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Obstructive sleep apnea (OSA) is a syndrome characterized by intermittent nocturnal hypoxia, sleep fragmentation, hypercapnia and respiratory effort, and it has been associated with several complications, such as diabetes, hypertension and obesity. Quantitative real-time PCR has been performed in previous OSA-related studies; however, these studies were not validated using proper reference genes. We have examined the effects of chronic intermittent hypoxia (CIH), which is an experimental model mainly of cardiovascular consequences of OSA, on reference genes, including beta-actin, beta-2-microglobulin, glyceraldehyde-3-phosphate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase and eukaryotic 18S rRNA, in different areas of the brain. All stability analyses were performed using the geNorm, Normfinder and BestKeeper software programs. With exception of the 18S rRNA, all of the evaluated genes were shown to be stable following CIH exposure. However, gene stability rankings were dependent on the area of the brain that was analyzed and varied according to the software that was used. This study demonstrated that CIH affects various brain structures differently. With the exception of the 18S rRNA, all of the tested genes are suitable for use as housekeeping genes in expression analyses.

KEYWORDSAsthma; activity impairment; healthcare resource use; quality of life; burden of asthma; disease control ABSTRACTObjective: To determine the association of asthma on health-related quality of life (QoL), productivity, and use of healthcare resources among adults in Brazil. Methods: Data were analyzed from the 2015 Brazil National Health and Wellness Survey, a cross-sectional survey with 12,000 adult respondents. Asthma and control groups were compared with respect to health-related QoL, asthma control, work productivity, and adherence. Generalized linear models were developed to compare asthma-related associations controlling for potential confounding factors. Results: Among respondents, 4.1% (n = 494) reported an asthma diagnosis; those without asthma symptoms were used as the control group (n = 11,487). Regarding asthma control, 51.2% of patients had uncontrolled asthma, 36.4% partially controlled asthma, and 12.3% were fully controlled. Short-acting β2 agonists were the most commonly used class of drugs (38.5%). Approximately 32.4% of asthma patients were considered fully adherent to their treatment. In multivariable analyses, asthma patients presented lower health-related QoL and had more frequent visits with medical healthcare providers (6.1 versus 4.2) emergency room visits (1.0 versus 0.5), and more hospitalizations (0.4 versus 0.2), than control respondents six months prior to the study (p < 0.05). Rates of absenteeism and presenteeism varied between 11.5% and 7.4% (p < 0.05) and 30.4% and 20.9% (p < 0.001) between asthma patients and controls, respectively. Conclusions: Asthma had a negative association on health-related QoL, work productivity, and use of healthcare resources. Excessive use of short-acting β2 agonists and poor treatment adherence reflect poor asthma control and suggest the need to implement new strategies for asthma treatment in Brazil.

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