Influence of environmental temperature and humidity on the acute ventilatory response to exercise in asthmatic adolescents

Asthma is a chronic inflammatory disorder of the respiratory airways affecting people of all ages, and constitutes a serious public health problem worldwide (6). Such a chronic inflammation is invariably associated with injury and repair of the bronchial epithelium known as remodelling (11). Inflammation, remodelling, and altered neural control of the airways are responsible for both recurrent exacerbations of asthma and increasingly permanent airflow obstruction (11, 29, 34). Excessive airway narrowing is caused by altered smooth muscle behaviour, in close interaction with swelling of the airway walls, parenchyma retractile forces, and enhanced intraluminal secretions (29, 38). All these functional and structural changes are associated with the characteristic symptoms of asthma – cough, chest tightness, and wheezing –and have a significant impact on patients’ daily lives, on their families and also on society (1, 24, 29). Recent epidemiological studies show an increase in the prevalence of asthma, mainly in industrial countries (12, 25, 37). The reasons for this increase may depend on host factors (e.g., genetic disposition) or on environmental factors like air pollution or contact with allergens (6, 22, 29). Physical exercise is probably the most common trigger for brief episodes of symptoms, and is assumed to induce airflow limitations in most asthmatic children and young adults (16, 24, 29, 33). Exercise-induced asthma (EIA) is defined as an intermittent narrowing of the airways, generally associated with respiratory symptoms (chest tightness, cough, wheezing and dyspnoea), occurring after 3 to 10 minutes of vigorous exercise with a maximal severity during 5 to 15 minutes after the end of the exercise (9, 14, 16, 24, 33). The definitive diagnosis of EIA is confirmed by the measurement of pre- and post-exercise expiratory flows documenting either a 15% fall in the forced expiratory volume in 1 second (FEV1), or a ≥15 to 20% fall in peak expiratory flow (PEF) (9, 24, 29). Some types of physical exercise have been associated with the occurrence of bronchial symptoms and asthma (5, 15, 17). For instance, demanding activities such as basketball or soccer could cause more severe attacks than less vigorous ones such as baseball or jogging (33). The mechanisms of exercise-induced airflow limitations seem to be related to changes in the respiratory mucosa induced by hyperventilation (9, 29). The heat loss from the airways during exercise, and possibly its post-exercise rewarming may contribute to the exercise-induced bronchoconstriction (EIB) (27). Additionally, the concomitant dehydration from the respiratory mucosa during exercise leads to an increased interstitial osmolarity, which may also contribute to bronchoconstriction (4, 36). So, the risk of EIB in asthmatically predisposed subjects seems to be higher with greater ventilation rates and the cooler and drier the inspired air is (23). The incidence of EIA in physically demanding coldweather sports like competitive figure skating and ice hockey has been found to occur in up to 30 to 35% of the participants (32). In contrast, swimming is often recommended to asthmatic individuals, because it improves the functionality of respiratory muscles and, moreover, it seems to have a concomitant beneficial effect on the prevalence of asthma exacerbations (14, 26), supporting the idea that the risk of EIB would be smaller in warm and humid environments. This topic, however, remains controversial since the chlorified water of swimming pools has been suspected as a potential trigger factor for some asthmatic patients (7, 8, 20, 21). In fact, the higher asthma incidence observed in industrialised countries has recently been linked to the exposition to chloride (7, 8, 30). Although clinical and epidemiological data suggest an influence of humidity and temperature of the inspired air on the bronchial response of asthmatic subjects during exercise, some of those studies did not accurately control the intensity of the exercise (2, 13), raising speculation of whether the experienced exercise overload was comparable for all subjects. Additionally, most of the studies did not include a control group (2, 10, 19, 39), which may lead to doubts about whether asthma per se has conditioned the observed results. Moreover, since the main targeted age group of these studies has been adults (10, 19, 39), any extrapolation to childhood/adolescence might be questionable regarding the different lung maturation. Considering the higher incidence of asthma in youngsters (30) and the fact that only the works of Amirav and coworkers (2, 3) have focused on this age group, a scarcity of scientific data can be identified. Additionally, since the main environmental trigger factors, i.e., temperature and humidity, were tested separately (10, 28, 39) it would be useful to analyse these two variables simultaneously because of their synergic effect on water and heat loss by the airways (31, 33). It also appears important to estimate the airway responsiveness to exercise within moderate environmental ranges of temperature and humidity, trying to avoid extreme temperatures and humidity conditions used by others (2, 3). So, the aim of this study was to analyse the influence of moderate changes in air temperature and humidity simultaneously on the acute ventilatory response to exercise in asthmatic children. To overcome the above referred to methodological limitations, we used a 15 minute progressive exercise trial on a cycle ergometer at 3 different workload intensities, and we collected data related to heart rate, respiratory quotient, minute ventilation and oxygen uptake in order to ensure that physiological exercise repercussions were the same in both environments. The tests were done in a “normal” climatic environment (in a gymnasium) and in a hot and humid environment (swimming pool); for the latter, direct chloride exposition was avoided.

Estudo de tecnologias domóticas e a sua aplicação em projectos

Actualmente a área da domótica (automação de casas e edifícios) encontra-se em franca expansão, com principal relevância nos países mais desenvolvidos, com um crescimento de mercado de mais de 10% ao ano. Existem inúmeras razoes para a crescente implantação da domótica em edifícios, entre as quais a maior eficiência energética, o aumento da segurança e a redução do custo de aquisição das tecnologias. No que diz respeito as habitações particulares, acrescenta-se essencialmente o aumento do conforto devido ao grau de automação trazido pela domótica. Apesar da domótica não ser uma área cientifico-tecnológica recente, a rápida evolução das tecnologias associadas, nomeadamente a nível das redes de comunicação com e sem fios, foi uma das razoes fundamentais para a elaboração desta Tese. Acresce o facto de o candidato estar actualmente envolvido profissionalmente na área, pelo qual esta Tese assume uma particular importância. Realizou-se um estudo comparativo das tecnologias de domótica mais relevantes, escolhidas quer pelas suas características técnicas quer pela sua implantação de mercado e potencial futuro - KNX/EIB, LonWorks, HomePlug, ZigBee e Z-Wave. Destas, comprovou-se que as duas primeiras são aquelas que, actualmente, tem maior adequabilidade para serem aplicadas em projectos de domótica. Foi por isso efectuado um estudo mais elaborado das tecnologias LonWorks e KNX/EIB, incluindo a forma pratica de instalação/programação, a elaboração de dois demonstradores e de dois projectos (de acordo com um caderno de encargos real), usando as duas tecnologias. Concluiu-se que a tecnologia LonWorks apresenta vantagens no que respeita a escalabilidade (dimensão) dos sistemas. Em termos futuros, prevê-se a necessidade da interoperabilidade entre os nos/redes cablados (tradicionais) com nos/redes sem fio, seguindo a tendência para os ambientes inteligentes (“ambient intelligence/assisted living”, “smart spaces”, “ubiquitous computing).

A criação de valor no binómio: “Casa inteligente” / consumidor

Este trabalho tem como objectivo entender a criação de valor no binómio casa inteligente/consumidor, esperando assim contribuir para um novo equilíbrio procura/oferta tendente a que uma casa inteligente fique acessível a mais lares portugueses. O método utilizado baseou‐se na pesquisa do mercado português de sistemas de domótica e posteriormente no estudo das motivações do consumidor recorrendo ao método quantitativo de análise de inquéritos. Do cruzamento do conhecimento dos sistemas disponibilizados para casas inteligentes e das motivações dos consumidores poderá resultar uma melhor aproximação à solução que conduz à satisfação do consumidor. Neste estudo concluiu‐se que, actualmente, em Portugal, estão disponíveis sistemas domóticos capazes de satisfazer as necessidades e motivações dos diferentes consumidores. Assim, os sistemas baseados no protocolo EIB com excelentes características enquadram‐se no segmento mais exigente e com maior investimento. O protocolo X10 oferecendo uma elevada flexibilidade a baixo custo, disponibilizando pequenos kits de inicialização acessíveis e facilitando a sua instalação, dado utilizarem a rede eléctrica para comunicação e interligação, parece dar resposta ao segmento de mercado de menor investimento nesta área. O segmento intermédio encontra uma resposta diversificada nas soluções oferecidas baseados em sistemas proprietários desenhados para responder às exigências mais comuns dos consumidores.