Biomedical subjects

M Paiva

Publications and source records attributed to M Paiva.

At least 19 recordsLinked to original sources

PubMed2004

Music: a new cause of primary spontaneous pneumothorax.

Most cases of primary spontaneous pneumothorax are thought to be caused by air leaks at so-called "emphysema-like changes" or in areas of pleural porosity at the surface of the lung. Environmental pressure swings may cause air leaks as a result of transpulmonary pressure changes across areas of trapped gas in the distal lung. This is the first report of music as a specific form of air pressure change causing pneumothorax (five episodes in four patients). While rupture of the interface between the alveolar space and pleural cavity in these patients may be linked to the mechanical effects of acute transpulmonary pressure differences caused by exposure to sound energy in association with some form of distal air trapping, we speculate that repetitive pressure changes in the high energy-low frequency range of the sound exposures is more likely to be responsible. Exposure to loud music should be included as a precipitating factor in the history of patients with spontaneous pneumothorax.

Adult↗

PubMed2004

Lower pulmonary diffusing capacity in the prone vs. supine posture.

We evaluated the effect of prone positioning on gas-transfer characteristics in normal human subjects. Single-breath (SB) and rebreathing (RB) maneuvers were employed to assess carbon monoxide diffusing capacity (DlCO), its components related to capillary blood volume (Vc) and membrane diffusing capacity (Dm), pulmonary tissue volume (Vti), and cardiac output (Qc). Alveolar volume (Va) was significantly greater prone than supine, irrespective of the test maneuver used. Nevertheless, Dl(CO) was consistently lower prone than supine, a difference that was enhanced when appropriately corrected for the higher Va prone. When adequately corrected for Va, diffusing capacity significantly decreased by 8% from supine to prone [SB: Dl(CO,corr) supine vs. prone: 32.6 +/- 2.3 (SE) vs. 30.0 +/- 2 ml x min(-1) x mmHg(-1) stpd; RB: Dl(CO,corr) supine vs. prone: 30.2 +/- 2.2 (SE) vs. 27.8 +/- 2.0 ml x min(-1) x mmHg(-1) stpd]. Both Vc and Dm showed a tendency to decrease from supine to prone, but neither reached significance. Finally, there were no significant differences in Vti or Qc between supine and prone. We interpret the lower diffusing capacity of the healthy lung in the prone posture based on the relatively larger space occupied by the heart in the dependent lung zones, leaving less space for zone 3 capillaries, and on the relatively lower position of the heart, leaving the zone 3 capillaries less engorged.

Adult↗

PubMed2003

Microgravity alters respiratory sinus arrhythmia and short-term heart rate variability in humans.

We studied heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA) in four male subjects before, during, and after 16 days of spaceflight. The electrocardiogram and respiration were recorded during two periods of 4 min controlled breathing at 7.5 and 15 breaths/min in standing and supine postures on the ground and in microgravity. Low (LF)- and high (HF)-frequency components of the short-term HRV (< or =3 min) were computed through Fourier spectral analysis of the R-R intervals. Early in microgravity, HR was decreased compared with both standing and supine positions and had returned to the supine value by the end of the flight. In microgravity, overall variability, the LF-to-HF ratio, and RSA amplitude and phase were similar to preflight supine values. Immediately postflight, HR increased by approximately 15% and remained elevated 15 days after landing. LF/HF was increased, suggesting an increased sympathetic control of HR standing. The overall variability and RSA amplitude in supine decreased postflight, suggesting that vagal tone decreased, which coupled with the decrease in RSA phase shift suggests that this was the result of an adaptation of autonomic control of HR to microgravity. In addition, these alterations persisted for at least 15 days after return to normal gravity (1G).

Adult↗

PubMed2003

Novel concept for a noninvasive cardiopulmonary monitor for infants: a pair of pajamas with an integrated sensor module.

We present a noninvasive cardiopulmonary monitor for use in infants in which sensors are incorporated into conventional pajamas. It consists of dry electrodes for picking up the electrocardiogram and of two capacitive based elastic strain gauges for the measurement of thoracic and abdominal respiratory movements. The quality of the signals was assessed by performing at home seven sleep recordings in parallel with a conventional system and 16 overnight sleep recordings. In the former tests, the acquisition of all mean R-R intervals agreed in both systems with an accuracy of 15.6 ms, determined by the sampling frequency of the commercial system. For the overnight recordings, more than 99% of the R peaks were correctly detected. In 1.5%, both respiratory traces were simultaneously out of range. Finally, it was observed that more saturated episodes and less errors in R-peak detection appeared in prone than in supine position. In summary, these results demonstrated that the dry electrodes can be a good alternative to the sticking electrodes, and that this simple system is reliable. In contrast with the existing monitors, skin irritations are avoided, redundancy of respiratory signals is provided and user-friendliness of the system is reached.

Clothing↗

PubMed2002

Effect of training on the physiological factors of performance in elite marathon runners (males and females).

This study examined the effect of 8 weeks of specific marathon training before the Olympic trials on the physiological factors of the marathon performance in top-class marathon runners. Five males and four females, age 34 +/- 6 yr (+/- SD) with a marathon performance time of 2 h 11 min 40 s +/- 2 min 27 s for males and 2 h 35 min 34 s +/- 2 min 54 s for females, performed one test ten and two weeks before the trials. Between this period they trained weekly 180 +/- 27 km and 155 +/- 19 km with 11 +/- 7 and 7 +/- 0% of this distance at velocity over 10000 m for males and females, respectively. The purpose of this test was to determine in real conditions i. e. on level road: VO2 peak, the energy cost of running and the fractional utilisation of VO2 peak at the marathon velocity (vMarathon). They ran 10 km at the speed of their personal best marathon performance on a level road and after a rest of 6 min they ran an all-out 1000 m run. VO2 peak increased after the 8 weeks of pre-competitive training (66.3 +/- 9.2 vs 69.9 +/- 9.4 ml x min(-1) x kg(-1), p = 0.01). Moreover, since the oxygen cost of running at vMarathon did not change after this training, the fractional utilization (F) of VO2 peak during the 10 km run at vMarathon decreased significantly after training (94.6 +/- 6.2% VO2 peak vs 90.3 +/- 9.5% VO2 peak, p = 0.04). The high intensity of pre-competitive training increased VO2 peak and did not change the running economy at vMarathon and decreased the fractional utilization of VO2 peak at vMarathon.

Adult↗

PubMed2002

Similar ventilation distribution in normal subjects prone and supine during tidal breathing.

Multiple-breath washout (MBW) tests, with end-expiratory lung volume at functional residual capacity (FRC) and 90% O(2), 5% He, and 5% SF(6) as an inspired gas mixture, were performed in healthy volunteers in supine and prone postures. The semilog plot of MBW N(2) concentrations was evaluated in terms of its curvilinearity. The MBW N(2) normalized slope analysis yielded indexes of acinar and conductive ventilation heterogeneity (Verbanck S, Schuermans D, Van Muylem A, Paiva M, Noppen M, and Vincken W. J App Physiol 83: 1907-1916, 1997). Also, the difference between SF(6) and He normalized phase III slopes was computed in the first MBW expiration. Only MBW tests with similar FRC in the prone and supine postures (P > 0.1; n = 8) were considered. Prone and supine postures did not reveal any significant differences in curvilinearity, N(2) normalized slope-derived indexes of conductive or acinar ventilation heterogeneity, nor SF(6)-He normalized phase III slope difference in the first MBW expiration (P > 0.1 for all). The absence of significant changes in any of the MBW indexes suggests that ventilation heterogeneity is similar in the supine and prone postures of normal subjects breathing near FRC.

Adult↗

PubMed2002

Discriminant serum biochemical parameters in top class marathon performances.

Blood chemical parameters were analyzed by Fourier-transform infrared spectrometry (notably for determining the concentrations of glucose, lactate, urea, glycerol, triglycerides, and proteins) in 14 top-class marathon runners (133.7+/-4.1 min at marathon, 10.1% difference between extremes) who performed a 10-km run at their individual marathon velocity. Marathon performance level was correlated to glycemia increase during exercise (9% difference between extremes; r=0.93; p<0.005). The best marathon runners presented longer and/or less unsaturated blood fatty acids during exercise (17% difference between extremes; r=0.89; p<0.01), suggesting an improved fatty acid selectivity for muscular metabolism. The marathon performance level was also found correlated to a decrease of blood triglycerides during exercise (r=20.95; p<0.003) and to a proportional glycerol concentration increase (11% difference between extremes; r=0.94; p<0.005). The best marathon runners presented higher amino acid blood delivery (r=0.88; p<0.01), which was correlated to an apparent protein catabolism. These results show that the best runners have enhanced both carbohydrate, lipid, and amino acid metabolisms to improve energetic supply to skeletal muscle during exercise.

Adult↗

PubMed2001

Involvement of peripheral airways during methacholine-induced bronchoconstriction after lung transplantation.

Previous studies have shown that the presence of nonspecific bronchial hyperreactivity (NSBHR) in transplanted subjects is associated with the development of bronchiolitis obliterans, which suggests that NSBHR in these subjects may involve the peripheral airways. We investigated this question by studying the effects of methacholine on the distribution of ventilation using single-breath washouts in 15 heart-lung transplant recipients; 17 nontransplanted subjects with NSBHR were studied for comparison. All subjects had normal baseline lung function, and seven transplanted subjects displayed NSBHR. Methacholine induced a similar decline in FEV1 and specific airway conductance in the two groups. In contrast, whereas methacholine produced similar increases in the slope of the alveolar plateau for SF6 (SSF6) and He (SHe) in the nontransplanted subjects, it always produced greater increases in SHe than SSF6 in the transplanted subjects. This suggests that in the latter, methacholine-induced bronchoconstriction made the distribution of ventilation more heterogeneous in peripheral airways. This involvement of small airways may help in understanding why assessing bronchial reactivity in transplanted subjects provides information on the presence of a pathologic process affecting the bronchioles, and hence on the risk of progression to bronchiolitis obliterans.

Adolescent↗

PubMed2001

Physical and training characteristics of top-class marathon runners.

PURPOSE: This study compares the physical and training characteristics of top-class marathon runners (TC), i.e., runners having a personal best of less than 2 h 11 min for males and 2 h 32 min for females, respectively, versus high-level (HL) (< 2 h 16 min and < 2 h 38 min). METHODS: Twenty marathon runners (five TC and HL in each gender) ran 10 km at their best marathon performance velocity (vMarathon) on a level road. This velocity was the target velocity for the Olympic trials they performed 8 wk later. After a rest of 6 min, they ran an all-out 1000-m run to determine the peak oxygen consumption on flat road (.VO(2peak)). RESULTS: Marathon performance time (MPT) was inversely correlated with .VO(2peak). (r = -0.73, P < 0.01) and predicted 59% of the variance of MPT. Moreover, TC male marathon runners were less economical because their energy cost of running (Cr) at marathon velocity was significantly higher than that of their counterparts (212 +/- 17 vs 195 +/- 14 mL.km(-1).kg(-1), P = 0.03). For females, no difference was observed for the energetic characteristics between TC and HL marathon runners. However, the velocity reached during the 1000-m run performed after the 10-km run at vMarathon was highly correlated with MPT (r = -0.85, P < 0.001). Concerning training differences, independent of the gender, TC marathon runners trained for more total kilometers per week and at a higher velocity (velocity over 3000 m and 10,000 m). CONCLUSION: The high energy output seems to be the discriminating factor for top-class male marathon runners who trained at higher relative intensities.

Body Weight↗

PubMed2001

Mathematical assessment of qualitative diagnostic calibration for respiratory inductive plethysmography.

We present a critical assessment of qualitative diagnostic calibration (QDC), which claims to provide a relative calibration of respiratory inductive plethysmography during natural breathing (Sackner MA, Watson H, Belsito AS, Feinerman D, Suarez M, Gonzalez G, Bizousky F, and Krieger B. J Appl Physiol 66: 410-420, 1989). QDC computes the calibration factor (K) by considering breaths of constant tidal volume (VT) and provides a criterion to select breaths when VT is unknown. We applied QDC on uncalibrated data constructed from simulated sets of thoracic and abdominal volumes, with a predefined K. As expected, QDC yields a correct K when applied to breaths at constant VT. In breathing at quasi-constant VT, the criterion for breath selection is shown to bias the results toward K = 1. For spontaneous breathing, the calculated K deviates from its predefined value and depends heavily on the selection criterion. We conclude that QDC will only provide a correct calibration factor when applied to an entire set of breaths with constant or quasi-constant VT. More generally, physiological conclusions based on QDC should be critically evaluated on a case-by-case basis.

Abdomen↗

PubMed2001

Single-breath washouts in a rotating stretcher.

Vital capacity single-breath washouts using 90% O2-5% He-5% SF6 as a test gas mixture were performed with subjects sitting on a stool (upright) or recumbent on a stretcher (prone, supine, lateral left, lateral right, with or without rotation at end of inhalation). On the basis of the combinations of supine and prone maneuvers, gravity-dependent contributions to N2 phase III slope and N2 phase IV height in the supine posture were estimated at 18% and 68%, respectively. Whereas both He and SF6 slope decreased from supine to prone, the SF6-He slope difference actually increased (P = 0.015). N2 phase III slopes, phase IV heights, and cardiogenic oscillations were smallest in the prone posture, and we observed similarities between the modifications of He and SF6 slopes from upright to prone and from upright to short-term microgravity. These results suggest that phase III slope is partially due to emptying patterns of small units with different ventilation-to-volume ratios, corresponding to acini or groups of acini. Of all body postures under study, the prone position most reduces the inhomogeneities of ventilation during a vital capacity maneuver at both inter- and intraregional levels.

Adult↗

PubMed2001

Saline aerosol bolus dispersion. I. The effect of acinar airway alteration.

We explored the possibility of using a saline aerosol for bolus dispersion measurements to detect peripheral airway alterations in smokers. Indexes of ventilation inhomogeneity in conductive (S(cond)) and acinar (S(acin)) lung zones, as derived from the multiple-breath N(2) washout (Verbanck S, Schuermans D, Van Muylem A, Noppen M, Paiva M, and Vincken W, J Appl Physiol 83: 1807-1816, 1997), were also measured. The saline bolus test consisted of inhaling 60-ml saline aerosol boluses to different volumetric lung depths (VLD) in the 1.1 liter volume above functional residual capacity. In the never-smoker group (n = 12), saline boluses showed bolus dispersion values consistent with normal values reported in the literature for 0.5- to 1-microm aerosols. In the smoker group (n = 12; 28 +/- 9 pack years, mean +/- SD), significant increases were seen on dispersion and skew of the most peripherally inhaled saline boluses (VLD = 800 ml; P < 0.05) as well as on S(acin) (P = 0.007) with respect to never-smokers. Shallow inhaled boluses (VLD = 200 ml) and S(cond) did not reveal any significant differences between smokers and never-smokers. This study shows the consistent response of two conceptually independent tests, in which both saline aerosol and gas-derived indexes point to a heterogeneous distribution of smoking-induced structural alterations in the lung periphery.

Adult↗

PubMed2001

Saline aerosol bolus dispersion. II. The effect of conductive airway alteration.

In a companion study (Verbanck S, Schuermans D, Vincken W, and Paiva M, J Appl Physiol 90: 1754-1762, 2001), we investigated whether saline aerosol bolus tests could also be used to detect proximal, as opposed to peripheral, airway alterations. We studied 10 never-smokers before and after histamine challenge, obtaining, for various volumetric lung depths (VLD), saline bolus-derived indexes computed by discarding aerosol concentrations below either 50% of the exhaled bolus maximum (half-width, H) or below cutoffs ranging from 5 to 25% (standard deviation, sigma(5%)-sigma(25%)) and skew (sk(5)-sk(25%)). Multiple-breath N(2) washout-derived indexes of conductive (S(cond)) and acinar (S(acin)) ventilation inhomogeneity were also determined. After histamine, S(cond) significantly increased (P = 0.008) whereas S(acin) remained unaffected, indicating purely conductive airway alteration. Consistent with this observation, sk(5%) (or sk(25%)) was increased to the same extent at all VLD, and sigma(5%) was increased preferentially at low VLD. By contrast, H and sigma(25%) displayed preferential increases at high VLD, a pattern similar to that induced by peripheral alterations. The present work shows that proximal airway alteration can be reliably identified by saline bolus tests only if these include measurements at low and high VLD and if bolus dispersion is quantified as a standard deviation with a low cutoff.

Aerosols↗

PubMed2001

Methacholine versus histamine: paradoxical response of spirometry and ventilation distribution.

We investigated the differential effect of histamine and methacholine on spirometry and ventilation distribution (where indexes S(cond) and S(acin) represent conductive and acinar ventilation heterogeneity; Verbanck S, Schuermans D, Van Muylem A, Noppen M, Paiva M, and Vincken W. J Appl Physiol 83: 1807-1816, 1997). Thirty normal subjects were challenged with cumulative doses of 6.52 micromol histamine and, on a separate day, with either 6.67 micromol methacholine (equal-dose group; n = 15) or 13.3 micromol methacholine (double-dose group; n = 15). Largest average forced expiratory volume in 1 s (FEV(1)) decreases or S(cond) increases obtained in either group were -9% and +286%, respectively; S(acin) remained unaffected at all times. In the equal-dose group, a smaller FEV(1) decline (P = 0.002) after methacholine was paralleled by a smaller S(cond) increase (P = 0.041) than with histamine. However, in the double-dose group, methacholine maintained a smaller FEV(1) decline (P = 0.009) while inducing a larger S(cond) increase (P = 0.006) than did histamine. The differential action of histamine and methacholine is confined to the conductive airways, where histamine likely causes the greatest overall airway narrowing and methacholine induces the largest parallel heterogeneity in airway narrowing, probably at the level of the large and small conductive airways, respectively. The observed ventilation heterogeneities predict a risk for dissociation between ventilation-perfusion mismatch and spirometry, particularly after methacholine challenge.

Bronchoconstrictor Agents↗

PubMed2001

Three-dimensional ballistocardiography and respiratory motion in sustained microgravity.

BACKGROUND: We measured the three-dimensional ballistocardiogram (BCG) in a free-floating subject in sustained microgravity during spaceflight to test the usefulness of such measurements for future non-invasive monitoring of cardiac function, and to examine the effects of respiratory movement on the BCG in three axes. METHODS: Acceleration was measured using a three-axis accelerometer fastened to the lumbar region of the subject while simultaneous recordings of ECG, and respiratory motion via impedance plethysmography were also made. Data were recorded during a 146-s period of inactivity on the part of the subject during which time there was no contact with the spacecraft. RESULTS: Total body motion due to respiratory activity was consistent with that calculated from the known action of the diaphragm and conservation of momentum. The accelerations due to cardiac activity, ensemble averaged over the R-R interval, were greatest along the head-to-foot axis. Maximum amplitude of the HIJK complex of the BCG generated by ventricular ejection was greatest in the head to foot axis (approximately 70 x 10(-3) m x s(-2)), but there were also substantial accelerations along the dorsoventral axis of up to 43 10(-3) m x s(-2), that are not measured interrestrial two-dimensional studies. The amplitude of the BCG was strongly affected by lung volume, with accelerations being reduced 50 to 70% between end-inspiration and end-expiration. CONCLUSIONS: These data suggest a greatly reduced transmission of the cardiac motion to the body at end-expiration (FRC) than at higher lung volumes. The BCG might be further developed as a non-invasive means of monitoring parameters such as stroke volume in microgravity.

Acceleration↗

PubMed2000

Overexpression of NGF ameliorates ethanol neurotoxicity in the developing cerebellum.

Transgenic mice overexpressing NGF in the central nervous system under the control of the glial fibrillary acidic protein (GFAP) promoter were exposed to ethanol via vapor inhalation on postnatal days 4 and 5 (P4-5), the period of maximal cerebellar Purkinje cell sensitivity to ethanol. Wild-type controls were exposed in a similar manner. There were no differences in body weight or size following these procedures, but the transgenic brain weights at this age were significantly greater than wild-type controls. In the wild-type animals, a significant 33.3% ethanol-mediated loss of Purkinje cells in lobule I was detected via unbiased three-dimensional stereological counting on P5. In the GFAP-NGF transgenic animals, however, the 17.6% difference in Purkinje cell number in control and ethanol-exposed animals was not significant. There was a similar difference in Purkinje cell density in both groups, which did reach statistical significance (-32.7% in wild-type ethanol-treated animals, -17% in transgenic ethanol-exposed animals). These results suggest that endogenous overexpression of neurotrophic factors, which have previously been shown to protect against ethanol neurotoxicity in culture, can serve a similar protective function in the intact animal.

Alcohol-Induced Disorders, Nervous System↗

PubMed2000

Neurotrophic factor protection against ethanol toxicity in rat cerebellar granule cell cultures requires phosphatidylinositol 3-kinase activation.

Neonatal rat cerebellar granule cells were used to assess the possible role of the phosphatidylinositol 3-kinase (PI3-K) signaling pathway in the neuroprotective effects of neurotrophic factors against ethanol toxicity. Culture conditions included medium with ethanol (400 and 600 mg/dl), nerve growth factor (NGF) or brain-derived neurotrophic factor (BDNF), ethanol+NGF or BDNF, the PI3-K inhibitor wortmannin (10 or 100 microM), and wortmannin+ethanol+NGF or BDNF. Neuronal survival was determined via the MTT assay. The results indicated that both NGF and BDNF ameliorate ethanol neurotoxicity, and wortmannin abolished this effect, except at the higher ethanol concentration combined with the lower wortmannin level. These data strongly implicate the PI3-K pathway in growth factor protection against ethanol neurotoxicity.

Androstadienes↗

PubMed2000

Ethanol-induced alterations in the expression of neurotrophic factors in the developing rat central nervous system.

Neonatal rats were exposed to ethanol throughout gestation, or during the early postnatal period (postnatal days 4-10 (P4-10)), and enzyme-linked immunoabsorbent assays were subsequently conducted in order to assess nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) protein content in hippocampus, septum, cortex/striatum and cerebellum. These determinations revealed that following prenatal ethanol treatment, there were significant ethanol-induced increases in NGF in P1 cortex/striatum, but no changes in any of the three neurotrophic factors (NTFs) in the other brain regions. Cortex/striatal NGF protein returned to control levels by P10. Following early postnatal exposure, BDNF was elevated in hippocampus and cortex/striatum (assessed on P10), and NGF was also enhanced in cortex/striatum at this age. Hippocampal and cortex/striatal BDNF returned to control levels by P21, but cortex/striatal NGF levels remained enhanced at this age. This NTF did not differ in ethanol and control animals by P60, however. The possible significance of elevated levels of NTFs as a function of ethanol exposure is discussed, and it is speculated that while such alterations could play a protective role, increases in these substances during critical developmental periods could also prove to be deleterious, and could even contribute to certain of the neuropathologies which have been observed following developmental ethanol exposure.

Animals↗