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An analysis of the ionic transport properties of BMIM [NTf2] in supported ionic-liquid-like phase (SILLP)-based membranes has been carried out based on experimental impedance spectroscopy measurements. The direct current (dc)-conductivity was analyzed to determine the temperature and frequency dependence. The fit of the loss tangent curve data with the Cole-Cole approximation of the electrode polarization model provides the conductivity, diffusivity, and density of charge carriers. Among these quantities, a significant increase in conductivity is observed when an ionic liquid is added to the polymeric matrix containing imidazolium fragments. The use of a recent generalization of Eyring's absolute rate theory allowed the elucidation of how the local entropy restrictions, due to the porosity of the polymeric matrix, control the conductive process. The fit of the conductivity data as a function of temperature manifests the behavior of the excess entropy with respect to the temperature. The activation entropy and enthalpy were also determined. Our results correlate the Debye length (LD) with the experimental values of conductivity, electrode polarization relaxation time, and sample relaxation time involved. Our work provides novel insights into the description of ionic transport in membranes as the diffusivity, mobility, and free charge density depend on the LD. Moreover, we discuss the behavior of the polarization relaxation time, the sample relaxation time, and the static permittivity as a function of the temperature.
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BACKGROUND: Prevention of incisional hernias with a prophylactic mesh in emergency surgery is controversial. The present study aimed to analyze the long-term results of prophylactic mesh used for preventing incisional hernia after emergency midline laparotomies. METHODS: This study was a registered (NCT04578561) retrospective analysis of patients who underwent an emergency midline laparotomy between January 2009 and July 2010 with a follow-up period of longer than 2 years. Long-term outcomes and risk factors for the development of incisional hernias between patients who received a prophylactic reinforcement mesh (Group M) and suture (Group S) were compared. RESULTS: From an initial 266 emergency midline laparotomies, 187 patients were included. The median follow-up time was 64.4 months (SD 35). Both groups had similar characteristics, except for a higher rate of previous operations (62 vs. 43.2%; P = 0.01) and operation due to a revision laparotomy (32.5 vs.13%; P = 0.02) in the M group. During follow-up, 29.9% of patients developed an incisional hernia (Group S 36.6% vs. Group M 14.3%; P = 0.002). Chronic mesh infections were diagnosed in 2 patients, but no mesh explants were needed, and no patient in the M group developed chronic pain. Long-term risk factors for incisional hernia were as follows: smoking (HR = 2.47; 95% CI 1.318-4.624; P = 0.05), contaminated surgery (HR = 2.98; 95% CI 1.142-7.8; P = 0.02), surgical site infection (SSI; HR = 3.83; 95% CI 1.86-7.86; P = 0.001), and no use of prophylactic mesh (HR = 5.09; 95% CI 2.1-12.2; P = 0.001). CONCLUSION: Incidence of incisional hernias after emergency midline laparotomies is high and increases with time. High-risk patients, contaminated surgery, and surgical site infection (SSI) benefit from mesh reinforcement. Prophylactic mesh use is safe and feasible in emergencies with a low long-term complication rate. TRIAL REGISTRATION: NCT04578561. www.clinicaltrials.gov.
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Hérnia Incisional , Laparotomia , Emergências , Seguimentos , Humanos , Hérnia Incisional/epidemiologia , Hérnia Incisional/etiologia , Hérnia Incisional/prevenção & controle , Laparotomia/efeitos adversos , Estudos Retrospectivos , Telas CirúrgicasRESUMO
Appropriately used, computational fluid dynamics models are powerful tools to design and optimize primary settling tanks (PSTs). This paper uses a Fluent-based 3D model to identify the possible causes for underperformance of the circular PSTs at the Cali waste-water treatment plant, Colombia, and to propose design modifications to improve performance. A new configuration for the center well (CW) is proposed and evaluated. The influence of a rotational sludge scraper and of continuous sludge removal were considered in the numerical simulation. The new configuration included the modification of the current CW diameter and the location of a second baffle with the CW. The results suggest that the installation of the second baffle allows a more uniform flow distribution within the PST and consequently, the hydrodynamic problems associated with short-circuiting of the influent to the bottom of the tank are reduced. The second baffle suppresses the downward current, effectively dissipates the kinetic energy in the influent and forces the particles to move toward the bottom of the PST. In addition, the second CW baffle allows the formation in the inlet zone of a consistently more concentrated sludge blanket layer and thicker sludge, reducing the risk of solids leaving in the effluent of the PST.
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Hidrodinâmica , Purificação da Água , Colômbia , Modelos Teóricos , Esgotos , Eliminação de Resíduos LíquidosRESUMO
Introduction and aims: A case series of ten patients that received protocolized care for SARS-CoV-2 infection and developed severe gastrointestinal complications, is presented. The aim of our study was to contribute to the ongoing discussion regarding gastrointestinal complications related to SARS-CoV-2 infection. After reviewing the current literature, ours appears to be the first detailed case series on the topic. Materials and methods: A retrospective filtered search of all patients admitted to our hospital for SARS-CoV-2 infection, who developed severe gastrointestinal complications, was performed. All relevant data on hospital patient management, before and after surgery, were collected from the medical records. Results: Of the 905 patients admitted to our hospital due to SARS-CoV-2 infection, as of August 26, 2020, ten of them developed severe gastrointestinal complications. Seven of those patients were men. There were four cases of perforation of the proximal jejunum, three cases of perforations of the ascending colon, one case of concomitant perforation of the sigmoid colon and terminal ileum, one case of massive intestinal necrosis, and one preoperative death. Three right colectomies, four intestinal resections, one Hartmann's procedure with bowel resection, and one primary repair of the small bowel were performed. The mortality rate of the patients analyzed was 50%. Conclusion: Spontaneous bowel perforations and acute mesenteric ischemia are emerging as severe, life-threatening complications in hospitalized SARS-CoV-2 patients. More evidence is needed to identify risk factors, establish preventive measures, and analyze possible adverse effects of the current treatment protocols.
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We report on dual-polarization Dirac cones in a simple square lattice two-dimensional (2D) photonic crystal (PC) based on transmission at accidental degeneracies centered at the $k = {0}$k=0 symmetry ($ \Gamma $Γ) point. Finite difference time domain simulations are used to identify the material and geometric parameters for Dirac-like dispersion. A configuration that produces a Dirac-like point for both transverse electric and transverse magnetic polarizations at the same frequency is presented. The PC dispersion shows the expected threefold degenerate linear branch crossings at the Dirac-like point. Full-field electromagnetic wave simulations exhibit some common behaviors of devices based on Dirac-like dispersion, such as cloaking and waveguiding. The configuration works for a considerable range of the parameter space, and thus is experimentally realizable with a wide range of materials.
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There is sparse direct experimental evidence that atomic nuclei can exhibit stable "pear" shapes arising from strong octupole correlations. In order to investigate the nature of octupole collectivity in radium isotopes, electric octupole (E3) matrix elements have been determined for transitions in ^{222,228}Ra nuclei using the method of sub-barrier, multistep Coulomb excitation. Beams of the radioactive radium isotopes were provided by the HIE-ISOLDE facility at CERN. The observed pattern of E3 matrix elements for different nuclear transitions is explained by describing ^{222}Ra as pear shaped with stable octupole deformation, while ^{228}Ra behaves like an octupole vibrator.
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BACKGROUND: Few data are available about the frequency of incisional hernia in an emergency subcostal laparotomy. Our objective is to analyze the incidence of incisional hernia after emergency subcostal laparotomy and evaluate if prophylactic mesh could help prevent it. METHODS: This study is a monocentric retrospective analysis following STROBE guideline statements of all patients who underwent an emergency subcostal laparotomy between January 2011 and July 2017 in our University Hospital. We compared complications and incidence of incisional hernia between patients who received sutures (Group S; N = 203) and patients with prophylactic onlay mesh (Group M; N = 80). A multivariate risk factor analysis of incisional hernia was performed. An incisional hernia-estimated risk calculator equation was created. RESULTS: A total of 283 patients were analyzed. There were 80 patients in Group M and 203 in Group S. In short-term outcomes, length of surgery (213 ± 115 min vs 165 ± 73.3 min, P = 0.001) and hospital stay (16.4 ± 18.7 vs 11.6 days ± 13.4, P = 0.038) were longer in Group M. Long-term follow-up was conducted in 207 patients with a mean follow-up time of 39.3 ± 23 months. Incisional hernia was detected in 29 (19.1%) patients in Group S but in only two (3.8%) patients in Group M (P = 0.008). In the multivariate analysis, a risk factor analysis included wound infection (4.91 HR (2.12-11.4); P < 0.001), previous hernia repair (2.86 HR (1.24-6.61); P = 0.014), and shock (2.64 HR (1.01-6.93); P = 0.048). CONCLUSIONS: The incidence of incisional hernia after emergency subcostal laparotomy is high. Risk factors are wound infection, shock, and previous hernia surgery. The use of prophylactic mesh augmentation was safe and reduced the incidence of incisional hernia.
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Hérnia Incisional/epidemiologia , Laparotomia/efeitos adversos , Telas Cirúrgicas , Idoso , Idoso de 80 Anos ou mais , Emergências , Feminino , Humanos , Incidência , Hérnia Incisional/prevenção & controle , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Técnicas de SuturaRESUMO
In the original article some of the column headings in Tables 1-4 were mislabeled.
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INTRODUCTION AND OBJECTIVES: With the objective of making informed decisions on resource allocation, there is a critical need for studies that provide accurate information on hospital costs for treating respiratory syncytial virus (RSV)-related bronchiolitis, mainly in middle-income countries (MICs). The aim of the present study was to evaluate the direct medical costs associated with bronchiolitis hospitalizations caused by infection with RSV in Bogota, Colombia. MATERIAL AND METHODS: We reviewed the available electronic medical records (EMRs) for all infants younger than two years of age who were admitted to the Fundacion Hospital de La Misericordia with a discharge principal diagnosis of RSV-related bronchiolitis over a 24-month period from January 2016 to December 2017. Direct medical costs of RSV-related bronchiolitis were retrospectively collected by dividing the infants into three groups: those requiring admission to the pediatric ward (PW) only, those requiring admission to the pediatric intermediate care unit (PIMC), and those requiring to the pediatric intensive care unit (PICU). RESULTS: A total of 89 patients with a median (IQR) age of 7.1 (3.1-12.2) months were analyzed of whom 20 (56.2%) were males. Overall, the median (IQR) cost of infants treated in the PW, in the PIMC, and in the PICU was US$518.0 (217.0-768.9) vs. 1305.2 (1051.4-1492.2) vs. 2749.7 (1372.7-4159.9), respectively, with this difference being statistically significant (p<0.001). CONCLUSIONS: The present study helps to further our understanding of the economic burden of RSV-related bronchiolitis hospitalizations among infants of under two years of age in a middle-income tropical country.
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Bronquiolite Viral/economia , Hospitalização/economia , Infecções por Vírus Respiratório Sincicial/economia , Colômbia/epidemiologia , Efeitos Psicossociais da Doença , Feminino , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
INTRODUCTION AND OBJECTIVES: With the aim of making informed decisions on resource allocation, there is a critical need for studies that provide accurate information on hospital costs for treating pediatric asthma exacerbations, mainly in middle-income countries (MICs). The aim of the present study was to evaluate the direct medical costs associated with pediatric asthma exacerbations requiring hospital attendance in Bogota, Colombia. PATIENTS AND METHODS: We reviewed the available electronic medical records (EMRs) for all pediatric patients who were admitted to the Fundacion Hospital de La Misericordia with a discharge principal diagnosis pediatric asthma exacerbation over a 24-month period from January 2016 to December 2017. Direct medical costs of pediatric asthma exacerbations were retrospectively collected by dividing the patients into four groups: those admitted to the emergency department (ED) only; those admitted to the pediatric ward (PW); those admitted to the pediatric intermediate care unit (PIMC); and those admitted to the pediatric intensive care unit (PICU). RESULTS: A total of 252 patients with a median (IQR) age of 5.0 (3.0-7.0) years were analyzed, of whom 142 (56.3%) were males. Overall, the median (IQR) cost of patients treated in the ED, PW, PIMC, and PICU was US$38.8 (21.1-64.1) vs. US$260.5 (113.7-567.4) vs. 1212.4 (717.6-1609.6) vs. 2501.8 (1771.6-3405.0), respectively: this difference was statistically significant (p<0.001). CONCLUSIONS: The present study helps to further our understanding of the economic burden of pediatric asthma exacerbations requiring hospital attendance among pediatric patients in a MIC.
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Asma/economia , Custos de Cuidados de Saúde , Hospitalização/economia , Adolescente , Criança , Pré-Escolar , Colômbia , Serviço Hospitalar de Emergência/economia , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica/economia , Tempo de Internação/economia , Masculino , Exacerbação dos SintomasRESUMO
INTRODUCTION AND OBJECTIVES: Wheezing (RW) infants with a positive asthma predictive index (API+) have a lower lung function as measured by forced expiratory techniques. Tidal flow-volume loops (TFVL) are easy to perform in infants, and sedation is not necessary. MATERIALS AND METHODS: A total of 216 wheezing infants were successfully measured, and 183 of them were followed for over a year. TFVL loops were classified into one of three categories depending of their geometric shape (symmetric, convex, and concave). Respiratory rate (Rr), presence of API+, and the number of exacerbations during the following year were also recorded. RESULTS: Children with concave loops had more exacerbations in the following year (ORâ¯=â¯6.8 [IC95% 3.33;13.91]). Infants APIâ¯+â¯were also significantly more related to concave loops (ORâ¯=â¯10.02 [IC 95% 4.53; 22.15]). Rr was higher in infants with concave loops (44+/-15.5 vs. 36.6 +/-12.6; pâ¯<â¯0.01). CONCLUSION: Infants with a concave TFVL have a higher probability of experiencing exacerbations in the following year, and are at a higher risk of suffering asthma.
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Asma/diagnóstico , Asma/fisiopatologia , Testes de Função Respiratória/métodos , Sons Respiratórios/diagnóstico , Sons Respiratórios/fisiopatologia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Volume de Ventilação PulmonarRESUMO
Surgery increases the risk (by 20-fold) of venous thromboembolism (VTE), but there are prophylaxis methods (mechanical, pharmaceutical or combined) that safely reduce the incidence rate of VTE. The administration of prophylaxis requires a prior assessment of the risks associated with the patient and with the type of surgery. The Caprini and Rogers scales classify patients into four VTE risk categories (very low, low, moderate and high). In pharmacological prophylaxis, the risk of bleeding should also be assessed. At this time, the recommendation is to administer prophylaxis to all patients: mechanical prophylaxis for low, moderate or high risk with contraindications for the administration of heparin; combined with heparin for very high risk; and with drugs such as low-molecular-weight heparin, unfractionated heparin and fondaparinux for moderate to high risk. These measurements should be kept until full ambulation, discharge, or at least seven days (for major oncologic and bariatric surgery, maintain for four weeks).
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OBJECTIVE: This paper aims to provide a Spanish version of the nursing students'' perceptions of instructor caring with content validity and reliability. METHODS: A forward and backward translation procedure was conducted, and a panel of 15 experts assessed face validity. Content validity was established by calculating content validity indexes for each item and for the scale. The internal consistency was assessed in a sample of 120 students. RESULTS: Content validity indexes resulted in higher than 0.78 for all items except Does not reveal any of his or her personal sides and serves as a trusted resource for personal problem solving; content validity index for the scale was 0.9 and Cronbach α was 0.942. DISCUSSION: Results regarding reliability were similar to that of other studies in which the nursing students' perceptions of instructor caring has been used as a measuring tool. Item 12 deletion implies a considerable improvement in internal consistency. CONCLUSION: The Spanish nursing students' perceptions of instructor caring is a valid and reliable tool to be used in the Spanish context. Its use will enhance the understanding of clinical mentors' impact on nursing students.
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Empatia , Mentores/psicologia , Estudantes de Enfermagem/psicologia , Traduções , Competência Cultural , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
Ceria-titania interfaces play a crucial role in different chemical processes but are especially promising for the photocatalytic splitting of water using light in the visible wavelength region when Pt is added to the system. However, the complexity of this hierarchical structure hampers the study of the origin of its outstanding properties. In this article, the structural, electronic and optoelectronic properties of CeO2 /TiO2 systems containing 1D, 2D, and 3D particles of ceria are analyzed by means of density functional calculations. Adsorption sites and vacancy effects have been studied to model Pt adsorption. Density of states calculations and absorption spectra simulations explain the behavior of these systems. Finally, these models are used for the screening of other metals that can be combined with this heterostructure to potentially find more efficient water splitting photocatalysts.
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Zika virus (ZIKV) cases have been detected across the United States (US) and locally acquired cases have been reported in Florida. Currently, there are no ZIKV screening guidelines and no data on the incidence among organ donors in the US. This retrospective study was conducted at Jackson Memorial-Miami Transplant Institute. Positive ZIKV tests in local deceased organ donors were investigated from 6/2016 to 1/2017. We evaluated demographics and risk factors for ZIKV infection among organ donors and transplant outcomes among recipients of donors with positive ZIKV testing. One hundred forty-two donors were analyzed. Ten percent had traveled to ZIKV-endemic countries and 19% had outdoor occupations. Only 3% had positive ZIKV IGG. None had a positive ZIKV IGM or PCR. ZIKV-positive donors were more likely to have traveled to ZIKV-endemic countries (50% vs. 9%, P = .05). The kidneys from a ZIKV-positive donor were transplanted in our hospital with no 6-month rejection, graft failure, or death in the recipients. Our study demonstrated a low prevalence of ZIKV among deceased donors in our community. Despite local ZIKV transmission, ZIKV was more common in donors who traveled to ZIKV-endemic countries. This cohort demonstrated excellent outcomes in recipients of ZIKV IGG-positive donors. However, larger studies are needed.
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Doadores de Sangue/provisão & distribuição , Seleção do Doador/normas , Programas de Rastreamento , Infecção por Zika virus/diagnóstico , Zika virus/isolamento & purificação , Adulto , Feminino , Florida/epidemiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/genética , Estudos Retrospectivos , Zika virus/genética , Zika virus/imunologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/virologiaRESUMO
The first 2^{+} and 3^{-} states of the doubly magic nucleus ^{132}Sn are populated via safe Coulomb excitation employing the recently commissioned HIE-ISOLDE accelerator at CERN in conjunction with the highly efficient MINIBALL array. The ^{132}Sn ions are accelerated to an energy of 5.49 MeV/nucleon and impinged on a ^{206}Pb target. Deexciting γ rays from the low-lying excited states of the target and the projectile are recorded in coincidence with scattered particles. The reduced transition strengths are determined for the transitions 0_{g.s.}^{+}â2_{1}^{+}, 0_{g.s.}^{+}â3_{1}^{-}, and 2_{1}^{+}â3_{1}^{-} in ^{132}Sn. The results on these states provide crucial information on cross-shell configurations which are determined within large-scale shell-model and Monte Carlo shell-model calculations as well as from random-phase approximation and relativistic random-phase approximation. The locally enhanced B(E2;0_{g.s.}^{+}â2_{1}^{+}) strength is consistent with the microscopic description of the structure of the respective states within all theoretical approaches. The presented results of experiment and theory can be considered to be the first direct verification of the sphericity and double magicity of ^{132}Sn.
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BACKGROUND: Frequent wheezing in original asthma predictive index (API) was defined by parental report of recurrent wheezing within 1 year during the first 3 years of life. The nature of frequent wheezing in children, particularly aged over 3 years, has not been studied. We aimed to assess the frequency and interval of wheezing to define frequent wheezing in ascertaining asthma for children using medical records. METHODS: Among children who participated in a previous study (n = 427), all wheezing episodes documented in medical records were collected for children who had ≥2 wheezing episodes PLUS met one major criterion or two minor criteria of API. We compared the distribution of known risk factors for asthma between subjects having two consecutive wheezing episodes with shorter interval (≤1 year) compared to those with longer interval (1 to 3 years). RESULTS: A total of 62 children met API at median age of 2.3 years. During follow-up period (median age: 11.3 years), a total of 198 wheezing episodes were observed. 81% of wheezing intervals were within 3 years from the earlier wheezing episode, including 60% within 1 year. Children who met API based on 1-year interval (n = 40) vs 1- to 3-year interval (n = 13) appeared to be similar in regard to the known risk factors for asthma. CONCLUSIONS: Our exploratory study finding suggests that children who had frequent wheezing episodes with longer interval (<3 years) need to be considered to be determined as asthma cases when API is applied to retrospective medical records. Prospective studies with a larger sample size need to replicate this finding.
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Asma/epidemiologia , Asma/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Prontuários Médicos , Minnesota/epidemiologia , Prevalência , Vigilância em Saúde Pública , Sons Respiratórios , Estudos Retrospectivos , Fatores de Risco , Avaliação de SintomasRESUMO
Lactate dehydrogenase (LDH) is key for anaerobic glycolysis. LDH is induced by the hypoxia inducible factor -1 (HIF-1). HIF-1 induces genes involved in glucose metabolism and regulates cellular oxygen homeostasis. HIF-1 is formed by a regulatory α-subunit (HIF-1α) and a constitutive ß-subunit (HIF-1ß). The white spot syndrome virus (WSSV) induces anaerobic glycolysis in shrimp hemocytes, associated with lactate accumulation. Although infection and lactate production are associated, the LDH role in WSSV-infected shrimp has not been examined. In this work, the effects of HIF-1 silencing on the expression of two LDH subunits (LDHvan-1 and LDHvan-2) in shrimp infected with the WSSV were studied. HIF-1α transcripts increased in gills, hepatopancreas, and muscle after WSSV infection, while HIF-1ß remained constitutively expressed. The expression for both LDH subunits increased in each tissue evaluated during the WSSV infection, translating into increased enzyme activity. Glucose concentration increased in each tissue evaluated, while lactate increased in gills and hepatopancreas, but not in muscle. Silencing of HIF-1α blocked the increase of LDH expression and enzyme activity, along with glucose (all tissues) and lactate (gills and hepatopancreas) concentrations produced by WSSV infection. These results demonstrate that HIF-1 up regulates the expression of LDH subunits during WSSV infection, and that this induction contributes to substrate metabolism in energetically active tissues of infected shrimp.
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Regulação da Expressão Gênica/imunologia , Fator 1 Induzível por Hipóxia/genética , Imunidade Inata/genética , L-Lactato Desidrogenase/genética , L-Lactato Desidrogenase/imunologia , Penaeidae/genética , Penaeidae/imunologia , Sequência de Aminoácidos , Animais , Proteínas de Artrópodes/química , Proteínas de Artrópodes/genética , Proteínas de Artrópodes/imunologia , Sequência de Bases , Perfilação da Expressão Gênica , Fator 1 Induzível por Hipóxia/metabolismo , L-Lactato Desidrogenase/química , Filogenia , Alinhamento de Sequência , Vírus da Síndrome da Mancha Branca 1/fisiologiaRESUMO
BACKGROUND: Low levels of serum CC16 were reported in asthmatic adults, but the studies on children were scarce and conflicting. The aim of this study was to compare serum CC16 levels in pre-school children with recurrent wheezing assessed using an asthma predictive index (API). METHODS: We performed a case-control study based on API, with all enrolled pre-school children who had recurrent wheezing episodes (>3 episodes/last year confirmed by a physician) and had presented at one paediatric clinic in Santiago, Chile. The population was divided according to stringent API criteria into positive or negative. RESULTS: In a one-year period, 60 pre-schoolers were enrolled. After excluding 12, 48 pre-schoolers remained (27 males, age range from 24 to 71 months) and completed the study; 34 were API positive and 14 were API negative. There were no significant differences in demographics between groups. The level of serum CC16 levels for pre-schoolers with a positive API and negative API were (median 9.2 [7.1-11.5] and 9.4 [5.5-10], p=0.26, respectively). The area under the curve for the serum CC16 levels to predict a positive API was 0.6, 95% CI [0.43-0.77], p=0.3. A correlation between serum CC16 levels and age was found (r=0.36 [0.07-0.59], p=0.01], but not between serum CC16 levels and peripheral eosinophils blood. CONCLUSION: There was no evidence that serum CC16 levels played a role in recurrent wheezing and a positive API in pre-school children. More studies are needed to confirm this finding.
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Asma/sangue , Asma/imunologia , Biomarcadores/sangue , Sons Respiratórios/imunologia , Uteroglobina/sangue , Estudos de Casos e Controles , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Masculino , Uteroglobina/imunologiaRESUMO
BACKGROUND: In contrast to adult asthmatic patients, studies on the role of serum periostin levels in schoolchildren with asthma are still conflictive, and very few studies have been performed in pre-schoolers. The aim of this study was to compare serum periostin levels in recurrent wheezer pre-schoolers according to their asthma predictive index (API) condition. METHODS: We performed a case-control study enrolling pre-schoolers with recurrent wheezing episodes (>3 episodes confirmed by physician) presented at one paediatric clinic in Santiago, Chile. The population was divided according to stringent API criteria into positive or negative. RESULTS: In a one-year period, 60 pre-schoolers were enrolled. After excluding 12 (due to not fulfilment of inclusion criteria or refusal of blood sample extraction), 48 remaining pre-schoolers (27 males, age range from 24 to 71 months) completed the study; 34 were API positive and 14 were API negative. There were no significant differences in demographics between groups. The level of serum periostin levels for pre-schoolers with positive API and negative API were (median 46.7 [25.5-83.1] and 67.5 [20.5-131.8], p=0.9, respectively). The area under the curve for the serum periostin levels for predict positive API was 0.5, 95% CI [0.29-0.70], p=0.9. No significant correlation between serum periostin levels and peripheral blood eosinophils was found. CONCLUSION: Serum periostin levels were no significantly different between wheezer pre-schoolers with positive and negative API. More studies are needed to confirm this finding.