Original article
Mucociliary clearance and its relation with the level of physical activity in daily life in healthy smokers and nonsmokers
Transporte mucociliar e sua relação com o nível de atividade física na vida diária em fumantes saudáveis e não fumantes
M. Proençaa,b, F. Pittaa,b, D. Kovelisb, L.C. Mantoanib, K.C. Furlanettob, J. Zabatierob, D. Ramosa, E.M.C. Ramosa,
Corresponding author
a Laboratório de Estudos do Aparelho Muco-Secretor (LEAMS), Programa de Mestrado em Fisioterapia, Departamento de Fisioterapia, UNESP - Univ Estadual Paulista, Presidente Prudente, São Paulo, Brazil
b Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
Read
1036
Timeswas read the article
555
Total PDF
481
Total HTML
Share statistics
array:25 [ "pii" => "S2173511512000334" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2012.04.006" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "93" "copyright" => "Sociedade Portuguesa de Pneumologia" "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2012;18:233-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5337 "formatos" => array:3 [ "EPUB" => 251 "HTML" => 3770 "PDF" => 1316 ] ] "Traduccion" => array:1 [ "pt" => array:20 [ "pii" => "S0873215912000347" "issn" => "08732159" "doi" => "10.1016/j.rppneu.2012.03.003" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "93" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2012;18:233-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7647 "formatos" => array:3 [ "EPUB" => 241 "HTML" => 5779 "PDF" => 1627 ] ] "pt" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>" "titulo" => "Transporte mucociliar e sua relação com o nível de atividade física na vida diária em fumadores saudáveis e não fumadores" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => array:2 [ 0 => "pt" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "233" "paginaFinal" => "238" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mucociliary clearance and its relation with the level of physical activity in daily life in healthy smokers and nonsmokers" ] ] "contieneResumen" => array:2 [ "pt" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 883 "Ancho" => 2306 "Tamanyo" => 103175 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Correlação entre o Tempo de Trânsito de Sacarina (TTS) e atividade física na vida diária (AFVD, em passos/dia) em A) fumadores leves e B) Não fumadores.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Proença, F. Pitta, D. Kovelis, L.C. Mantoani, K.C. Furlanetto, J. Zabatiero, D. Ramos, E.M.C. Ramos" "autores" => array:8 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Proença" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Pitta" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Kovelis" ] 3 => array:2 [ "nombre" => "L.C." "apellidos" => "Mantoani" ] 4 => array:2 [ "nombre" => "K.C." "apellidos" => "Furlanetto" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Zabatiero" ] 6 => array:2 [ "nombre" => "D." "apellidos" => "Ramos" ] 7 => array:2 [ "nombre" => "E.M.C." "apellidos" => "Ramos" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173511512000334" "doi" => "10.1016/j.rppnen.2012.04.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511512000334?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215912000347?idApp=UINPBA00004E" "url" => "/08732159/0000001800000005/v2_201509041422/S0873215912000347/v2_201509041422/pt/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2173511512000498" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2012.04.011" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "95" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2012;18:239-43" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5807 "formatos" => array:3 [ "EPUB" => 243 "HTML" => 3932 "PDF" => 1632 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Impact of diabetes on the presenting features of tuberculosis in hospitalized patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "239" "paginaFinal" => "243" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Impacto da diabetes na forma de apresentação da tuberculose em doentes hospitalizados" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Carreira, J. Costeira, C. Gomes, J.M. André, N. Diogo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Carreira" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Costeira" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Gomes" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "André" ] 4 => array:2 [ "nombre" => "N." "apellidos" => "Diogo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0873215912000360" "doi" => "10.1016/j.rppneu.2012.04.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215912000360?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511512000498?idApp=UINPBA00004E" "url" => "/21735115/0000001800000005/v1_201305151607/S2173511512000498/v1_201305151607/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2173511512000292" "issn" => "21735115" "doi" => "10.1016/j.rppnen.2012.04.002" "estado" => "S300" "fechaPublicacion" => "2012-09-01" "aid" => "90" "copyright" => "Sociedade Portuguesa de Pneumologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2012;18:226-32" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 8423 "formatos" => array:3 [ "EPUB" => 239 "HTML" => 6079 "PDF" => 2105 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Sedation with midazolam in flexible bronchoscopy – A prospective study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "226" "paginaFinal" => "232" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Sedação com midazolam na broncofibroscopia – estudo prospectivo" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2424 "Ancho" => 2083 "Tamanyo" => 279450 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Questionnaire no. 2.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Rolo, P.C. Mota, F. Coelho, D. Alves, G. Fernandes, J. Cunha, V. Hespanhol, A. Magalhães" "autores" => array:8 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Rolo" ] 1 => array:2 [ "nombre" => "P.C." "apellidos" => "Mota" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Coelho" ] 3 => array:2 [ "nombre" => "D." "apellidos" => "Alves" ] 4 => array:2 [ "nombre" => "G." "apellidos" => "Fernandes" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Cunha" ] 6 => array:2 [ "nombre" => "V." "apellidos" => "Hespanhol" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Magalhães" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0873215912000311" "doi" => "10.1016/j.rppneu.2012.03.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215912000311?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511512000292?idApp=UINPBA00004E" "url" => "/21735115/0000001800000005/v1_201305151607/S2173511512000292/v1_201305151607/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Mucociliary clearance and its relation with the level of physical activity in daily life in healthy smokers and nonsmokers" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "233" "paginaFinal" => "238" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Proença, F. Pitta, D. Kovelis, L.C. Mantoani, K.C. Furlanetto, J. Zabatiero, D. Ramos, E.M.C. Ramos" "autores" => array:8 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Proença" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Pitta" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "D." "apellidos" => "Kovelis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "L.C." "apellidos" => "Mantoani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "K.C." "apellidos" => "Furlanetto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "J." "apellidos" => "Zabatiero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "D." "apellidos" => "Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:4 [ "nombre" => "E.M.C." "apellidos" => "Ramos" "email" => array:1 [ 0 => "ercy@fct.unesp.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Laboratório de Estudos do Aparelho Muco-Secretor (LEAMS), Programa de Mestrado em Fisioterapia, Departamento de Fisioterapia, UNESP - Univ Estadual Paulista, Presidente Prudente, São Paulo, Brazil" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Transporte mucociliar e sua relação com o nível de atividade física na vida diária em fumantes saudáveis e não fumantes" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 875 "Ancho" => 2306 "Tamanyo" => 101986 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Correlation between saccharin transit time (STT) and physical activity in daily life (PADL, in steps per day) in (A) light smokers and (B) nonsmokers.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Studies have shown that the effectiveness of mucociliary clearance is impaired in smokers compared to nonsmokers.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> It is also known that, in nonsmokers, regular physical activity when performed at moderate intensity improves the immune system response.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However, the relationship between physical activity and mucociliary transport is not completely clear and has shown conflicting results. Wolff et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> observed a slight increase in mucociliary clearance after exercise, unlike Olseni and Wollmer<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> who observed no substantial changes. Furthermore, these studies only described the acute (<span class="elsevierStyleItalic">i.e</span>., transient) response of the mucociliary system to exercise, but the chronic adaptive response to regular daily physical activity remains unknown. In addition, these studies were performed only in nonsmokers, and to the authors’ best knowledge, no studies involving this issue had yet been carried out in smokers.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Thus, the aim of this study was to describe the relationship between mucociliary transport and the level of physical activity in daily life (PADL) in healthy smokers (<span class="elsevierStyleItalic">i.e</span>., with no lung function impairment) and healthy nonsmokers.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Design and study subjects</span><p id="par0015" class="elsevierStylePara elsevierViewall">This cross-sectional observational study was undertaken with a convenience sample of 52 current smokers (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) assessed during intake process before starting a program with the aim of increasing their daily physical activity. They were volunteers and had learned about the project through advertisements in the media, buses and health centers. Inclusion criteria were: current smoking; normal lung function (according to internationally accepted criteria)<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>; and absence of history of cystic fibrosis, bronchiectasis, immotile cilia syndrome, nasal surgery or trauma and chronic and/or recent inflammation process in the upper airway which was established during an initial interview. Exclusion criterion was the presence of bone, nervous and/or muscle dysfunction which could interfere in the objective assessment of PADL. Subjects were included regardless of whether they intended to quit smoking in the future or not, and no subject quit or reduced smoking during the assessment period. No pharmacological treatment for smoking or any other reason was provided during the assessment period. For comparison, a group composed of 30 healthy nonsmokers (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) was also assessed. This group was matched to the smoker groups by similar age, gender and body mass index.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">For analysis purposes, smokers were divided into three groups according to the intensity of cigarette consumption: light smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17), who smoked up to 15 cigarettes/day; moderate smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22), 16–25 cigarettes/day, and heavy smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13), more than 25 cigarettes/day (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> All participants had been previously informed about the objectives and procedures of the study and, after signing the consent form, became part of the research. The study was approved by the institution's Committee of Ethics in Research (No. 007/07).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protocol</span><p id="par0025" class="elsevierStylePara elsevierViewall">All individuals included in the study were interviewed to obtain personal data and smoking history (duration of smoking, number of cigarettes per day, pack/years index) and were then assessed for lung function (by spirometry), mucociliary transport (by saccharin transit time) and carbon monoxide (COexh) levels in the exhaled air (MicroCO Meter). The tests were performed in an environment with controlled temperature and relative humidity. All assessments were performed in the morning, between 8:00 and 10:00<span class="elsevierStyleHsp" style=""></span>h, after a period of 12<span class="elsevierStyleHsp" style=""></span>h of tobacco abstinence which started after the last cigarette smoked the previous evening (between 20:00 and 22:00<span class="elsevierStyleHsp" style=""></span>h, according to formal instructions given to the patients and confirmed by them). In addition, subjects remained for six days with a waist-worn pedometer (DigiWalker SW-200 Yamax, Japan) in order to determine the level of PADL (number of steps/day).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Lung function assessment</span><p id="par0030" class="elsevierStylePara elsevierViewall">Spirometry was performed by Spirobank-MIR (MIR, Italy) 3.6, connected to a microcomputer. The technique was in accordance with the recommendations of the American Thoracic Society and European Respiratory Society guidelines.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Reference values were specific for the Brazilian population.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Measurement of mucociliary transport (MCT): the saccharin transit time (STT)</span><p id="par0035" class="elsevierStylePara elsevierViewall">Measurement of MCT was performed by STT, as described by Rutland and Cole.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The test was shown to be valid and reproducible.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a> Subjects were seated and positioned with the head slightly extended. Granulated sodium saccharin (5<span class="elsevierStyleHsp" style=""></span>μg) was deposited under visual control 2<span class="elsevierStyleHsp" style=""></span>cm inside the right nostril. The time from the placing of the particle to the first perception of a sweet taste in the mouth was recorded in minutes. Participants were instructed to maintain the original position and were not allowed to breath deeply, talk, cough, sneeze or sniff. They were also instructed to swallow only a few times per minute until they felt a sweet taste in the mouth. If they could not taste anything within 60<span class="elsevierStyleHsp" style=""></span>min, the test was stopped and the subjects’ ability to perceive the taste of saccharin was evaluated by placing it on the tongue, and then the procedure was repeated in another occasion.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,12</span></a> Participants were strictly instructed not to use pharmacological agents such as anesthetics, analgesics, barbiturates, tranquilizers and antidepressants as well as alcohol and caffeine-based substances for at least 12<span class="elsevierStyleHsp" style=""></span>h before the test.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Measurement of carbon monoxide levels in the exhaled air (COexh)</span><p id="par0040" class="elsevierStylePara elsevierViewall">The COexh was measured by a CO analyzer (MicroCO Meter Micro Medical Ltd., Rochester, UK), using an electrochemical sensor, for confirmation of smoking. Subjects were instructed to breathe deeply, hold their breath for 20<span class="elsevierStyleHsp" style=""></span>s and to exhale slowly and completely through the mouthpiece. Values above 6<span class="elsevierStyleHsp" style=""></span>ppm COexh were indicative of smoking.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Assessment of physical activity in daily life (PADL)</span><p id="par0045" class="elsevierStylePara elsevierViewall">The level of PADL was assessed by monitoring the number of steps/day with a pedometer Digiwalker SW200 (Yamax, Japan). The equipment is simple, small, relatively inexpensive and worn on the right side of the waist (in line with the knee). Previous literature<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> clearly showed that the use of pedometers, especially the model used in this study, provides a reliable estimate of the number of steps performed by an individual in a given period of time. Classification of PADL level according to steps/day was: <5000<span class="elsevierStyleHsp" style=""></span>steps/day, “sedentary”; 5000–7499, “low active”; 7500–9999, “somewhat active”; ≥10,000, “active”; and >12,500, “highly active”.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The pedometer was used for six consecutive days (Sunday to Friday) for at least 12<span class="elsevierStyleHsp" style=""></span>h a day, and the number of steps/day was recorded daily by each individual in a logbook. For data analysis, the average of steps/day performed during the six days was used.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">Statistical analysis was performed with GraphPad Prism 3.0 (GraphPad Inc., San Diego, USA). Due to the relatively reduced number of subjects in each of the 3 groups of smokers, non-parametric statistics were used and results were expressed as median (95% confidence interval). Comparison among the 3 groups of smokers was performed by the Kruskal–Wallis test (Dunns <span class="elsevierStyleItalic">pos-hoc</span> test). For the comparison between nonsmokers and the general group of smokers, the Mann–Whitney test was used. Correlations were evaluated using the Spearman coefficient. The level of statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 for all analysis.</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">Eighty-two subjects entered the study (52 smokers and 30 nonsmokers), and none of them were excluded during the assessments. Results are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. All three groups of smokers had higher COexh than the nonsmokers group (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 for all). There was no difference in the number of steps/day between any of the groups (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05 for all). According to the number of steps/day, there was a wide range of subjects with different activity levels, although in general, all groups could be classified as somewhat active to physically active (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><p id="par0065" class="elsevierStylePara elsevierViewall">The median (confidence interval) of STT in light smokers showed no significant reduction in the mucociliary transport compared to nonsmokers (9 [7–11]<span class="elsevierStyleHsp" style=""></span>min and 8 [8–11]<span class="elsevierStyleHsp" style=""></span>min, respectively; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.08). Both moderate and heavy smokers had significantly higher STT values than nonsmokers (13 [11–17]<span class="elsevierStyleHsp" style=""></span>min; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04 and 13 [10–21]<span class="elsevierStyleHsp" style=""></span>min; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04, respectively) and light smokers (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02 for both).</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the general group of smokers, no significant correlation occurred between STT and steps/day (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.04; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.78). There was a negative significant correlation between STT and steps/day only in light smokers (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.55; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02) and in nonsmokers (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No such significant correlation was found in the groups of moderate (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.31; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.15) and heavy smokers (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.36, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.23).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Furthermore, in the general group of smokers, there was no significant correlation between STT and pack/years index (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.14; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.30), years of smoking (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.13; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.37) and age (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.23; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.09). Similarly, number of steps/day was not correlated to pack/years index (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.01; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.92), years of smoking (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.18; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.22) and age (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.03; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.81).</p><p id="par0080" class="elsevierStylePara elsevierViewall">The power of the study was calculated by comparing the difference between two correlations, <span class="elsevierStyleItalic">i.e.</span>, STT <span class="elsevierStyleItalic">versus</span> steps/day in the control group (0.42) and in the general group of smokers (0.04). By using an <span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05 (double-sided) and a power of 80%, a total of 52 subjects provided a power of 0.82 in order to detect this difference.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study showed that, specifically in smokers with light cigarette consumption and non-smokers, PADL is modestly but significantly associated with mucociliary function, unlike for smokers with moderate to severe cigarette consumption. Such results can be linked to the fact that there was no impairment in mucociliary transport in light smokers, while those with moderate to severe consumption showed impaired clearance. However, caution is required to avoid the interpretation of these results as describing a causative relationship between physical activity and mucociliary function, since the results are based solely on simple correlations.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Mucociliary transport (MCT) is the main defense mechanism of upper and lower airways<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15,16</span></a> and may be influenced by different conditions such as in response to stress, physical exercise and exposure to noxious particles (<span class="elsevierStyleItalic">e.g</span>., cigarette smoke).<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Physical exercise is, in general, classified as a stressful stimulus,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> but the MCT response to exercise can be divided into acute (<span class="elsevierStyleItalic">i.e.</span>, transient) and chronic adaptation.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> The acute response to exercise is associated with increased levels of adrenergic mediators,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> which stimulate the ciliary beat frequency<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21,22</span></a> and thus the airways clearance. Some studies<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23–25</span></a> have confirmed this idea and found that the respiratory mucosa function is significantly altered by exercise, with improved activity during light-moderate exercise, and impaired activity after strenuous exercise. The novel feature of our study, however, was to investigate how the MCT behaves in relation to the regular level of physical activity (<span class="elsevierStyleItalic">i.e</span>., its chronic adaptation). In our view, the fact that the MCT in light smokers behaves similar to nonsmokers might underline the benefits of regular physical activity for the respiratory system in light smokers. However, in those who already have impairment in STT (<span class="elsevierStyleItalic">i.e</span>., moderate and heavy smokers), the mucociliary system is slowed down by the intensity of tobacco consumption regardless of the level of physical activity. Therefore, in these subjects, regular physical activity is not linked to MCT, but a substantial reduction in smoking intensity is required. On the other hand, as previously mentioned, the design of the present study does not provide solid proof of a causative relationship between higher PADL and better MCT.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The similarities between the results of light smokers and nonsmokers might be due to the degree of daily exposure to cigarette smoke for the former, which was possibly not intense enough to cause important structural damage and reduce mucociliary transport, as happened with moderate and heavy smokers. Since for the general group of smokers STT was not correlated to PADL level, age, pack/years and years of smoking, it is hypothesized that the MCT in smokers depends more on the current daily cigarette consumption than on smoking history and physical activity level. This hypothesis is in line with what was previously suggested by Stanley <span class="elsevierStyleItalic">et al.</span>,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> although that study did not include a detailed profile of the smoking habits (which the present study does) and did not include regular physical activity as one of its outcomes.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The sample size of this present study is relatively small, particularly after stratification according to daily cigarette consumption. This reduces further sub-analysis and could be considered as a limitation of the study. However, despite the relatively small sample in each group, this stratification was important since it provided relevant results such as the differences between light smokers <span class="elsevierStyleItalic">versus</span> moderate/heavy smokers. Further studies with larger number of smokers with different intensities of cigarette consumption would be welcome. Moreover, the authors used minutes to express saccharin transit time for reasons of clarity, although the specialized literature occasionally reports it in seconds.</p><p id="par0105" class="elsevierStylePara elsevierViewall">In conclusion, specifically in light smokers and non-smokers, better mucociliary function is associated to higher daily physical activity level, as opposed to the decreased mucociliary function observed in smokers <span class="elsevierStyleItalic">i.e</span>., those with moderate and heavy cigarette consumption.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Funding</span><p id="par0110" class="elsevierStylePara elsevierViewall">This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Brazil.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres173839" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objectives" 2 => "Methods" 3 => "Results" 4 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec162138" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres173840" "titulo" => array:5 [ 0 => "Resumo" 1 => "Objetivos" 2 => "Métodos" 3 => "Resultados" 4 => "Conclusão" ] ] 3 => array:2 [ "identificador" => "xpalclavsec162137" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Design and study subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Protocol" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Lung function assessment" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Measurement of mucociliary transport (MCT): the saccharin transit time (STT)" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Measurement of carbon monoxide levels in the exhaled air (COexh)" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Assessment of physical activity in daily life (PADL)" ] 6 => array:2 [ "identificador" => "sec0045" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-12-01" "fechaAceptado" => "2012-03-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec162138" "palabras" => array:3 [ 0 => "Mucociliary clearance" 1 => "Physical activity" 2 => "Smoking" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec162137" "palabras" => array:3 [ 0 => "Transporte mucociliar" 1 => "Atividade física" 2 => "Tabagismo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To investigate the relationship between mucociliary transport and physical activity in daily life (PADL) in smokers and nonsmokers.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Fifty-two current smokers were submitted to an assessment of mucociliary transport (saccharin transit time, STT), carbon monoxide levels in the exhaled air, lung function and smoking history. In addition, subjects kept a pedometer worn at the waist for six days in order to determine their level of PADL (steps/day). The tests were also performed on 30 matched healthy nonsmokers who served as control group.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Light smokers (≤15 cigarettes/day) had a STT of 9 (7–11) min (median [confidence interval]), which was similar to nonsmokers (8 [8–11]<span class="elsevierStyleHsp" style=""></span>min; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8). Both moderate (16–25 cigarettes/day) and heavy (>25 cigarettes/day) smokers had a significantly higher STT (13 [11–17]<span class="elsevierStyleHsp" style=""></span>min and 13 [10–21]<span class="elsevierStyleHsp" style=""></span>min, respectively) than nonsmokers and light smokers (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 for all). There was no difference in the number of steps/day between any of the groups (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05 for all). In the general group of smokers, STT was not significantly correlated with PADL, pack/years index, years of smoking or age (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>−0.23; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.09 for all). There was significant negative correlation between STT and PADL only in light smokers (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.55; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02) and nonsmokers (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.42; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02), but not in moderate and heavy smokers.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In light smokers and non-smokers, better mucociliary function is associated to higher daily physical activity level, as opposed to the decreased mucociliary function observed in smokers, <span class="elsevierStyleItalic">i.e</span>., those with moderate and heavy cigarette consumption.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Investigar a relação entre o transporte mucociliar e a atividade física na vida diária (AFVD) em fumantes e não fumantes.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cinquenta e dois fumantes foram submetidos à avaliação do transporte mucociliar (Tempo de Trânsito de Sacarina, TTS), dos níveis de monóxido de carbono no ar expirado, da função pulmonar e do histórico tabagístico. Além disso, os sujeitos permaneceram por 6 dias com um pedómetro para determinar o seu nível de AFVD (passos/dia). Os testes também foram realizados em 30 indivíduos não fumantes saudáveis, pareados, que serviram como grupo controlo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Os fumantes leves (≤15 cigarros/dia) apresentaram um TTS de 9 (7-11) minutos (mediana [intervalo de confiança]), que foi similar aos não-fumantes (8 [8-11] min; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,8). Ambos os fumantes moderados (16-25 cigarros/dia) e severos (>25 cigarros/dia) apresentaram TTS significativamente maior (13 [11-17] min e 13 [10-21] min, respetivamente) do que os não fumantes e fumantes leves (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05 para todos). No grupo de fumantes em geral, não houve correlação estatisticamente significante entre o TTS e AFVD, índice anos/maço, anos de tabagismo e idade (r<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>-0,23; p<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,09 para todos). Houve correlação negativa significativa entre o TTS e a AFVD apenas em fumantes leves (r<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>-0,55; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,02) e não fumantes (r<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>-0,42; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,02), mas não em fumantes moderados e pesados.</p> <span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Em fumantes leves e não fumantes, uma melhor função mucociliar está associada a maiores níveis de atividade física diária, ao contrário dos fumantes com função mucociliar diminuída, ou seja, aqueles com consumo moderado e severo de cigarros.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Proença M, et al. Transporte mucociliar e sua relação com o nível de atividade física na vida diária em fumantes saudáveis e não fumantes. Rev Port Pneumol. 2012. <span class="elsevierStyleInterRef" href="doi:10.1016/j.rppneu.2012.03.003">http://dx.doi.org/10.1016/j.rppneu.2012.03.003</span>.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 875 "Ancho" => 2306 "Tamanyo" => 101986 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Correlation between saccharin transit time (STT) and physical activity in daily life (PADL, in steps per day) in (A) light smokers and (B) nonsmokers.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Values are described as median (95% confidence interval).</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BMI: body mass index; STT: saccharin transit time; FEV<span class="elsevierStyleInf">1</span>: forced expiratory volume in the first second; COexh: carbon monoxide in the exhaled air.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">General group of smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Light smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Moderate smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Heavy smokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Nonsmokers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (43–50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51 (41–54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (38–49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (41–57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 (44–5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Men/women \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25/27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7/10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10/12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12/18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI (kg/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (22–27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (23–27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (24–29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (23–29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (24–28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">STT (min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (10–13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (7–11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (11–17)<span class="elsevierStyleSup">*†</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (10–21)<span class="elsevierStyleSup">*†</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (8–11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">FEV<span class="elsevierStyleInf">1</span> (%pred) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 (89–98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97 (90–105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 (90–102) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (81–97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102 (97–106) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">FEV1/FVC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 (79–83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (77–84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 (78–85) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (76–87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (84–94) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cigarettes/day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (18–24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (10–13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (19–20)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (34–45)<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">*,#</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pack years index \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (23–36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (13–23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (19–30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (36–78)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COexh (ppm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (10–12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (6–10)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">†</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (9–15)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">†</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (10–17)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">†</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2–3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of steps/day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9700 (8539–10,579) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8783 (7037–11,214) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10297 (9063–11,957) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8215 (6568–12,440) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9573 (8304–10,859) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab266797.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 <span class="elsevierStyleItalic">versus</span> light smokers.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "†" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 <span class="elsevierStyleItalic">versus</span> non-smokers.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "#" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 <span class="elsevierStyleItalic">versus</span> moderate smokers.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the groups of smokers and nonsmokers.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cigarette smoke condensate inhibits transepithelial chloride transport and ciliary beat frequency" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.A. Cohen" 1 => "S. Zhang" 2 => "D.B. Sharp" 3 => "E. Tamashiro" 4 => "B. Chen" 5 => "E.J. Sorscher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/lary.20223" "Revista" => array:7 [ "tituloSerie" => "Laryngoscope" "fecha" => "2009" "volumen" => "119" "numero" => "11" "paginaInicial" => "2269" "paginaFinal" => "2274" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19418539" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of cigarette smoking on nasal mucociliary clearance and ciliary beat frequency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.J. Stanley" 1 => "R. Wilson" 2 => "M.A. Greenstone" 3 => "L. Macwilliam" 4 => "P.J. Cole" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Thorax" "fecha" => "1986" "volumen" => "41" "numero" => "7" "paginaInicial" => "519" "paginaFinal" => "523" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3787531" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Special feature for the Olympics: effects of exercise on the immune system: exercise effects on mucosal immunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Gleeson" 1 => "D.B. Pyne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1440-1711.2000.t01-8-.x" "Revista" => array:7 [ "tituloSerie" => "Immunol Cell Biol" "fecha" => "2000" "volumen" => "78" "numero" => "5" "paginaInicial" => "536" "paginaFinal" => "544" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11050537" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of exercise and eucapnic hyperventilation on bronchial clearance in man" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.K. Wolff" 1 => "M.B. Dolovich" 2 => "G. Obminski" 3 => "M.T. Newhouse" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Appl Physiol" "fecha" => "1977" "volumen" => "43" "numero" => "1" "paginaInicial" => "46" "paginaFinal" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/893265" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucociliary clearance in healthy men at rest and during exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L. Olseni" 1 => "P. Wollmer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Physiol" "fecha" => "1990" "volumen" => "10" "numero" => "4" "paginaInicial" => "381" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2394088" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.F. Rabe" 1 => "S. Hurd" 2 => "A. Anzueto" 3 => "P.J. Barnes" 4 => "S.A. Buist" 5 => "P. Calverley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200703-456SO" "Revista" => array:7 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2007" "volumen" => "176" "numero" => "6" "paginaInicial" => "532" "paginaFinal" => "555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17507545" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking among adults reporting lifetime depression, anxiety, anxiety with depression, and major depressive episode, United States, 2005–2006" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Trosclair" 1 => "S.R. Dube" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.addbeh.2009.12.011" "Revista" => array:7 [ "tituloSerie" => "Addict Behav" "fecha" => "2010" "volumen" => "35" "numero" => "5" "paginaInicial" => "438" "paginaFinal" => "443" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20079577" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standardisation of spirometry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Miller" 1 => "J. Hankinson" 2 => "V. Brusasco" 3 => "F. Burgos" 4 => "R. Casaburi" 5 => "A. Coates" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.05.00034805" "Revista" => array:7 [ "tituloSerie" => "Eur Respir J" "fecha" => "2005" "volumen" => "26" "numero" => "2" "paginaInicial" => "319" "paginaFinal" => "338" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16055882" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New reference values for forced spirometry in white adults in Brazil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.A.C. Pereira" 1 => "T. Sato" 2 => "S.C. Rodrigues" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Bras Pneumol" "fecha" => "2007" "volumen" => "33" "numero" => "4" "paginaInicial" => "397" "paginaFinal" => "406" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17982531" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nasal mucociliary clearance and ciliary beat frequency in cystic fibrosis compared with sinusitis and bronchiectasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Rutland" 1 => "P.J. Cole" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Thorax" "fecha" => "1981" "volumen" => "36" "numero" => "9" "paginaInicial" => "654" "paginaFinal" => "658" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7314040" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of a saccharin test for screening to detect abnormal mucociliary clearance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Stanley" 1 => "L. MacWilliam" 2 => "M. Greenstone" 3 => "I. Mackay" 4 => "P. Cole" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Br J Dis Chest" "fecha" => "1984" "volumen" => "78" "numero" => "1" "paginaInicial" => "62" "paginaFinal" => "65" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6691910" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of nasal and tracheobronchial clearance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Andersen" 1 => "P. Camner" 2 => "P.L. Jensen" 3 => "K. Philipson" 4 => "D.F. Proctor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Arch Environ Health" "fecha" => "1974" "volumen" => "29" "numero" => "5" "paginaInicial" => "290" "paginaFinal" => "293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4472935" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breath carbon monoxide as an indication of smoking habit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.T. Middleton" 1 => "A.H. Morice" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "2000" "volumen" => "117" "numero" => "3" "paginaInicial" => "758" "paginaFinal" => "763" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10713003" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pedometer measures of free-living physical activity: comparison of 13 models" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.L. Schneider" 1 => "S.E. Crouter" 2 => "D.R. Bassett" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1249/01.MSS.0000113486.60548.E9" "Revista" => array:7 [ "tituloSerie" => "Med Sci Sports Exerc" "fecha" => "2004" "volumen" => "36" "numero" => "2" "paginaInicial" => "331" "paginaFinal" => "335" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14767259" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucociliary clearance is impaired in acutely ill patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.K. Nakagawa" 1 => "M.L. Franchini" 2 => "P. Driusso" 3 => "L.R. de Oliveira" 4 => "P.H. Saldiva" 5 => "G. Lorenzi-Filho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.128.4.2772" "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "2005" "volumen" => "128" "numero" => "4" "paginaInicial" => "2772" "paginaFinal" => "2777" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16236954" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ciliary function and the role of cilia in clearance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W. Stannard" 1 => "C. O’Callaghan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/jam.2006.19.110" "Revista" => array:7 [ "tituloSerie" => "J Aerosol Med" "fecha" => "2006" "volumen" => "19" "numero" => "1" "paginaInicial" => "110" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16551222" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of cigarette smoke and alcohol on ciliated tracheal epithelium and inflammatory cell recruitment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.K. Elliott" 1 => "J.H. Sisson" 2 => "T.A. Wyatt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1165/rcmb.2005-0440OC" "Revista" => array:7 [ "tituloSerie" => "Am J Respir Cell Mol Biol" "fecha" => "2007" "volumen" => "36" "numero" => "4" "paginaInicial" => "452" "paginaFinal" => "459" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17079783" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute phase response in exercise. II. Associations between vitamin E, cytokines, and muscle proteolysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.G. Cannon" 1 => "S.N. Meydani" 2 => "R.A. Fielding" 3 => "M.A. Fiatarone" 4 => "M. Meydani" 5 => "M. Farhangmehr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Am J Physiol" "fecha" => "1991" "volumen" => "260" "numero" => "6 Pt 2" "paginaInicial" => "R1235" "paginaFinal" => "R1240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1905495" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The immune response to exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.C. Nieman" 1 => "S.L. Nehlsen-Cannarella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Semin Hematol" "fecha" => "1994" "volumen" => "31" "numero" => "2" "paginaInicial" => "166" "paginaFinal" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8066473" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sympathoadrenal and parasympathetic responses to exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Holmqvist" 1 => "N.H. Secher" 2 => "K. Sander-Jensen" 3 => "U. Knigge" 4 => "J. Warberg" 5 => "T.W. Schwartz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/02640418608732108" "Revista" => array:7 [ "tituloSerie" => "J Sports Sci" "fecha" => "1986" "volumen" => "4" "numero" => "2" "paginaInicial" => "123" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3586105" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of salmeterol and salbutamol on ciliary beat frequency of cultured human bronchial epithelial cells, in vitro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.L. Devalia" 1 => "R.J. Sapsford" 2 => "C. Rusznak" 3 => "M.J. Toumbis" 4 => "R.J. Davies" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Pulm Pharmacol" "fecha" => "1992" "volumen" => "5" "numero" => "4" "paginaInicial" => "257" "paginaFinal" => "263" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1362105" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucus clearance at rest and during exercise in patients with bronchial hypersecretion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Olseni" 1 => "B. Midgren" 2 => "P. Wollmer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Scand J Rehabil Med" "fecha" => "1992" "volumen" => "24" "numero" => "1" "paginaInicial" => "61" "paginaFinal" => "64" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1604263" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Special feature for the Olympics: effects of exercise on the immune system: exercise effects on systemic immunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.C. Nieman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1440-1711.2000.t01-5-.x" "Revista" => array:7 [ "tituloSerie" => "Immunol Cell Biol" "fecha" => "2000" "volumen" => "78" "numero" => "5" "paginaInicial" => "496" "paginaFinal" => "501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11050532" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Monitoring training in athletes with reference to overtraining syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Foster" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Med Sci Sports Exerc" "fecha" => "1998" "volumen" => "30" "numero" => "7" "paginaInicial" => "1164" "paginaFinal" => "1168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9662690" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of exercise on secretory and natural immunity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.T. Mackinnon" 1 => "T.W. Chick" 2 => "A. van As" 3 => "T.B. Tomasi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Adv Exp Med Biol" "fecha" => "1987" "volumen" => "216A" "paginaInicial" => "869" "paginaFinal" => "876" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3687561" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735115/0000001800000005/v1_201305151607/S2173511512000334/v1_201305151607/en/main.assets" "Apartado" => array:4 [ "identificador" => "9710" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735115/0000001800000005/v1_201305151607/S2173511512000334/v1_201305151607/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511512000334?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 8 | 14 |
| 2024 October | 23 | 35 | 58 |
| 2024 September | 38 | 40 | 78 |
| 2024 August | 47 | 47 | 94 |
| 2024 July | 30 | 36 | 66 |
| 2024 June | 25 | 33 | 58 |
| 2024 May | 40 | 32 | 72 |
| 2024 April | 23 | 22 | 45 |
| 2024 March | 26 | 18 | 44 |
| 2024 February | 26 | 23 | 49 |
| 2024 January | 20 | 35 | 55 |
| 2023 December | 28 | 26 | 54 |
| 2023 November | 23 | 34 | 57 |
| 2023 October | 16 | 33 | 49 |
| 2023 September | 18 | 32 | 50 |
| 2023 August | 19 | 23 | 42 |
| 2023 July | 17 | 31 | 48 |
| 2023 June | 13 | 12 | 25 |
| 2023 May | 26 | 26 | 52 |
| 2023 April | 17 | 9 | 26 |
Show all
