aimed to assess cyclists' exposure to noise in a medium-sized Brazilian city. Mobile sensors were used to conduct noise measurements in streets with and without dedicated cycling infrastructures. The method can be summarized in the following procedures: i) characterization of the study area; ii) data collection and validation; iii) calculation of exposure indicators; and iv) comparison and representation of the results on maps. Two strategies were adopted for the analysis, namely, spatial data aggregation and temporal data aggregation. Thus, measurements were initially organized in 1,200 nodes distributed along the paths. The results indicate that bicycle riders in São Carlos may be exposed, in some routes, to a high proportion of high noise-level segments. In the two routes selected for this study, the cyclist was exposed to noise levels above the adopted threshold (> 75dBA) in 33.2% and 18.9% of the nodes. Also, the possibility of simultaneously working with two related indicators has broadened the classification criteria of the route segments regarding noise exposure.

O objetivo deste estudo foi avaliar a exposição dos ciclistas ao ruído em uma cidade média brasileira. Um sensor móvel foi utilizado para as medições de ruído em ruas com e sem infraestruturas cicloviárias segregadas. O método proposto contempla as seguintes etapas: i) caracterização da área de estudo; ii) coleta e validação de dados; iii) cálculo dos indicadores de exposição; e iv) comparação e representação de resultados em mapas. Dois tipos de análises foram realizadas, por agregação espacial e por agregação temporal. Para isto, as medições foram inicialmente organizadas em 1.200 nós distribuídos nos percursos considerados. Os resultados apontam que os ciclistas que percorrem alguns trechos na cidade de São Carlos podem estar expostos a uma proporção considerável de ambientes com altos níveis de ruído. Nos dois trechos selecionados para este estudo, o ciclista esteve exposto à níveis acima do valor adotado (> 75dBA) em 33,2% e 18,9% dos nós. Além disso, observou-se que a possibilidade de trabalhar concomitantemente dois indicadores relacionados amplia os critérios de classificação dos trechos quanto à exposição do ruído.

Exposição de ciclistas ao ruído em uma cidade média brasileira / Cyclists noise exposure in a Brazilian medium-sized city

Resumo O objetivo deste estudo foi avaliar a exposição dos ciclistas ao ruído em uma cidade média brasileira. Um sensor móvel foi utilizado para as medições de ruído em ruas com e sem infraestruturas cicloviárias segregadas. O método proposto contempla as seguintes etapas: i) caracterização da área de estudo; ii) coleta e validação de dados; iii) cálculo dos indicadores de exposição; e iv) comparação e representação de resultados em mapas. Dois tipos de análises foram realizadas, por agregação espacial e por agregação temporal. Para isto, as medições foram inicialmente organizadas em 1.200 nós distribuídos nos percursos considerados. Os resultados apontam que os ciclistas que percorrem alguns trechos na cidade de São Carlos podem estar expostos a uma proporção considerável de ambientes com altos níveis de ruído. Nos dois trechos selecionados para este estudo, o ciclista esteve exposto à níveis acima do valor adotado (> 75dBA) em 33,2% e 18,9% dos nós. Além disso, observou-se que a possibilidade de trabalhar concomitantemente dois indicadores relacionados amplia os critérios de classificação dos trechos quanto à exposição do ruído.

Abstract This study aimed to assess cyclists' exposure to noise in a medium-sized Brazilian city. Mobile sensors were used to conduct noise measurements in streets with and without dedicated cycling infrastructures. The method can be summarized in the following procedures: i) characterization of the study area; ii) data collection and validation; iii) calculation of exposure indicators; and iv) comparison and representation of the results on maps. Two strategies were adopted for the analysis, namely, spatial data aggregation and temporal data aggregation. Thus, measurements were initially organized in 1,200 nodes distributed along the paths. The results indicate that bicycle riders in São Carlos may be exposed, in some routes, to a high proportion of high noise-level segments. In the two routes selected for this study, the cyclist was exposed to noise levels above the adopted threshold (> 75dBA) in 33.2% and 18.9% of the nodes. Also, the possibility of simultaneously working with two related indicators has broadened the classification criteria of the route segments regarding noise exposure.

Sexual addiction in drug addicts: The impact of drug of choice and poly-addiction.

OBJECTIVE:: To compare the risk of comorbid sexual addiction in a sample of individuals with a diagnosis of substance dependence, stratifying the sample by drug of choice as well as by mono versus polysubstance addiction. METHOD:: All data were collected at Santa Casa de São Paulo, Brazil. The study sample comprised all alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014. A generalized linear model with a binomial distribution was performed to compare the odds of having a Sexual Addiction Screening Test (SAST) score greater than 6 points in the subgroups analyzed. RESULTS:: A total of 133 participants were included in our analysis, all reporting cocaine/crack and/or alcohol as drug of choice. Polysubstance addicts had a significant higher risk of a positive screening for sexual addiction compared to monosubstance addicts, age-sex adjusted odds ratios of sexual addiction being respectively 2.72 (95CI 1.1-6.71) and 0.37 (95CI 0.15-0.91). The odds of a SAST score greater than 6 was not statistically different between the cocaine/crack and alcohol groups, respectively 0.38 (95CI 0.14-1.02) and 2.67 (95CI 0.98-7.25). We found a significant relation between stronger drug addiction and greater levels of sexual addiction in the cocaine/crack group (p=0.0012), but not in the alcohol group. CONCLUSION:: Our study reinforces the importance of assessing sexual behavior of drug addicts in clinical practice, especially considering users of multiple substances or with severe dependence.

Sexual addiction in drug addicts: The impact of drug of choice and poly-addiction / Dependência sexual em dependentes químicos: o impacto de diferentes drogas de escolha e de polidependência

Summary Objective: To compare the risk of comorbid sexual addiction in a sample of individuals with a diagnosis of substance dependence, stratifying the sample by drug of choice as well as by mono versus polysubstance addiction. Method: All data were collected at Santa Casa de São Paulo, Brazil. The study sample comprised all alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014. A generalized linear model with a binomial distribution was performed to compare the odds of having a Sexual Addiction Screening Test (SAST) score greater than 6 points in the subgroups analyzed. Results: A total of 133 participants were included in our analysis, all reporting cocaine/crack and/or alcohol as drug of choice. Polysubstance addicts had a significant higher risk of a positive screening for sexual addiction compared to monosubstance addicts, age-sex adjusted odds ratios of sexual addiction being respectively 2.72 (95CI 1.1-6.71) and 0.37 (95CI 0.15-0.91). The odds of a SAST score greater than 6 was not statistically different between the cocaine/crack and alcohol groups, respectively 0.38 (95CI 0.14-1.02) and 2.67 (95CI 0.98-7.25). We found a significant relation between stronger drug addiction and greater levels of sexual addiction in the cocaine/crack group (p=0.0012), but not in the alcohol group. Conclusion: Our study reinforces the importance of assessing sexual behavior of drug addicts in clinical practice, especially considering users of multiple substances or with severe dependence.

Resumo Objetivo: Comparar o risco de dependência sexual em uma amostra de indivíduos com diagnóstico de dependência química, estratificados por droga de escolha e por dependência única ou de múltiplas substâncias. Método: Todos os dados foram coletados na Santa Casa de São Paulo, Brasil. A amostra estudada correspondeu a todos os indivíduos dependentes de álcool ou outras substâncias admitidos no Ambulatório de Dependência Química entre novembro de 2013 e agosto de 2014. Modelos lineares generalizados com distribuição binomial foram utilizados para comparar o risco de escores maiores que seis na Escala de Rastreamento para Dependência de Sexo (SAST) nos subgrupos analisados. Resultados: Foram analisados os dados de 133 pacientes usuários de cocaína/crack e/ou álcool. Usuários de múltiplas substâncias apresentaram risco significativamente maior de um screening positivo para dependência sexual comparados com usuários de uma única substância. Os odds ratios de dependência sexual ajustados por sexo e idade obtidos nos dois grupos foram, respectivamente, 2.72 (IC95% 1.1-6.71) e 0.37 (IC95% 0.15-0.91). O risco de dependência sexual entre usuários de cocaína/crack e álcool foi estimado, respectivamente, em 0.38 (IC95% 0.14-1.02) e 2.67 (IC95% 0.98-7.25), não indicando diferença significativa. Foi encontrada uma relação significativa entre severidade de dependência química e maiores níveis de dependência sexual entre dependentes de cocaína/crack, mas não de álcool. Conclusão: Nosso estudo reforça a importância de avaliar o comportamento sexual de dependentes químicos na prática clínica, especialmente considerando usuários de múltiplas substâncias, ou casos de maior severidade.

Uterine Microbiota Progression from Calving until Establishment of Metritis in Dairy Cows.

The objective of this study was to evaluate the progression of the uterine microbiota from calving until establishment of metritis. Uterine swabs (n = 72) collected at 0, 2, and 6 ± 2 days postpartum (dpp) from 12 metritic and 12 healthy cows were used for metagenomic sequencing of the 16S rRNA gene on the Illumina MiSeq platform. A heat map showed that uterine microbiota was established at calving. The microbiota changed rapidly from 0 to 6 ± 2 dpp, with a decrease in the abundance of Proteobacteria and an increase in the abundance of Bacteroidetes and Fusobacteria, which were dominant in metritic cows. Uterine microbiota composition was shared; however, metritic and healthy cows could be discriminated using relative abundance of bacterial genera at 0, 2, and 6 ± 2 dpp. Bacteroides was the main genus associated with metritis because it was the only genus that showed significantly greater abundance in cows with metritis. As the abundance of Bacteroides organisms increased, the uterine discharge score, a measure of uterine health, worsened. Fusobacterium was also an important genus associated with metritis because Fusobacterium abundance increased as Bacteroides abundance increased and the uterine discharge score worsened as the abundance increased. The correlation with uterine discharge score and the correlation with Bacteroides or Fusobacterium showed that other bacteria, such as Helcoccocus, Filifactor, and Porphyromonas, were also associated with metritis. There were also bacteria associated with uterine health, such as "Candidatus Blochmannia," Escherichia, Sneathia, and Pedobacter.

A decision-support tool for the control of urban noise pollution.

Improving the quality of life is increasingly seen as an important urban planning goal. In order to reach it, various tools are being developed to mitigate the negative impacts of human activities on society. This paper develops a methodology for quantifying the population's exposure to noise, by proposing a classification of urban blocks. Taking into account the vehicular flow and traffic composition of the surroundings of urban blocks, we generated a noise map by applying a computational simulation. The urban blocks were classified according to their noise range and then the population was estimated for each urban block, by a process which was based on the census tract and the constructed area of the blocks. The acoustical classes of urban blocks and the number of inhabitants per block were compared, so that the population exposed to noise levels above 65 dB(A) could be estimated, which is the highest limit established by legislation. As a result, we developed a map of the study area, so that urban blocks that should be priority targets for noise mitigation actions can be quickly identified.

Ferramenta de apoio à decisão para o controle da poluição sonora urbana / A decision-support tool for the control of urban noise pollution

Resumo Com a preocupação cada vez maior em atingir uma melhor qualidade de vida nos centros urbanos, várias ferramentas são disponibilizadas a fim de nortear ações e planos para minimizar ou mitigar os impactos nocivos à população. Este trabalho procura contribuir com uma metodologia de quantificação da população exposta ao ruído, por meio de uma classificação da poluição sonora urbana. A partir da contagem de fluxo de veículos e composição de tráfego ao redor de quadras urbanas, foi gerado um mapa de ruído por simulação computacional. As quadras urbanas foram classificadas quanto à faixa de ruído e sua população foi estimada com base nos setores censitários e na metragem de área construída. Os dados de classes acústicas de quadras e número de moradores por quadra foram comparados, permitindo estimar a população exposta a níveis de ruído acima de 65 dB(A), limite superior ao estabelecido pela legislação. Como resultado, foi possível desenvolver um mapa da área de estudo que permite rápida identificação de quadras prioritárias para ações de mitigação ao ruído.

Abstract Improving the quality of life is increasingly seen as an important urban planning goal. In order to reach it, various tools are being developed to mitigate the negative impacts of human activities on society. This paper develops a methodology for quantifying the population's exposure to noise, by proposing a classification of urban blocks. Taking into account the vehicular flow and traffic composition of the surroundings of urban blocks, we generated a noise map by applying a computational simulation. The urban blocks were classified according to their noise range and then the population was estimated for each urban block, by a process which was based on the census tract and the constructed area of the blocks. The acoustical classes of urban blocks and the number of inhabitants per block were compared, so that the population exposed to noise levels above 65 dB(A) could be estimated, which is the highest limit established by legislation. As a result, we developed a map of the study area, so that urban blocks that should be priority targets for noise mitigation actions can be quickly identified.

Rectal temperatures, respiratory rates, production, and reproduction performances of crossbred Girolando cows under heat stress in northeastern Brazil.

This study compared the two breed groups of Girolando (½ Holstein ½ Gyr vs. ¾ Holstein » Gyr) through analysis of the percentages (stressed or non-stressed cows) of rectal temperature (RT), respiratory rate (RR) and pregnancy rate (PR), and means of production and reproduction parameters to determine the group best suited to rearing in semiarid tropical climate. The experiment was conducted at the farm, in the municipality of Umirim, State of Ceará, Brazil. Two hundred and forty cows were used in a 2 × 2 factorial study; 120 of each group were kept under an intensive system during wet and dry seasons. The environmental parameters obtained were relative humidity (RH), air temperature (AT), and the temperature and humidity index (THI). Pregnancy diagnosis (PD) was determined by ultrasonography 30 days after artificial insemination (AI). The milk production of each cow was recorded with automated milkings in the farm. The variables were expressed as mean and standard error, evaluated by ANOVA at 5% probability using the GLM procedure of SAS. Chi-square test at 5% probability was applied to data of RT, RR, pregnancy rate (PR), and the number of AIs to obtain pregnancy. The majority of ½ Holstein cows showed mean values of RT and RR within the normal range in both periods and shifts. Most animals of the ¾ Holstein group exhibited the RR means above normal during the afternoon in the rainy and dry periods and RT means above normal during the afternoon in the dry period. After analyses, ½ Holstein crossbred cows are more capable of thermoregulating than ¾ Holstein cows under conditions of thermal stress, and the dry period was more impacting for bovine physiology with significant changes in physiological parameters, even for the first breed group. Knowledge of breed groups adapted to climatic conditions of northeastern Brazil can directly assist cattle farmers in selecting animals best adapted for forming herds.

Perfil hematológico de cabras Saanen e mestiças (1/2 Saanen e 1/2 Anglo-nubiana) criadas em clima tropical do Ceará / Hematological profile of Saanen and mixed-breed (1/2 Saanen x 1/2 Anglo-Nubian) raised in the tropical climate of Ceará, Brazil

Objetivou-se verificar a influência das condições climáticas sobre o perfil hematológico de cabras Saanen e mestiça (1/2 Saanen x 1/2 Anglo-nubiana), bem como determinar valores de referência para esses animais criados no Ceará. Foram utilizadas 30 cabras que tiveram o sangue coletado mensalmente durante a época chuvosa (fevereiro a maio) e seca (agosto a novembro) para realização do eritrograma e leucograma. As médias foram comparadas pelo teste t-Student e Mann Whitney, quando constatada distribuição paramétrica e não paramétrica dos dados, respectivamente, com significância quando p<0,05. Procedeu-se ainda um estudo de correlações simples de Pearson dos parâmetros hematológicos com variáveis ambientais e fisiológicas. O número de hemácias foi maior em cabras Saanen e na época chuvosa, enquanto que o hematócrito foi maior na época seca (p<0,05). Os leucócitos e linfócitos foram maiores em cabras mestiças nas duas épocas (p<0,05). Nos dois genótipos, os leucócitos e linfócitos foram maiores na época seca e os neutrófilos segmentados maiores na época chuvosa (p<0,05). Os demais parâmetros não diferiram (p>0,05). As hemácias e neutrófilos segmentados apresentaram uma correlação negativa com a temperatura ambiente, porém positiva com a umidade do ar e a temperatura retal (p<0,05). O hematócrito correlacionou-se positivamente com a temperatura ambiente e frequência respiratória (p<0,05). Os leucócitos e linfócitos mostraram uma correlação negativa com a temperatura retal (p<0,05). Conclui-se, portanto, que fêmeas Saanen sofrem mais influência das variações climáticas e a época chuvosa tem maior impacto negativo sobre os parâmetros hematológicos. Os valores obtidos poderão servir como referência para esses genótipos no Ceará...

The aim of this study was to determine the influence of climatic conditions on the hematological profile of Saanen and mixed-breed (1/2 Saanen x 1/2 Anglo-Nubian) goats, as well as to define reference values for these animals bred in Ceará, Brazil. Thirty goats were utilized and blood samples were collected monthly during the rainy (February to May) and dry (August to November) periods to obtain an erythrogram a leukogram. The averange were compared by the t-Student test and Mann Whitney test, with parametric and non-parametric distribution of the data, respectively, where p<0.05 was considered significant. A study was carried out of simple Pearson correlations of the hematological parameters with environmental and physiological variables. The number of red blood cells (RBCs) was higher in the Saanen goats and in the rainy period, while the hematocrit was higher in the dry period (p<0.05). The leukocytes and lymphocytes were higher in the 1/2S1/2AN goats in the two periods (p<0.05). In the two genotypes, the leukocytes and lymphocytes were higher in the dry season and the segmented neutrophils higher in the rainy season (p<0.05). The other parameters did not differ (p>0.05). The RBCs and segmented neutrophils displayed a negative correlation with air temperature, but positive with relative humidity and rectal temperature (p<0.05). The hematocrit positively correlated with air temperature and respiratory rate (p<0.05). The leukocytes and lymphocytes showed a negative correlation with rectal temperature (p<0.05). It was therefore concluded that Saanen females are more affected by climatic variations and that the rainy season has a greater negative impact on hematological parameters. The values obtained could serve as a reference for these genotypes in Ceará...

Hormonal profiles, physiological parameters, and productive and reproductive performances of Girolando cows in the state of Ceará-Brazil.

This study compared two breed groups of Girolando (½ Holstein ½ Gyr vs. ¾ Holstein » Gyr) through analysis of physiological, productive, and reproductive parameters to determine the group best suited to rearing in a semiarid tropical climate. The experiment was conducted at the Companhia de Alimentos do Nordeste (CIALNE) farm, in the municipality of Umirim, State of Ceará, Brazil. Eighty cows were used in a 2 × 2 factorial study; 40 of each breed group were kept under an extensive system during the wet season and an intensive system during the dry season. The collection of physiological data and blood samples were obtained in the afternoon after milking. Rectal temperature (RT), surface temperature (ST), and respiratory rate (RR) were obtained for each cow after milking. Blood samples were obtained by tail vein puncture and were determined triiodothyronine (T3) and thyroxine (T4) and cortisol. The environmental parameters obtained were relative humidity (RH) and air temperature (AT), and from these, a temperature and humidity index (THI) was calculated. Pregnancy diagnosis (PD) was determined by ultrasonography 30 days after artificial insemination (AI). The milk production of each cow was recorded with automated milkings in the farm. The variables were expressed as mean and standard error, evaluated by ANOVA at 5% probability using the Proc GLM of SAS. Chi-square test at 5% probability was applied to data of pregnancy rate (PR) and the number of AI's to obtain pregnancy. It can be concluded that the breed group ½ Holstein ½ Gyr is most suited for farming under conditions of thermal stress.

Physiological and production response of dairy goats bred in a tropical climate.

The aim of this work was to determine the adaptability of Saanen and ½Saanen × ½Anglo-Nubian (½S½AN) goats bred in tropical climates. The study included 30 goats, 15 Saanen and 15 ½S½AN. The data was collected during the rainy and dry seasons. During the whole experimental period, the environment variables were recorded, as well as rectal temperature (RT), superficial temperature (ST), respiratory rate (RR) and heart rate (HR) and milk production (MP). The adaptability coefficient (AC) was calculated for both genotypes. The averages were evaluated by ANOVA at 5% probability. There was a genotype and period of year effect, as well as the interaction genotype × period of year. Pearson's simple correlation analysis was then carried out between milk production and physiological and environment variables. There was a statistical difference (p < 0.05) between the seasons for RT, ST and RR. RT, RR and HR were lower for ½S½AN than Saanen goats, regardless of the season. MP was greater in the dry season (p < 0.05) (2.52 ± 0.50 kg/day for ½S½AN and 2.41 ± 0.38 kg/day for Saanen) than the rainy season (2.17 ± 0.27 kg/day for ½S½AN and 2.28 ± 0.53 kg/day for Saanen). The MP correlations were very significant (p < 0.05), however low and negative, where it was higher when correlated with RR in Saanen goats. Under the conditions of the present study, it is concluded that the goats were influenced by climatic factors, where the rainy period was more likely to cause thermal stress in the animals.

Testes de funçäo ventilatória e obesidade / Ventilatory function and obesity tests

Com a finalidade de conhecer o comportamento das provas funcionais respiratórias nos pacientes obesos, os autores as realizaram em 86 pacientes, sendo 31 homens e 55 mulheres, que foram separados de acordo com o peso, em obesidade mórbida e näo-mórbida. A idade dos pacientes era de 30ñ15 anos e o peso de 84.0ñ17,2 kg, com IMC médio de 31.5. Todos realizaram provas funcionais quando da internaçäo, e consideramos neste estudo, a capacidade vital forçada, o volume expiratório forçado e a ventilaçäo voluntária máxima. Os pacientes com obesidade mórbida apresentaram, em média, valores menores de ventilaçäo voluntária máxima quando comparados com os obesos näo-mórbidos, caracterizando entäo uma alteraçäo restritiva, com p = 0.024.