Background and Rationale: Asthma and overweight are public health concerns. Lifestyle, including dietary and activity patterns, is associated with overweight and asthma. Moreover, an association between these two diseases has been described. Yet, few studies have considered these associations longitudinally in youth. Methods: Based on data from the 1995 Manitoba Birth Prospective Cohort (n=723, 404 [55.9%] boys), we designed a series of studies to address the question: “Do obesity and related lifestyle behaviours influence asthma and airway hyperresponsivess (AHR) outcomes in children?” Following protocol for a mixed methods sequential explanatory design study, we first considered this research question using quantitative methods. Exposure variables included weight status (body mass index (BMI); BMI z-scores; normal weight vs. overweight), diet, physical activity and screen time. Outcome variables included asthma and AHR at 8-10 years old and at 12-13 years old. Quantitative findings provided direction for the qualitative investigations. That is, we sought to further explain some of the quantitative findings using qualitative methods. For the qualitative portion of this dissertation, 15-16 year old youth were purposively selected (Winnipeg residency, asthma status, gender) from the 1995 Manitoba Prospective Birth Cohort. Due to recruitment challenges, participation was supplemented with youth from the Canadian Asthma Primary Prevention Study, using the same purposive selection criteria. Quantitative Results: Overweight at 12-13 years old was associated with a two-fold increased odds of persistent asthma in girls. In contrast, boys within the highest BMI quartile at 8-10 years old were nearly twice as likely to have remittent asthma at 12-13 years old. High vegetable intake was protective against allergic asthma and moderate-to-severe AHR by 50% and 42%, respectively. High screen time at 8-10 years old, particularly amongst overweight youth, was associated with an increased odds of asthma, but not AHR at 8-10 years and 12-13 years; there were no associations between physical activity, asthma and AHR. Qualitative Results: Youth spoke of asthma as a condition that neither limits physical activity, nor is an excuse for refraining from physical activity. Conclusions: Modest evidence that some quantitatively-measured weight and related lifestyle behaviours during the pubertal years is associated with asthma. Yet, qualitative data suggest that youth with asthma believe that physical activity is achievable despite their condition, although some describe that asthma interferes with physical activity.

No description available.

Thesis (Ph.D.)--University of Adelaide, Dept. of Physiology, 2002. / "May 2002." Bibliography: leaves 123-144.

Made available in DSpace on 2014-06-11T19:29:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-07-29Bitstream added on 2014-06-13T20:38:16Z : No. of bitstreams: 1 limafilho_ja_me_botfm.pdf: 965475 bytes, checksum: a90c8ecac9393f9d894352cba987f7a7 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A dificuldade na intubação traqueal é causa de mortalidade em anestesiologia e pode estar relacionada à obesidade. Reconhecer o paciente com intubação difícil contribui para o sucesso da abordagem da via aérea, contudo os parâmetros preditores de intubação difícil não estão bem estabelecidos. A classificação de Mallampati, a distância interincisivos, a circunferência do pescoço, a distância tireomentoniana, a conformação da face e a presença da síndrome da apnéia obstrutiva do sono (SAOS) são parâmetros que podem indicar a intubação difícil. O tratamento cirúrgico da obesidade proporciona redução do índice de massa corpórea (IMC), com estabilização deste por volta de dois anos. Assim, o objetivo desta pesquisa foi reavaliar os parâmetros acima descritos com os valores obtidos antes da cirurgia. Cinquenta e um pacientes de ambos os sexos, foram avaliados no período pré-operatório, quanto ao IMC, a classificação de Mallampati, a circunferência do pescoço, a distância interincisivos, a distância tireomentoniana e o grau da SAOS por meio da polissonografia. Após dois anos da cirurgia e redução do IMC para valores inferiores a 35 kg.m-2 os valores preditores de intubação difícil foram reavaliados por outro médico anestesiologista que possuía apenas o conhecimento do IMC prévio. Foram excluídos nove pacientes, uma gestante, dois por não redução do IMC e seis por recusa. Executada reavaliação dos parâmetros supracitados. Para os pacientes que não realizaram nova polissonografia foi aplicada a escala de sonolência de Epiworth. Dos 42 pacientes reavaliados, 17 foram do sexo masculino e os restantes do feminino. Todos apresentaram redução do IMC, da circunferência do pescoço da distância interincisivos e tireomentoniana. Apenas um paciente apresentou redução na escala de Mallampati e somente 4 pacientes realizaram a polissonografia... / Difficulty in intubation is a cause of mortality in anesthesiology and may be related to obesity. Recognize the patient with difficult intubation contributes to a successful approach to air, however the parameters predictive of difficult intubation is not well established. The Mallampati classification, the distance interincisal, neck circumference, the distance thyromental, the conformation of the face and the presence of the syndrome of obstructive sleep apnea (OSA) are parameters that may indicate difficult intubation. Surgical treatment of obesity provides a reduction of body mass index (BMI), with this stabilizing around two years. The objective of this research was to reassess the parameters described above with the values obtained before surgery. Fifty-one patients of both sexes were evaluated during the preoperative period, with respect to BMI, Mallampati classification, neck circumference, the distance interincisal, distance thyromental and degree of OSA by polysomnography. After two years of surgery and reduction of BMI to less than 35 kg.m-2 values predicting difficult intubation were reviewed by another anesthesiologist who had only prior knowledge of the IMC. Excluding nine patients, one pregnant, two by not reducing the BMI and six refused. Performed reassessment of the parameters mentioned above. For patients who did not undergo polysomnography was applied to Epiworth Sleepiness Scale. Of the 42 patients reviewed, 17 were male and the rest of feminino.Todos showed reduction in BMI, neck circumference, distance and interincisal thyromental. Only one patient showed a reduction in the scale of Mallampati and only four patients underwent polysomnography. The reduction ... (Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:29:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-05Bitstream added on 2014-06-13T20:38:16Z : No. of bitstreams: 1 cerqueira_bgp_me_botfm.pdf: 624148 bytes, checksum: eda616e209e0b23f30c488325f184ade (MD5) / Universidade Estadual Paulista (UNESP) / A dificuldade na intubação traqueal é causa de mortalidade em anestesiologia e pode estar relacionada à obesidade. Reconhecer o paciente com intubação difícil contribui para o sucesso da abordagem da via aérea, contudo os parâmetros preditores de intubação difícil não estão bem estabelecidos. A classificação de Mallampati, a distância interincisivos, a circunferência do pescoço, a distância tireomentoniana, a conformação da face e a presença da síndrome da apnéia obstrutiva do sono são parâmetros que podem indicar a intubação difícil. A manobra de BURP tem por objetivo melhorar a visualização da via aérea durante a laringoscopia e variações da mesma também podem ser efetivas. Assim, o objetivo desta pesquisa foi correlacionar os parâmetros acima descritos com a dificuldade de intubação traqueal observada durante a laringoscopia, avaliada por meio da escala de Cormack e Lehane (ECL), sem e com manipulação de laringe (variação da manobra de BURP). Cento e trinta e quatro pacientes de ambos os sexos, foram avaliados no período pré-operatório, quanto ao índice massa corpórea, a classificação de Mallampati, a circunferência do pescoço, a distância interincisivos, a distância tireomentoniana e o grau da síndrome da apnéia obstrutiva do sono. Após a monitorização, o posicionamento adequado e a indução anestésica os pacientes foram submetidos à laringoscopia direta, sendo avaliado o grau da escala de Cormack e Lehane. Nos pacientes com graus superiores a um, realizou-se a manipulação da laringe, reavaliando-se o grau da mesma. A manobra de manipulação da laringe é variação da de BURP e consiste no deslocamento da laringe pelo anestesiologista que esta Introdução e Objetivo 9 realizando a laringoscopia, sem um direcionamento pré-estabelecido. Foram registrados os graus da... / The difficulty in tracheal intubation is a cause of mortality in anesthesiology and can be associated with obesity. To be able to recognize a patient of difficult intubation may add to the success of the airway approach; however, parameters used to predict difficult intubations are not well established. Mallampati’s classification, the distance between incisive teeth, neck circumference, thyroid-chin distance, facial shape and the presence of sleep apnea syndrome are parameters that can point towards a challenging intubation. BURP’s maneuver aims at improving airway visualization during laryngoscopy and its variations may also be effective. Thus, the goal of the present study is to correlate the aforementioned parameters with the difficulties associated with tracheal intubation observed during laryngoscopy, evaluated by means of Cormack and Lehane’s scale, with and without laryngeal handling (BURP’s maneuver variation). One hundred and thirty four patients from both genders were assessed in the pre-operative time as to body mass index, Mallampati’s classification, neck circumference, distance between incisive teeth, thyroid-chin distance and the level of obstructive sleep apnea. After monitoring, proper positioning and anesthetic induction, the patients were submitted to direct laryngoscopy, and we assessed their classification according to Cormack and Lehane’s scale. In those patients classified above level one, we manipulated their larynx and reassessed their classification. Laryngeal manipulation maneuver is a variation of BURP’s maneuver and is based on laryngeal shifting by the anesthesiologist who is doing the laryngoscopy, with no pre-established direction. We recorded the patient’s classifications according to Introdução e Objetivo 11 Cormack and Lehane’s scale ...(Complete abstract click electronic access below)

Basal cells (BCs) are multipotent tissue-specific stem cells of a variety of organs including the skin, digestive and respiratory tract. BCs are broadly identified by expression of Krt5, Krt14 and the transcription factor p63. In the adult airways, BCs are not only important for normal maintenance but also crucial for epithelial repair after injury. However, the embryonic origin of these adult stem cells remains elusive. Previous reports showed that p63+ cells appear early during airway development, but these do not express markers of adult BCs, raising the question whether these cells represent BC precursors. Moreover, little was known whether embryonic BCs have an impact in the adult pool of progenitors that mediate responses of the lung to injury or pulmonary diseases. The goal of this thesis is to address these gaps of knowledge using a variety of technologies, including functional and lineage tracing analysis in vivo in mouse genetic models, injury modeling, high-throughput profiling and gene regulation approaches. This thesis is to comprehensively characterize airway BCs in development, injury-repair, and homeostasis. These studies revealed a previously unrecognized broader role of embryonic p63+ cells in the establishment of the stem cell pools of the lung pre and postnatally. Surprisingly, lineage analysis showed that early in development these cells were able to generate all epithelial cell types of the airways and alveolar compartment. However, as development proceeds, they underwent two sequential lineage segregation events to finally generate two regionally distinct adult stem cell pools. One of these became the well-known BCs that populate extrapulmonary airways through an undescribed maturation process from the perinatal stage to adulthood, and the other was identified as a rare stem cell pool in the pseudostratified epithelium of intrapulmonary airways which maintained immature and quiescent throughout lifetime. Moreover, the latter responded uniquely to lung injury induced by H1N1 viral infection. Recent studies have demonstrated that BC-like p63+ Krt5+ cell clusters (“Krt5+ pods”) are ectopically present in the areas of severe alveolar injury by H1N1 viral infection. The presence of these pods has been associated with pathological scars in several human pulmonary diseases including idiopathic pulmonary fibrosis (IPF) and acute respiratory distress syndrome (ARDS). However, their cellular origin has been intensely debated. This thesis showed that this rare progenitor pool is established during embryonic development when airways are still branching. Further characterization demonstrated a p63 gene dosage dependency in the specification/maintenance of this rare progenitor pool. By utilizing multiple lineage-tracing lines, an underappreciated diversity of this pool was revealed by showing a novel subpopulation carrying secretory lineage marker spatially restricted to intrapulmonary airways. Further molecular characterization and genetic manipulation of this rare progenitor pool may provide valuable cues to understand the pathogenesis about pulmonary disorders and to develop effective therapies. Moreover, the molecular signatures of tracheal embryonic E18.5 preBCs and adult TrBCs were generated through high-throughput profiling, which provided hints about the genetic regulation of airway BC maturation process and generated potential molecular landmarks for the in vitro ES/iPS cell differentiation towards airway BCs. In addition, single cell RNA-sequencing analyses revealed heterogeneity of adult BCs in the tracheal and esophageal epithelia. Lastly, candidate master regulators of their differentiation programs in homeostatic and metaplastic states were identified through unbiased systems biology algorithms, which will be further validated in functional assays in the near future. Taken together, the studies in this thesis comprehensively characterized airway BCs in development, injury-repair and homeostasis. This thesis work showed the newly identified p63+ airway progenitors before E10.5 are multipotent for all lung epithelial lineages and this multipotency gets restricted to proximal fate at E10.5. In the adult injury-repair, this thesis work for the first time revealed that the H1N1-induced Krt5+ pods are generated by bronchial p63+ Krt5- progenitors, which originate from a subpopulation of E13.5 intrapulmonary p63+ progenitors. At homeostasis, this thesis work uncovered a previously underappreciated heterogeneity of BCs in both airways and esophagus, and provided molecular foundations for further explorations into the mechanistic perspectives of BC cellular identity maintenance.

Respiratory disease represents an important component of small animal emergency medicine. The morbidity and mortality of respiratory disease and inflammation, although poorly defined, is considered to be significant. Much of the therapy used in the stabilization and management of respiratory disease in veterinary patients has been taken from human medicine, including inhalation therapy. Heparin has been shown to have substantial anticoagulant, anti-inflammatory, and antiibrotic effects within the lungs when administered via inhalation in human patients. To date, no studies have evaluated the use of nebulized heparin in dogs. This study is the first to attempt to generate pharmacokinetic data regarding nebulized unfractionated heparin in the dog.

Thesis (Ph. D.)--University of Sydney, 2009. / Title from title screen (viewed Aug. 11, 2009) Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Discipline of Pharmacology, Faculty of Medicine. Degree awarded 2009; thesis submitted 2008. Includes bibliographical references. Also available in print form.

No description available.

The airway epithelium demonstates the ability to quickly repair following physical injury. The morphologic features of this dynamic repair process have been well characterised at the anatomic and cellular level using a number of animal model systems and these studies have provided a solid foundation upon which our understanding of normal repair is build. With the advent of molecular and bioinformatic tools and resources the opportunity exists to extend the value of these models in defining the molecular pathways and interactions that underlay the normal repair process. This thesis represents a realisation of this opportunity. A large animal model was developed in which selected areas of airway epithelium were subjected to bronchial brush biopsy as part of routine bronchoscopic examination prcedures in anaethetised sheep. The process resulted in a physical perturbation of the normal pseudostratified structure of the sheep airwway epithelium at specific locations. By careful experimental design it was possible, within the same animals. to identify and sample from sites undergoing repair at different intervals subsequent in injury. To supplement the histological evaluation of the repair process and align findings with extablished small animal models of airway epithelial repair proliferative cell labelling strategies were implemented in order to study the location and extent of cellular proliferation occurring duringthe repair process. Molecular approaches towards defining the transcriptional response to physical injury comprised application of microarray technology using a commercially sources array platform. Such approach demanted preliminary effort directed towards optimising RNA integrity and yield from airway samples. Following preliminary studies directed towards optimising the model conditions patterns of airway epithelial repair following bronchial brush biopsy were studies in eight sheep at degined time points (6 hours, 1,3, & 7 days) post-injury. Bronchial brush biopsy resulted in the acute removal of the epithelial cell layer and components of the underlying structures. repair processes were rapidly implemented through initial epithelial dedifferentiation, proliferatino and migration at the wound margins and subsequent time-depentend changes in the proportion of subepithelial structures, including smooth muscle and blood vessels, as the epithelial surface moved towards repair. Transcriptional analysis revewaled that over 13,000 probes showed evidence of differential expession at some point during the repair process (p<0.05), whilst of these, 1491 probes had in excess of a two-fold change in expression. array results were validated against conventional semi-quantitative RT-PCR for selected genes. Differentially expressed genes with previously characterised roles in epithelial migration, prolifereation and differentiation were identified during the repair process. The relative emphasis of gene products with particular functional roles varied during the course of repair. Indeed gene ontology (GO) terms identified included those associated with the inflammatory response, cellular migration, extracellular matrix activities, differentiation, proliferation, cellular development, cell cycle activities, cellular adhesion, apoptosis and mitosis. In addition the Kyoto Encyclopedia of Genes and Gneomes (KEGG) databases were queried and such process indicated the involvement of cell communication, 053 and complement and coagulation cascade pathways throughout the repair process, initial (6h) Toll-like receptor and cytokine-cytoine receptor interaction pathways, and the progressive involement of cell cycle, focal adhesion and extracellulaar matrix (ECM)-receptor, and cytokine interaction pathways as the epithelium repaired. The model of airway epithelial injury developed in this thesis generated features broadly consistent with those previosly described in relation to various small animal model systems. Importantly, and in addition, this thesis defines the molecular features associated with repair in this model system and provides a useful resource with which to assess the comparative fetures of the airway transcriptional response to physical injury, It is through such comparison, using analogous methodology, that the fundamental pathways and interactions that underlay normal repair and regeneration can be identified and therafter extended towards inderstanding the basis for variation associated with natural and experimental disease.