Background: Chronic pain and poor sleep quality are biopsychosocial changes that are associated with human aging and have a bidirectional correlation. The objective was to evaluate the association between chronic pain and quality of sleep and quality of life of elderly people. Methods: This was a cross-sectional study with a correlational quantitative approach on the association of chronic pain with the quality of sleep and quality of life of elderly people in the community. The evaluation was carried out using sociodemographic, clinical and anthropometric questionnaires, Pittsburgh Sleep Quality Index, visual analogue scale, cognitive impairment, quality of life, and functional mobility. Descriptive statistical analysis was performed. The means between the groups were compared using the Student’s t-test for independent samples, using the Spearman correlation coefficient (ρ) to test the associations and one-way analysis of variance to compare the means between the three age groups. Results: This study included 131 elderly people, predominantly female (87%), with an average age of 68 ± 7 years, low income per capita (84.8% ≤2 MW), and low education (86.3% ≤3 years of study). The elderly with a history of chronic pain had worse quality of sleep and quality of life than those without chronic pain. There was a moderate (ρ = 0.590) and significant (p <0.01) positive correlation between sleep quality and chronic pain intensity, and a moderate (ρ = -0.57) and significant (p <0.01) correlation between quality of life and the intensity of chronic pain. Conclusion: Elderly people with chronic pain have worse quality of sleep and quality of life than those without chronic pain. We also found that the greater the number of chronic diseases, the worse the quality of sleep and quality of life. Trial Registration: Registro Brasileiro de Ensaios Clínicos (REBEC) Identifier: RBR-3cqzfy Keywords: Elderly; sleep; chronic pain; quality of life.

Aims: to test the hypothesis that a semi-supervised home physical exercise program improves the functional mobility and quality of life (QOL) of elderly in the community. Methods: This trial was conducted with elderly people (88% female), aged 60 years or older, sedentary and without cognitive decline. Elderly were randomly assigned to an intervention group - IG (home physical exercise and sleep hygiene) and a control group - CG (sleep hygiene). Were applied the International Questionnaire on Physical Activity; mental state mini-exam and the Timed Up and Go test (TUG) before and after the 12-week intervention period. Results: The IG showed an improvement in functional mobility, with a mean reduction in TUG execution time (p <0.01) and improvement in the QOL, (p <0.01) in WHOQOL-OLD. Conclusion: Semi-supervised physical home exercise is effective in improving the functional mobility and the QOL of sedentary elderly in the community. Trial Registration: Registro Brasileiro de Ensaios Clínicos (REBEC) Identifier: RBR-3cqzfy Keywords: Elderly; exercise; functional mobility; quality of life; community; physical activity; home exercise.

Background: Asthmatic children present variable degrees of airway inflammation, remodeling and resistance, which correlates with disease control and severity. Chronic inflammatory process of the airways triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. This study has investigated for the first time, whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present correlation with the resistance of respiratory system and of proximal and distal airways. Methods: 24 asthmatic children (persistent mild and moderate) and 24 non-asthmatic children (both between 6-13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, pulmonary and systemic immune response. Results: Asthmatic children showed an increased number of blood eosinophils (p<0.04), basophils (p<0.04), monocytes (p<0.002) and lymphocytes (p<0.03). In addition, asthmatic children showed an impaired lung function, as demonstrated by FEV1%pred. (p<0.0005) and FEV1/FVC (p<0.004), decreased total resistance of respiratory system (R5Hz; p<0.009), increased resistance of proximal airways (R20Hz; p<0.02), increased elastance (Z5Hz; p<0.02) and increased reactance (X5Hz; p<0.002). Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p<0.0001) and in the serum (p<0.0001); TGF-beta in the BC (p<0.0001) and in the serum (p<0.004); IL-5 in the BC (p<0.02) and in the serum (p<0.01); IL-4 in the serum (p<0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in asthmatic children, reflecting airway remodeling, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.

Background: Alterations of the circadian rhythm negatively impact several aspects of the health, including the lung function. Chronic shiftwork scale classically induces alterations in the circadian rhythm. However, its effects on pulmonary immune response are unknown. Aims: To evaluate the impact of chronic alteration of circadian rhythm on pulmonary function and immune response. Methods: In this context, a 12h x 24h and 12h x 48h work scale in shiftwork scale policemen (n = 25; 38,73±6,92 years old) were compared with fixed work scale (8h/day) civil men (n = 25; 34,00±9,60 years old) who were evaluated for perceived stress, sleepiness, physical activity levels, anthropometric characteristics, sleepiness levels, lung function, pulmonary and systemic cellular and humoral immune response. Results: Policemen presented increased levels of perceived stress (p<0.0008), impaired sleepiness (p<0.04) and lung function as demonstrated by reduced FVC (p<0.053) and FEV1 (p<0.043) when compared to civil men. In addition, increased levels of exhaled nitric oxide (p<0.037) and of IL-2 (p<0.0046) in the breath condensate revealed that policemen presented chronic lung inflammation compared to civil men. Although the whole blood analysis did not showed any differences between the two groups concerning the number of leukocytes, the humoral response revealed that policemen presented increased levels of IL-2 (p<0.002) and lower levels of IL-10 (p<0.001), clearly displaying a clinical status of low grade inflammation. Conclusions: Chronic alteration of circadian rhythm in shiftwork scale policemen results in impaired lung function, beyond to impair pulmonary and systemic immune function.

Background: Asthmatic children present variable degrees of airway inflammation, remodeling and resistance, which correlates with disease control and severity. Chronic inflammatory process of the airways triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. This study has investigated for the first time, whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present correlation with the resistance of respiratory system and of proximal and distal airways. Methods: 24 asthmatic children (persistent mild and moderate) and 24 non-asthmatic children (both between 6-13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, pulmonary and systemic immune response. Results: Asthmatic children showed an increased number of blood eosinophils (p<0.04), basophils (p<0.04), monocytes (p<0.002) and lymphocytes (p<0.03). In addition, asthmatic children showed an impaired lung function, as demonstrated by FEV1%pred. (p<0.0005) and FEV1/FVC (p<0.004), decreased total resistance of respiratory system (R5Hz; p<0.009), increased resistance of proximal airways (R20Hz; p<0.02), increased elastance (Z5Hz; p<0.02) and increased reactance (X5Hz; p<0.002). Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p<0.0001) and in the serum (p<0.0001); TGF-beta in the BC (p<0.0001) and in the serum (p<0.004); IL-5 in the BC (p<0.02) and in the serum (p<0.01); IL-4 in the serum (p<0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in asthmatic children, reflecting airway remodeling, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.

Background: Reduced peripheral and respiratory muscle strength correlates with impaired lung function in COPD, but whether diminishement in peripheral and respiratory muscle strength correlates with lung mechanis is unknown. Aims: To investigate whether spirometric and respiratory and peripheral muscle strength correlates with small airways obstruction evaluated by impulse oscillometry. Methods: Nighteen COPD GOLD II and twenty former smokers’ individuals were evaluated for lung function, lung mechanics, maximum inspiratory and expiratory pressure and hand grip strength test. Results: COPD presented reduced FEV1 and FEV1/FVC (p<0.001) compared to former smokers with no changes in FVC. In COPD the FEV1 and FEV1/FVC showed a negative correlation with BMI (P<0.05, R=-0.56 and -0.43, respectively). The total resistance of respiratory system and small airway resistance were reduced in the COPD compared to former smoke group. The COPD individuals showed a negative moderate correlation between FEV1 and impedance (R=-0,664; P<0.01); airway resistance (R=-0,593, P<0.05) and peripheral airway resistance (R=-0,547, P<0.05). The negative correlation was low in COPD individuals for reactance (R=-0,434, P<0.05) and proximal airway resistance (R=-0,480, P<0.05). These correlations were not found in the former smoke group. Hand grip strength measured in the right arm showed a moderate negative correlation with the maximal inspiratory pressure (R=-0,539, P<0.05) in COPD individuals. There was no correlation between PIMax and PEMax with none of the spirometric or oscillometric parameters (p>0.05) in COPD or former smokers’ individuals. Conclusions: Lung mechanics correlate with spirometric parameters in COPD patients but not with respiratory and peripheral muscle strength.