Evolución de las ecuaciones del Shuttle Run Test 20m para la obtención del VO2máx: Revisión documental / Evolution of the equations of the Shuttle Run Test 20m to obtain VO2max: Documentary review

Para la evaluación del fitness cardiorrespiratorio existen pruebas directas en laboratorio que proporcionan información objetiva respecto a esta cualidad. No obstante, cuando no se cuenta con los recursos se recurre al uso de pruebas de campo como el Shuttle Run Test 20 metros (SRT-20m), el cual busca establecer el VO2max para cada sujeto, relacionando los valores obtenidos con aspectos como la composición corporal, edad y contexto poblacional, siendo una de las pruebas más confiables y con concordancia clínica existente. El propósito fue reconocer los cambios o variaciones presentes en los modelos matemáticos o lineales empleados en esta prueba con diferentes grupos poblacionales. Se realizó una revisión de la literatura bajo el marco básico para revisiones integradoras con algunas precisiones dadas por la guía PRISMA, identificando en su mayoría estudios de corte transversal los cuales evidencian los cambios realizados al planteamiento de la fórmula matemática donde las variables que inciden en el valor resultante para la resistencia aeróbica son: velocidad final, etapa de la prueba, edad y aspectos antropométricos del sujeto. Por lo anterior, se concluye que, para efectos prácticos, la estimación del VO2máx debe considerar factores intrínsecos del sujeto y aquellos relacionados con la ejecución de la prueba (AU)

For the evaluation of cardiorespiratory fitness, there are direct laboratory tests that provide objective information regarding this quality. However, when the resources are not available, the use of field tests such as the Shuttle Run Test 20 meters (SRT-20m) is used, which seeks to establish the VO2max for each subject, relating the values obtained with aspects such as body composition, age, and population context, being one of the most reliable tests with existing clinical agreement. The purpose was to recognize the changes or variations present in the mathematical or linear models used in this test with different population groups. A review of the literature was carried out under the basic framework for integrative reviews with some clarifications given by the PRISMA guide, identifying mostly cross-sectional studies which show the changes made to the approach of the mathematical formula where the variables that affect the resulting value for aerobic endurance are final speed, stage of the test, age, and anthropometric aspects of the subject. Therefore, it is concluded that, for practical purposes, the estimation of VO2max should consider intrinsic factors of the subject and those related to the execution of the test (AU)

Efficacies of prokinetics and rifaximin on the positivity of a glucose breath test in patients with functional dyspepsia: a randomized trial

Background and aim: prokinetics could eradicate small intestinal bacterial overgrowth. This study aimed to evaluate the efficacy of mosapride, rifaximin and a combination of mosapride and rifaximin for the treatment of small intestinal bacterial overgrowth. Methods: we randomly assigned patients with functional dyspepsia diagnosed with small intestinal bacterial overgrowth in a 1:1:1 ratio to receive mosapride, rifaximin or a combination of both for two weeks. The hydrogen-methane glucose breath test and symptom questionnaire were surveyed before and after the treatment. Primary outcome was eradication rate of small intestinal bacterial overgrowth. Secondary outcomes were changes in the gas concentration, symptoms and safety. Results: the eradication rates were 17.2 % (5/29) for mosapride, 32.1 % (9/28) for rifaximin, and 34.6 % (9/26) for the combined groups, with no significant differences among the three groups. Total hydrogen concentration during the glucose breath test significantly decreased in the rifaximin group (p = 0.001). Total methane concentration significantly decreased in the rifaximin and combined groups (p = 0.005). Significant symptomatic improvements were observed in chest and abdominal discomfort with mosapride, in flatulence with rifaximin, and in chest discomfort with the combined groups. Adverse events were similar between the groups. Conclusions: rifaximin has an advantage of reducing gas, whereas mosapride can help to decrease breath hydrogen concentration. Certain intestinal symptoms improved with mosapride alone or combined with rifaximin (AU)

The importance of aeroallergen sensitivity in children with cystic fibrosis

Background Cystic fibrosis (CF) is an inherited autosomal recessive disorder that causes chronic airway disease. In addition to genetic factors, environmental factors may affect the clinical phenotype of CF. In this study, the presence of aeroallergen sensitivity in our patients with CF and its effects on clinical findings are evaluated. Methods In this study, patients included were diagnosed with CF and followed in the Pediatric Respiratory and Allergy Clinic of the Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. Demographic characteristics, clinical and laboratory findings, skin prick test (SPT) results, and modified Shwachman–Kulczycki (MSK) scores of the patients were evaluated. Results We evaluated 51 patients with CF with a median age of 10 (6–18) years. The mean MSK score of the patients was 72.54±11.50, and the mean predictive value of forced expiratory volume (FEV1) in the initial (1st) second was 80.43±19.50. According to SPT, aeroallergen sensitivity was detected in 17 (33.3%) patients. The prevalence of bacterial colonization and bronchiectasis was higher, and MSK scores were lower in Aspergillus fumigatus (AF)-sensitive patients (P ≤ 0.01). However, no similar difference was found in other allergen sensitivities. MSK scores (P = 0.001) and predictive FEV1 values (P = 0.005) of 25 (49%) patients with bacterial colonization were significantly lower than those without colonization. Conclusion Aeroallergen sensitivity was detected in approximately one-third of CF patients. Although it has been emphasized in studies that environmental factors may have an impact on lung functions and clinical conditions in CF, the effect of allergens other than AF sensitivity may be less important compared to other environmental factors, such as the presence of bacterial colonization (AU)

Relationship of cardiorespiratory control and vascular compliance in competitive young athletes / Relación entre el control cardiorrespiratorio y la distensibilidad vascular en atletas jóvenes de competición / Relação entre o controlo cardiorrespiratório e a conformidade vascular em jovens atletas competitivos

Objective: To study the haemodynamic properties of the peripheral circulation and its relationship with cardiorespiratory control, during anaerobicmuscle fatigue test, in young competitive athletes.Method: Nine adolescent of national and international competition level were recruited (age: 15.6 ± 1.9 years; male = 7) and cross-evaluated. Morphological measurements (body mass, percentage of total body fat and height), blood pressure (systolic, diastolic, mean and pulse blood pressure),respiratory measures (spirometry and pimometry), power, and fatigue were recorded through Wingate test.Results: Weight, height, and fat-free mass were positively correlated with the power parameters of the Wingate test (p < 0.05). The respiratoryparameters of forced vital capacity, peak expiratory flow, maximum inspiratory pressure (MIP) and maximum sustained pressure (SMIP) were alsosignificantly correlated with the power parameters. Additionally, the cardiorespiratory parameters of MIP and SMIP were positively correlated with pulsepressure at rest (p < 0.05).Conclusion: The increase in MIP and SMIP is associated with a lower arterial compliance, which indicates that a lower vascular elasticity influences agreater diaphragmatic strength and endurance of the young athlete.(AU)

Objetivo: Estudiar las propiedades hemodinámicas de la circulación periférica y su relación con el control cardiorrespiratorio, durante la prueba de fatiga muscular anaeróbica, en jóvenes atletas de competición.Método: Se reclutaron nueve adolescentes de nivel de competición nacional e internacional (edad: 15.6 ± 1.9 años; hombres = 7) y se evaluaron de forma cruzada. Se registraron medidas morfológicas (masa corporal, porcentaje de grasa corporal total y altura), presión arterial (presión arterial sistólica, diastólica, media y pulso), medidas respiratorias (espirometría y pimometría), potencia y fatiga mediante el test de Wingate. Resultados: El peso, la altura y la masa libre de grasa se correlacionaron positivamente con los parámetros de potencia del test de Wingate (p < 0.05). Los parámetros respiratorios de capacidad vital forzada, flujo espiratorio máximo, presión inspiratoria máxima (MIP) y presión inspiratoria máxima sostenida (SMIP) también se correlacionaron significativamente con los parámetros de potencia. Además, los parámetros cardiorrespiratorios de MIP ySMIP se correlacionaron positivamente con la presión del pulso en reposo (p < 0.05).Conclusión: El aumento de la MIP y SMIP se asocia a una menor compliance arterial, lo que indica que una menor elasticidad vascular influye en una mayor fuerza y resistencia diafragmática del joven atleta.(A)

Objetivo: Estudar as propriedades hemodinâmicas da circulação periférica e sua relação com o controle cardiorrespiratório, durante o teste de fadigamuscular anaeróbica, em jovens atletas competitivos.Método: Nove adolescentes de nível de competição nacional e internacional foram recrutados (idade: 15.6 ± 1.9 anos; masculino = 7) e avaliados de formacruzada. Medidas morfológicas (massa corporal, percentual de gordura corporal total e altura), pressão arterial (sistólica, diastólica, média e pulso),medidas respiratórias (espirometria e pimometria), potência e fadiga foram registradas através do teste Wingate.Resultados: Peso, altura e massa livre de gordura foram correlacionados positivamente com os parâmetros de potência do teste Wingate (p < 0.05). Osparâmetros respiratórios de capacidade vital forçada, pico de fluxo expiratório, pressão inspiratória máxima (MIP) e pressão inspiratória máximasustentada (SMIP) também foram significativamente correlacionados com os parâmetros de potência. Além disso, os parâmetros cardiorespiratórios daMIP e SMIP foram positivamente correlacionados com a pressão de pulso em repouso (p < 0.05).Conclusão: O aumento da MIP e SMIP está associado a uma menor complacência arterial, o que indica que uma menor elasticidade vascular influenciauma maior resistência diafragmática e resistência do jovem atleta.(AU)

Analysis of the Budget Impact of Fractional Exhaled Nitric Oxide Monitoring in the Management of Childhood Asthma: The Colombian National Health System Perspective

Background: Fractional exhaled nitric oxide (FeNO) testing is a simple, noninvasive approach to assessing airway inflammation withminimal discomfort that provides results within a few minutes. For policy makers, the economic impact of this technology is the mainconcern, especially in developing countries. We evaluated the budget impact of asthma management using FeNO monitoring in patientsaged between 4 and 18 years in Colombia.Methods: A budget impact analysis was performed to evaluate the potential cost of FeNO monitoring. The analysis was based on a5-year time horizon and performed from the perspective of the Colombian National Health System. The incremental budget impact wascalculated by subtracting the cost of the new treatment, in which FeNO is reimbursed, from the cost of conventional treatment withoutFeNO (management based on clinical symptoms [with or without spirometry/peak flow] or asthma guidelines [or both] for asthma-relatedcases). Univariate 1-way sensitivity analyses were performed.Results: In the base case analysis the 5-year costs associated with FeNO and non-FeNO were estimated to be €469 904 130 and€480 485 149, respectively, indicating savings for the Colombian National Health System of €10 581 019 if FeNO is adopted for theroutine management of patients with persistent asthma. This result proved to be robust in the univariate 1-way sensitivity analysis.Conclusion: FeNO monitoring generated cost savings in emergency settings for infants with persistent asthma. This evidence can be used bydecision makers in Colombia to improve clinical practice guidelines and should be replicated to validate the results in other middle-income countries (AU)

Antecedentes: El óxido nítrico en aire exhalado es una medición simple y no invasiva de la inflamación de las vías respiratorias cuyosresultados están disponibles en pocos minutos. Para los responsables de la formulación de políticas sanitarias, la principal preocupaciónes el impacto económico que implica la adaptación de esta tecnología, muy especialmente en los países en desarrollo. Este estudiotiene como objetivo evaluar el impacto presupuestario, en el sistema Nacional de Salud de Colombia, del manejo del asma mediante lamonitorización de óxido nítrico exhalado en pacientes entre 4 y 18 años.Métodos: Se realizó un análisis de impacto presupuestario para evaluar el posible impacto financiero derivado de la implementación de lamonitorización óxido nítrico exhalado fraccionado en el asma. El análisis consideró un horizonte temporal de 5 años y la perspectiva delSistema Nacional de Salud de Colombia. El impacto presupuestario incremental se calculó restando el coste del nuevo tratamiento, en elque se reembolsa el FeNO, del coste del tratamiento convencional sin FeNO (manejo basado en síntomas clínicos (con o sin espirometría /flujo máximo) o guías de asma (o ambos), para los relacionados con el asma). Se realizaron análisis de sensibilidad univariantes de una vía.Resultados: En el análisis del caso base, los costos a 5 años asociados a FeNO y no FeNO se estimaron en 469.904.130 € y 480.485.149 €respectivamente, lo que indica un ahorro para la Salud Nacional de Colombia de 10.581.019 € si se adopta la monitorización de FeNOen el manejo rutinario de pacientes con asma persistente. La solidez de este resultado fue confirmada en el análisis de sensibilidadunivariante, unidireccional.Conclusión: El óxido nítrico exhalado fraccionado ahorró costos en los entornos de emergencia en población pediátrica con asma persistente.Esta evidencia puede ser utilizada por los tomadores de decisiones en nuestro país para mejorar las guías de práctica clínic

Possible presence of undiagnosed asthma in children in Japan

Background: Asthma diagnosis in children is occasionally challenging, and the issue of undiagnosed asthma before adolescence has been poorly studied in Japan. The present study was conducted to investigate the possible presence of undiagnosed asthma in the general population of children living in a rural area of Japan. Methods: The participants comprised 120 fourth graders aged 9–10 years (boys/girls: 63/57) attending five elementary schools in Yawatahama, Ehime, Japan. All the children underwent respiratory function tests and fraction of exhaled nitric oxide (FeNO) measurements. Based on the results of a questionnaire, the children were also categorized into groups depending on their allergic diseases. The authors assessed the results of both the respiratory function tests and the FeNO measurements for children who were classified into the nonallergic group. Results: A total of 76 (63%) children, who completed the tests appropriately, were included in the analysis. According to the report, among the 24 children in the nonallergic group, six (25%) showed abnormalities in respiratory tests. One had an abnormal % forced vital capacity (%FVC; <80%), three had abnormalities in both forced expiratory volume in 1 sec (FEV1)/FVC (<80%) and % maximal mid-expiratory flow (<65%), three had concave flow–volume curves, and one had a high FeNO measurement (41 ppb). Conclusion: A certain proportion of Japanese elementary school children, categorized as having no allergy, showed respiratory function test abnormalities. A follow-up study is needed to determine the prognosis and outcomes of the children with these abnormalities (AU)

Miniesternotomía en deformidades de columna vertebral: más cirugía en menos espacio / Ministernotomy in spine deformities: more surgery in less space

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Relevance of Respiratory Muscle Function Assessment in Respiratory Disease / Relevancia de evaluar la función de los músculos respiratorios en la enfermedad respiratoria

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Nadar 2.5-km indoor disminuye el nitrito y ph en aire espirado condensado / Swim 2.5-Km Indoor Decreases the Nitrite and Ph in Exhaled Breath Condensate

OBJETIVO: determinar el efecto de una prueba aeróbica de natación en piscina clorada indoor sobre la concentración de NO2-, H2O2 y el pH en el condensado del aire espirado. MÉTODO: diez nadadores aficionados nadaron 2,5 km en piscina clorada. Se obtuvieron muestras antes y en cuatro oportunidades durante las ocho horas posteriores a la prueba. El análisis estadístico usó modelos mixtos y la prueba de Spearman RESULTADOS: la prueba se realizó a 74,99 ± 10,10 % de la reserva cardíaca y duró 50,80 ± 8,98 minutos. Posterior a la prueba disminuyó el NO2- (p = 0,04) y el pH (p = 0,02) en el condensado del aire espirado. Los valores pre-ejercicio se relacionaron con los cambios absolutos p = 0,0002, p = 0,047 y con el volumen de entrenamiento p = 0,017, p = 0,077 para NO2- y H2O2 respectivamente. CONCLUSIONES: la natación en piscina clorada disminuye la concentración de NO2- y el pH en el condensado del aire espirado

OBJECTIVE: to determine the effect of an aerobic swimming test in chlorinated indoor swimming pool on the concentration of NO2-, H2O2 and the pH in the exhaled breath condensate. METHODS: ten amateur swimmers swam 2,5 km in a chlorinated pool. Samples were obtained before and four times in the eight hours after the test. The statistical analysis used mixed models and the Spearman test. RESULTS: the test was performed at 74,99 ± 10,10 % of the cardiac reserve and lasted 50,80 ± 8,98 minutes. After the test the NO2- (p = 0,04) and the pH (p = 0,02) in the exhaled air condensate decreased. The pre-exercise values were related to the absolute changes p = 0,0002, p = 0.047 and with the training volume p = 0,017, p = 0.077 for NO2- and H2O2 respectively. CONCLUSIONS: Swimming in a chlorinated pool decreases the NO2-concentration and the pH in the exhaled breath condensate

Prospective, study comparing the accuracy of two different stool antigen tests (Premier Platinum HpSA and novel ImmunoCard STAT rapid test) for the diagnosis of Helicobacter pylori infection / Estudio prospectivo y comparativo entre la exactitud de 2 pruebas de antígenos en heces (Premier Platinum HpSA® y el nuevo test rápido ImmunoCard® STAT) para el diagnóstico de la infección por Helicobacter pylori

BACKGROUND: At present only monoclonal EIA (enzyme-immunoassay) stool antigen-tests have obtained optimal accuracy in the diagnosis of Helicobacter pylori. Our aim was to evaluate the accuracy of two stool antigen-tests, the validated Premier Platinum HpSA PLUS (EIA test) and the newly available ImmunoCard STAT! HpSA HD (rapid test) for the initial diagnosis and the confirmation of eradication of H. pylori infection. PATIENTS AND METHODS: Patients with indication of H. pylori diagnosis, or confirmation after treatment were included. Data were coded to protect personal data and ensure blindness between tests. Accuracy was considered as coincident diagnosis with the gold standard (13C-urea breath test, UBT). The EIA was used as a bench standard. All stool tests were performed in duplicate. RESULTS: 264 patients completed the protocol (100 naïve, 164 post-eradication). Average age was 52 years, 61% women, 11% ulcer. Positive diagnoses by UBT were 41% for naïve and 17% for post-eradication. Overall ImmunoCard and EIA accuracies were respectively 91% (95%C. I. =88-94%) and 89% (86-93%), sensitivities 72% (67-78%) and 72% (67-78%), and specificities 98% (96-100%), and 95% (92-97%). Concordance between ImmunoCard and EIA was 95% (93-98%). DISCUSSION: Our results indicate that the newly available ImmunoCard rapid stool antigen-test achieves 90% accuracy, with high specificity but suboptimal sensitivity. The ImmunoCard attained equivalent accuracies as the EIA bench standard, with 95% concordance

ANTECEDENTES: En la actualidad, únicamente los métodos de detección de antígenos en heces monoclonales basados en enzimoinmunoanálisis (ELISA) han obtenido una adecuada precisión para el diagnóstico de la infección por Helicobacter pylori. Nuestro objetivo fue evaluar la exactitud (sensibilidad y especificidad) de 2 métodos de antígenos en las heces, el previamente validado Premier Platinum HpSA® PLUS (ELISA) y el nuevo ImmunoCard® STAT! HpSA® HD (test rápido), para el diagnóstico inicial y la confirmación de la erradicación de la infección por H. pylori. PACIENTES Y MÉTODOS: Se incluyeron pacientes en los que estaba indicado el diagnóstico inicial de la infección por H. pylori o su confirmación tras el tratamiento. Los datos fueron codificados y los evaluadores de ambos test fueron ciegos para los resultados de las pruebas diagnósticas. El resultado principal fue la coincidencia con el resultado del patrón oro (prueba del aliento con 13C-urea). Los test en heces se realizaron por duplicado. RESULTADOS: Doscientos sesenta y cuatro pacientes completaron el protocolo (100 naïve, 164 posterradicación). La edad media fue de 52 años, el 61% fueron mujeres y el 11% tenían úlcera péptica. La prueba del aliento fue positiva en el 41% de los pacientes naïve y en el 17% posterradicación. La exactitud global del método rápido y del ELISA fue, respectivamente, 91% (IC 95%: 88-94%) y 89% (86-93%), la sensibilidad 72% (67-78%) y 72% (67-78%), y la especificidad 98% (96-100%) y 95% (92-97%). La concordancia entre el método ImmunoCard® y ELISA fue del 95% (93-98%). DISCUSIÓN: El nuevo método rápido de antígenos en heces (ImmunoCard® STAT! HpSA® HD) tiene una exactitud diagnóstica del 90%, con una elevada especificidad, pero una sensibilidad insuficiente. El método ImmunoCard® tiene una exactitud equivalente al método ELISA estándar, con una concordancia del 95%

Exhaled nitric oxide (eNO) measurements with the new evernoa device are valid and reproducible through an extended range of eNO levels

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Recurrent Left Pneumonia, is it the Right Diagnosis? / Neumonía izquierda recurrente ¿estamos ante el diagnóstico correcto?

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Mounier-Kuhn Syndrome / Síndrome de Mounier-Kuhn

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Small intestinal bacterial overgrowth: could it be associated with chronic abdominal pain in children with allergic diseases?

Background and aims: small intestinal bacterial overgrowth (SIBO) is a well-known cause of chronic abdominal pain (CAP) during the pediatric age. On the other hand, children with a history of some allergic disorder present CAP more frequently. The aim of this study was to determine the association between the presence of allergic diseases and SIBO in patients diagnosed with CAP. Materials and methods: this was an observational, analytical, retrospective study. Children with CAP who had undergone a lactulose hydrogen breath test to determine the presence of SIBO were included in the study. All patients underwent an evaluation for allergies by means of a skin prick test or the determination of specific IgE, according to clinical diagnosis. The study groups were established according to the presence of SIBO and the results of the allergic evaluation were statistically compared between the groups. Results: seventy patients were included (41 females and 29 males) and SIBO was diagnosed in 35 patients. In addition, 71.4% of children with SIBO were found to have an allergic disease, in contrast with 28.6% of children without SIBO (p = 0.001). The odds ratio for having any type of allergy in patients with SIBO was 5.45 (95% CI, 1.96-15.17; p = 0.001). Conclusions: we found an association between SIBO and allergic disease, especially allergic rhinitis, cow's milk protein allergy and asthma. Thus, SIBO should be ruled out in pediatric patients with CAP and allergic disease

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Limitación al flujo aéreo en pacientes con insuficiencia cardíaca: prevalencia y factores asociados / Airflow limitation in patients with heart failure: Prevalence and associated factors

Introducción: La enfermedad pulmonar obstructiva crónica y la insuficiencia cardíaca (IC) son 2 enfermedades con una elevada morbimortalidad. La coexistencia de estas 2 enfermedades se estima que es frecuente, pero ha sido escasamente estudiada. Objetivo: Estudiar la prevalencia de limitación al flujo aéreo en una muestra de pacientes diagnosticados de IC en seguimiento en una unidad de IC y valorar las características y comorbilidades de estos pacientes. Métodos: Se trata de un estudio prospectivo observacional. Se incluyeron de forma consecutiva los pacientes visitados en la Unidad de Insuficiencia Cardíaca del Hospital Universitari Germans Trias i Pujol entre enero del 2014 y junio del 2015. Se realizaron pruebas funcionales respiratorias y se obtuvieron datos clínicos. Resultados: Se incluyeron 118 pacientes en el estudio (edad 67,2 años; DE 12,1; el 77,1% hombres). La prevalencia de limitación al flujo aéreo fue del 36,4%, con un porcentaje de infradiagnóstico del 67,4%. Los pacientes con limitación al flujo aéreo presentaban un aumento de las comorbilidades y de la mortalidad. Conclusión: La prevalencia de limitación al flujo aéreo en pacientes con IC es elevada, con un importante grado de infradiagnóstico. Sería recomendable la realización de una espirometría de cribado en estos pacientes

Background: Chronic obstructive pulmonary disease and heart failure (HF) are 2 diseases with high morbidity and mortality. The coexistence of these two diseases is estimated to be frequent, but has been poorly studied. Aim: To study the prevalence of airflow limitation in a sample of patients diagnosed with HF in follow-up in an HF unit and to assess their characteristics and comorbidities. Methods: This is a prospective observational study. The patients who visited the HF Unit of the Hospital Universitari Germans Trias i Pujol between January 2014 and June 2015 were included consecutively. Respiratory functional tests were performed and clinical data were obtained. Results: 118 patients were included in the study (age 67.2 years, 77.1% men). The prevalence of non-reversible airflow obstruction was 36.4%, with an underdiagnosis percentage of 67.4%. Patients with airflow limitation had an increase in comorbidities, but no worse prognosis. Conclusion: The prevalence of airflow limitation in patients with HF is high, with a significant degree of underdiagnosis. It seems reasonable to recommend performing a screening spirometry in these patients

Aerobic fitness predicts the air consumption time in the self-contained breathing apparatus during physical task of firefighters / La capacidad aeróbica predice el tiempo de consumo de aire de un equipo de respiración autónoma durante tareas físicas de bomberos / Aptidão aeróbia prediz o tempo de consume de ar no equipamento autônomo de proteção respiratória durante tarefa física de bombeiros

Objective: The aerobic fitness on predicting firefighters' air consumption time from self-contained breathing apparatus (T_SCBA) during physical task was investigated. Methods: Twenty firefighters were divided in two groups: G1 (n=10; 28.0±3.1 years) for the generation of a predictive equation of T_SCBA and G2 (n=10; 25.4±2.3 years) for the validation of the predictive equation. The groups completed two performance tests in separate days: 1) maximal 1600m running in order to determine mean velocity (1600mV) and maximal heart rate; 2) submaximal running/walking at intensity between 88-92% of the maximal heart rate. In second test, the firefighters were equipped with protective clothing (boots, gloves, cape, helmet and balaclava) and the self-contained breathing apparatus. The T_SBCA (corresponding to 1020 liters of pressurized air), blood lactate, heart rate and rate of perceived exertion were measured. Results: The linear regression of G1 (T_SCBA vs. 1600mV) resulted in the following predictive equation: T_SCBA= 0.0442*1600mV (m.min-1) + 4.5029 (r= 0.85; SEE= 0.73; p<0.001). When analyzing in G2, the measured and predicted T_SCBA using the equation generated in G1, no significant differences were found (T_SCBA measured= 15.5±2.5 min vs. T_SCBA predicted= 14.7±0.4 min; p=0.21). High correlation (r=0.95; SEE= 0.79; p<0.001) and agreement of the difference of the means (0.9 min [-3.1/+4.8]) were also found. Conclusion: Aerobic fitness presented high correlation with T_SCBA. In addition, the proposed predictive equation was considered valid to estimate T_SCBA during physical task of firefighters, which can have practical application in the labor activity of this population

Objetivo: Investigar la capacidad aeróbica como factor de predicción del tiempo de consumo de aire de un equipo de respiración autónoma (T_ERA) durante la realización de tareas físicas de bomberos. Método: Veinte bomberos se dividieron en dos grupos: G1 (n=10; 28.0±3.1 años) para la generación de la ecuación predictiva de T_ERA y G2 (n=10; 25.4±2.3 años) para la validación de la ecuación predictiva. Los grupos completaron dos test en días separados: 1) 1600m de carrera máxima para determinar la velocidad media (1600mV) y la frecuencia cardiaca máxima; 2) carrera submáxima/caminata a una intensidad entre el 88-92% de la frecuencia cardiaca máxima. En el segundo test, los bomberos usaron su ropa de protección (botas, guantes, capa, casco y pasamontañas) y el equipo de respiración autónomo. Se midió: el T_ERA (correspondiente a 1020 litros de aire presurizado), el lactato en sangre, la frecuencia cardiaca y el índice de esfuerzo percibido. Resultados: La regresión lineal del G1 (T_ERA vs. 1600mV) resultó en la siguiente ecuación predictiva: T_ERA= 0.0442*1600mV (m.min-1) + 4.5029 (r= 0.85; EEE= 0.73; p<0.001). Cuando se analizó el G2, no se encontraron diferencias significativas entre el valor de T_ERA medido y el calculado usando la ecuación generada con el G1 (T_ERA medido= 15.5±2.5 min vs. T_ERA calculado= 14.7±0.4 min; p=0.21). Se encontró una alta correlación (r=0.95; EEE= 0.79; p<0.001) y concordancia con la diferencia de las medias (0.9 min [-3.1/+4.8]). Conclusión: La capacidad aeróbica presentó una alta correlación con el T_ERA. Además, la ecuación de predicción propuesta se consideró válida para estimar el T_ERA durante tareas físicas de bomberos, lo que tiene grandes aplicaciones prácticas en la labor de esta población

Objetivo: Investigar a aptidão aeróbia na predição do tempo de consumo de ar durante tarefa física de bombeiros a partir do equipamento de proteção respiratória (T_EPR). Método: Vinte bombeiros foram divididos em dois grupos: G1 (n=10; 28.0±3.1 anos) para geração da equação preditiva do T_EPR e G2 (n=10; 25.4±2.3 anos) para validação da equação preditiva. Os grupos realizaram dois testes de desempenho em dias distintos: 1) 1600m de corrida em máxima intensidade para determinar a velocidade média (Vm1600) e a frequência cardíaca máxima; 2) corrida/caminhada em intensidade submáxima entre 88-92% da frequência cardíaca máxima. No segundo teste, os bombeiros estavam equipados com roupa de proteção (botas, luvas, capa, capacete e balaclava) e equipamento de proteção respiratória. O T_EPR (correspondente a 1020 litros de ar pressurizado), lactate sanguíneo, frequência cardíaca e percepção subjetiva de esforço foram mensurados. Resultados: A regressão linear do G1 (T_EPR vs. Vm1600) resultou na seguinte equação de predição: T_EPR= 0.0442*Vm1600 (m.min-1) + 4.5029 (r= 0.85; EPM= 0.73; p<0.001). Quando analizado em G2, o T_EPR medido e predito a partir da equação gerada em G1, não foi encontrada diferença significante (T_EPR medido= 15.5±2.5 min vs. T_EPR predito= 14.7±0,4 min; p=0.21). Alta correlação (r=0.95; EPM= 0.79; p<0.001) e concordância na média das diferenças (0.9 min [-3.1/+4.8]) também foi encontrada. Conclusão: A aptidão aeróbia apresentou alta correlação com o T_EPR. Em adicional, a equação preditiva proposta foi considerada valida em estimar o T_EPR durante tarefa física de bombeiros, o que pode ter aplicação prática na atividade laboral dessa população

Disfunción de la pequeña vía aérea en niños con asma controlada / Small Airway Dysfunction in Children With Controlled Asthma

Introducción: El asma se caracteriza por una inflamación crónica de las vías respiratorias centrales y distales. El objetivo de este estudio ha sido evaluar la vía aérea pequeña (VAP) en niños con asma moderada y/o grave con FEV1 normal. Métodos: Estudio abierto, prospectivo, observacional y transversal con inclusión consecutiva de casos con asma moderada o grave, bajo tratamiento clínico habitual con FEV1 basal normal. Se ha determinado la FEno a flujos múltiples (CAno), resistencias y reactancia oscilatorias (R5-R20, X5), espirometría forzada (FEV1, FEF25-75), pletismografía corporal total (RV/TLC) y prueba de broncodilatación. La afectación de la VAP se definió por: Cano > 4,5 ppb, R5-R20 > 0,147kPa/L/s, X5 <-0,18kPa/L, FEF25-75 < -1,65 z-score, RV/TL > 33%. El mal control de asma se definió por ≤ 19 puntos en el cuestionario ACT o ≤ 20 en c-ACT. Resultados: Cohorte de 100 casos, 76 con asma moderada y 24 con asma grave, 71 niños clasificados como mal controlados y 29 bien controlados. El 77,78% del grupo con todas las determinaciones correctas (n =7 2) mostró ≥ 1 parámetro alterado de VAP y el 48,61% ≥ 2 parámetros. No hubo diferencias entre los casos bien y mal controlados. Conclusiones: Los niños con asma moderada y grave, con el FEV1 preservado, muestran un fenotipo de VAP disfuncionante. En nuestra muestra, la evaluación de la VAP mediante las técnicas descritas, no aporta información sobre el control habitual de la enfermedad

Introduction: Asthma is characterized by chronic inflammation of the central and distal airways. The aim of this study was to assess the small airway (SA) of children with moderate-severe asthma with normal FEV1. Methods: This was an open-label, prospective, observational, cross-sectional study with consecutive inclusion of patients with moderate-severe asthma, receiving standard clinical treatment, with normal baseline FEV1. We determined multiflow FEno (CAno), oscillatory resistance and reactance (R5-R20, X5), forced spirometry (FEV1, FEF25-75), total body plethysmography (RV/TLC) and bronchodilation test. SA involvement was defined as: Cano > 4.5 ppb, R5-R20 > 0.147kPa/L/s, X5< -0.18kPa/L, FEF25-75 < -1.65 z-score, RV/TLC > 33%. Poor asthma control was defined as ≤ 19 points on the ACT questionnaire or ≤ 20 on the c-ACT. Results: In a cohort of 100 cases, 76 had moderate asthma and 24 had severe asthma; 71 children were classified as poorly controlled and 29 were well-controlled. In total, 77.78% of the group with all the correct determinations (n=72) showed ≥ 1 altered SA parameter and 48.61% ≥ 2 parameters. There were no differences between well-controlled or poorly controlled cases. Conclusions: Children with moderate-severe asthma, with normal FEV1, show a phenotype of dysfunctional SA. In our series, the evaluation of SA using the techniques described above did not provide information on disease control