Luciana Aparecida Teixeira Soares’s research while affiliated with Faculdade de Medicina de Jundiaí and other places

In the real world, health professionals need to care for individuals with asthma-like symptoms who have a persistently negative bronchodilator response (BDR). Little is known about the evolution of symptoms and lung function of these individuals because they are usually excluded from studies on asthma. The aim of this study was to evaluate whether individuals with asthma-like symptoms but with a persistently negative BDR have a different evolution of symptoms and lung function compared to individuals with asthma proven by positive BDR. This prospective cohort study included adults with asthma-like symptoms. Individuals participated in two visits 12 months apart. They responded to questionnaires and underwent a spirometry test. In individuals without airway obstruction in the first visit, those with asthma-like symptoms and persistently negative BDR were less likely to lose forced expiratory volume in the first second during follow-up or progress to airway obstruction at the final visit compared to individuals with asthma proven by positive BDR. Among individuals with airway obstruction at baseline, those with asthma-like symptoms and persistently negative BDR were less likely to resolve the airway obstruction during follow-up compared to individuals with asthma proven by positive BDR. In individuals with proven asthma, the emergence or persistence of positive BDR during follow-up was accompanied by a worsening of asthma outcomes compared to the remission of positive BDR. Thus, BRD is an accessible marker of disease progression in individuals with asthma-like symptoms. In individuals with asthma proven by positive BDR, the trend in BDR was associated with the evolution of symptoms and lung function.

We hypothesize that green areas within cities affect the respiratory symptoms of individuals with asthma, but this effect may not be the same for all age groups, because the immunopathology of asthma in children-adolescents is different from the immunopathology of asthma in adults. The objective of this study is to evaluate whether there is an association between the percentage of green area close to the residence and asthma outcomes, stratified by age group. We included individuals with asthma over the age of ten years. Two independent trained researchers measured, in satellite images, the extent of green area around the residence. The primary outcome of the study was the severity of respiratory symptoms measured by the Asthma Control Test. The secondary outcome was the presence of airway obstruction in the spirometry test carried out on the day of the study visit. Binary logistic regression analyzes evaluated whether the percentage of green area close to the residence was associated with asthma outcomes. In children-adolescents, greater density of green area was associated with a greater frequency of uncontrolled asthma symptoms. In adults, greater density of green area was associated with a lower frequency of uncontrolled asthma symptoms and a lower frequency of airway obstruction. We conclude that the extent of green areas close to the residence is associated with asthma morbidity. The expansion of green areas within cities should favor species that do not disseminate pollen with allergenic potential, especially in regions close to schools and daycare centers.

Introduction: Studies have identified a greater risk of sensory neural hearing loss in individuals with COPD compared to healthy individuals, but it is unclear whether they are at increased risk of hearing loss with impaired speech recognition. The aim of this study was to assess whether COPD is associated with hearing loss that affects speech recognition. Methods: This is a case-control study. We screened individuals from health facilities in the municipality of Jundiai. We enrolled a test group of individuals with COPD and an age-matched control group composed of individuals with asthma. The selected individuals attended an appointment with a chest physician, responded questionnaires and underwent tonal and speech audiometry. Adjusted binary logistic regression analysis evaluated whether COPD was associated with reduced speech recognition. Results: We enrolled 36 individuals with COPD and 72 with asthma. Individuals with COPD were more likely to have a reduced speech recognition compared to asthmatic individuals [Reduced recognition of three-syllable words: adjusted OR 3.72, 95 CI (1.38 - 10.02)] [Reduced recognition of monosyllable words: adjusted OR 4.74, 95 CI (1.52 - 14.76)]. Conclusion: We conclude that individuals with COPD from primary and secondary healthcare facilities have at least 38% greater risk of hearing loss with reduced speech recognition compared to an age-matched control group of individuals with asthma recruited from the same facilities. We recommend that longitudinal studies evaluate whether regular screening could contribute to the prevention or early treatment of hearing loss in individuals with moderate-severe COPD.