Brazilian Thoracic Association Consensus on Sleep-disordered Breathing.

Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea.

Update on the approach to smoking in patients with respiratory diseases.

Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression.

Muscle strength as a determinant of oxygen uptake efficiency and maximal metabolic response in patients with mild-to-moderate COPD.

Objective: To compare the behavior of the oxygen uptake efficiency slope (OUES) with that of oxygen uptake at peak exertion (VO₂peak).

Methods: This was a prospective cross-sectional study involving 21 patients (15 men) with mild-to-moderate COPD undergoing spirometry, handgrip strength (HGS) testing, cardiopulmonary exercise testing, and determination of lactate at peak exertion (LACpeak).

Results: Mean weight was 66.

[Epidemiology of sleep-disordered breathing].

The principal types of sleep-disordered breathing--snoring and obstructive sleep apnea syndrome--are highly prevalent in the general population, although it is believed that the majority of cases continue to go undiagnosed. We should be aware of the principal risk factors that favor the onset of these disorders, such as male gender, obesity, aging and craniofacial features. Similarly, systemic arterial hypertension, cardiovascular diseases and metabolic disorders should alert us to the possibility of obstructive sleep apnea syndrome.

Isokinetic muscle evaluation of quadriceps in patients with chronic obstructive pulmonary disease.

Rationale: Muscle debility has a significant impact on health-related quality of life in subjects with chronic obstructive pulmonary disease (COPD), and is correlated to exacerbation and even mortality. Assessing muscle strength is extremely relevant. Lack of standardisation in numbers of sets and rest interval in isokinetic test protocol can lead to distinct results, making com- prehension and comparisons among studies difficult.

[Attitudes of Brazilian pulmonologists toward nicotine dependence: a national survey].

Smoking is a medical condition, since there is drug dependence, and health professionals should treat it as a chronic disease. In order to understand the attitudes of Brazilian pulmonologists toward smokers, we conducted a national survey, using a questionnaire posted on the Internet, of 2,800 pulmonologists, 587 (21%) of whom completed and returned the questionnaires. We found that 3.

Prevalence of smoking and its association with the use of other drugs among students in the Federal District of Brasília, Brazil.

Objective: To estimate the prevalence of smoking, as well as to determine the association between smoking and the use of other drugs, among middle and high school students in the Federal District of Brasília, Brazil.

Methods: Epidemiological study involving a reference population of students in the District. Our sample comprised 2,661 students from 9 to 19 years of age, in all middle and high school grades.

Prevalence of drug-resistant Mycobacterium tuberculosis in patients under intermittent or daily treatment.

Objective: To compare the prevalence rates of drug-resistant Mycobacterium tuberculosis in patients under intermittent treatment with those observed in patients under daily treatment.

Methods: We used World Health Organization data regarding 5,138 patients with active pulmonary TB in Brazil, separated into two groups: patients in the Federal District of Brasília, treated with a one-month daily regimen followed by an intermittent thrice-weekly regimen; and patients in other parts of Brazil, treated with a daily regimen only. The resistance pattern was categorized as primary or acquired, based on the history of previous treatment.

The influence of lung function and muscular strength on the functional capacity of chronic obstructive pulmonary disease patients.

Aim: To determine which variable (forced expiratory volume in 1 second (FEV1), partial pressure of oxygen in arterial blood (PaO2), nocturnal hypoxaemia and muscular strength of femoral quadriceps) can predict the distance walked in the six-minute walk test (6MWT) by COPD patients.

Methods: A cross-sectional and observational study of thirty patients referred to a pulmonary rehabilitation programme at a university hospital. Lung function was evaluated by spirometry, arterial blood gas analysis and nocturnal oximetry.

Noncigarette forms of tobacco use.

There are many preparations for tobacco use, which can be classified as smoking or smokeless tobacco. Among the noncigarette preparations that produce smoke, we cite cigars, pipes and narghiles. Smokeless tobacco can be found in preparations for chewing or for being absorbed by nasal and oral mucosae (snuff).

Correlation of levels of obstruction in COPD with lactate and six-minute walk test.

Unlabelled: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbid-mortality world wide, leading not only to pulmonary damage but also to multisystemic impairment, with repercussions on skeletal muscles and the ability to undertake effort, as measured in the six-minute walk test (6-MWT).

Aims: To correlate the level of obstruction in COPD with lactate concentration and heart rate (HR) at rest, and distance walked. To correlate distance walked with blood gas analysis and correlate desaturation in 6-MWT with post 6-MWT lactate concentration and heart rate.

Correlation between mild hypoxaemia and limb skeletal muscle function in chronic obstructive pulmonary disease - pilot study.

Rationale: Exercise capacity in COPD patients depends on the degree of airflow obstruction, the severity of the hypoxaemia and skeletal muscle function. Muscle atrophy and weakness are considered systemic consequences of COPD and are associated with reduced exercise capacity.

Aims: To investigate the correlation between mild hypoxaemia and muscular strength, muscular fatigue and functional capacity in COPD patients.

Systemic effects of nocturnal hypoxemia in patients with chronic obstructive pulmonary disease without obstructive sleep apnea syndrome.

Objective: To study the effects of nocturnal hypoxemia in patients with chronic obstructive pulmonary disease without obstructive sleep apnea syndrome.

Methods: We studied 21 patients-10 desaturators and 11 nondesaturators-submitted to arterial blood gas analysis, polysomnography, spirometry, cardiopulmonary exercise testing (cycle ergometer), and hand-grip dynamometry, as well as measurements of maximal inspiratory pressure, maximal expiratory pressure, and C-reactive protein (CRP) levels. Patients with arterial oxygen tension > 60 mmHg were included; those with an apnea-hypopnea index > 5 events/hour of sleep were excluded.

Prevalence of smoking among dentists in the Federal District of Brasília, Brazil.

Objective: To determine the prevalence of smoking among dentists in the Federal District of Brasília, Brazil.

Methods: A descriptive, cross-sectional survey, involving 446 dentists residing in the Federal District, was conducted in the second semester of 2004. Data regarding the smoking habit were obtained using a World Health Organization questionnaire that was translated and validated for use in Brazil by the Brazilian National Cancer Institute.

Inspiratory capacity, exercise limitation, markers of severity, and prognostic factors in chronic obstructive pulmonary disease.

Objective: To correlate the postbronchodilator (post-BD) inspiratory capacity (IC), % of predicted, with other markers of severity and prognostic factors in chronic obstructive pulmonary disease (COPD).

Methods: Eighty stable patients with COPD performed forced vital capacity and slow vital capacity maneuvers, as well as the 6-min walk test, prior to and after receiving albuterol spray (400 microg). Patients were divided into four groups, based on post-BD forced expiratory volume in one second.

Quality of sleep and pulmonary function in clinically stable adolescents with sickle cell anemia.

Objective: To evaluate quality of sleep and pulmonary function in clinically stable adolescents with sickle cell anemia (SCA).

Methods: A cross-sectional descriptive study involving 50 patients with SCA submitted to nocturnal polysomnography and spirometry at the Brasília University Hospital. Anthropometric, polysomnographic and pulmonary function data were analyzed.

Using clinical data to predict sleep hypoxemia in patients with acromegaly.

Hypoxemia secondary to sleep apnea is commonly seen in patients with acromegaly, and this alteration apparently leads to considerable morbidity and mortality among such patients. With the objective of identifying hypoxemia based on clinical data, we conducted a cross-sectional study of 34 patients with acromegaly, all of whom were submitted to nocturnal oximetry and evaluation of snoring, as well as to the determination of body mass index (BMI) and neck circumference. In addition, daytime sleepiness was evaluated using the Epworth sleepiness scale (ESS).

Characteristics of smoking among physicians in the Federal District of Brazil.

Objective: To profile the characteristics of smoking among physicians working in the Federal District of Brazil.

Methods: A questionnaire on smoking, adapted from that used by the World Health Organization, was mailed to all physicians registered with the Federal District Regional Council of Medicine. Of the 7023 questionnaires mailed, 830 (12%) were duly completed and returned.

Nocturnal desaturation: predictors and the effect on sleep patterns in patients with chronic obstructive pulmonary disease and concomitant mild daytime hypoxemia.

Objective: To determine the nocturnal oximetry pattern in chronic obstructive pulmonary disease patients having no sleep apnea and presenting mild daytime hypoxemia, to identify probable daytime parameters capable of predicting nocturnal desaturation, and to evaluate the influence of nocturnal desaturation on the sleep pattern of these patients.

Methods: Twenty-five patients were divided into two groups: those with nocturnal desaturation and those without.

Results: Comparing the first group (52%) with the second, we found the following: age, 63 +/- 5 years versus 63 +/- 6 years; forced expiratory volume in the first second = 53 +/- 31% versus 56 +/- 19% predicted; ratio of forced expiratory volume in the first second to forced vital capacity, 49 +/- 14% versus 52 +/- 10%; arterial oxygen tension, 68 +/- 8 mmHg versus 72 + 68 mmHg; and arterial oxygen saturation, 93 +/- 2% versus 94 +/- 1%.

Prevalence of risk factors for obstructive sleep apnea syndrome in interstate bus drivers.

Objective: To determine the prevalence of risk factors for obstructive sleep apnea syndrome in interstate bus drivers.

Methods: This study involved 262 professional interstate bus drivers employed by a Brazilian company headquartered in the Federal District. The drivers were evaluated using a questionnaire designed to assess respiratory sleep disorders, the Epworth Sleepiness Scale, test of sustained attention, test of divided attention and anthropometric measurements.

Prevalence and characteristics of smoking among youth attending the University of Brasília in Brazil.

Objective: To determine the prevalence of smoking and to describe the profile and smoking habits of students attending the Universidade de Brasília (University of Brasília) in Brasília, Brazil.

Methods: A total of 1341 students responded to a smoking questionnaire, adapted from the World Health Organization questionnaire, including questions directed at smokers, former smokers and nonsmokers. Twenty different courses in the areas of health, exact sciences and human sciences were evaluated.