Morphological Effects of Cigarette Smoking on Respiratory System and Related Functions Based on AQPs Expression

SUMMARY: A great deal of attention of air pollution on respiratory health is increasing, particularly in relation to haze days. It is that exposure to cigarette smoke augments the toxicity of common air contaminants, thereby increasing the complexity of respiratory diseases. Although there are various mechanisms involved to respiratory diseases caused or worsen by cigarette smoking, in which the role of AQPs in the lung with regard to fluid homeostasis still remains elusive. In this paper, we copied the rat models based on smoke generator, and investigated the morphological changes of mucosa and related functions depending on the balance of lining liquid of alveoli via AQPs expression. Compared with normal group, weak labelling of AQP1 and AQP5 protein abundance were clearly detected in the corresponding part of smoke exposure groups compared with normal group. Hence, it is suggested that the contribution of AQPs in the lung is diminished, thereby causing perturbed balancing between resorptive and secretory fluid homeostasis under cigarette smoking.

Cada vez se presta más atención a la contaminación del aire en la salud respiratoria, particularmente, en relación con los días de neblina. En consecuencia la exposición al humo del cigarrillo aumenta la toxicidad de los contaminantes comunes del aire, lo que además aumenta la complejidad de las enfermedades respiratorias. Aunque existen varios mecanismos involucrados en las enfermedades respiratorias causadas o empeoradas por el tabaquismo, en las que el papel de las AQP en el pulmón respecto a la homeostasis de líquidos sigue siendo difícil de alcanzar. En este artículo, copiamos los modelos de rata basados en el generador de humo e investigamos los cambios morfológicos de la mucosa y las funciones relacionadas según el equilibrio del líquido de revestimiento de los alvéolos a través de la expresión de AQP. En comparación con el grupo normal, se detectó claramente un etiquetado débil de la abundancia de proteínas AQP1 y AQP5 en la parte correspondiente de los grupos de exposición al humo en comparación con el grupo control. Por lo tanto, se sugiere que la contribución de las AQP en el pulmón está disminuida, provocando así un equilibrio perturbado entre la homeostasis del líquido secretor y de reabsorción bajo el hábito de fumar cigarrillos.

Efecto inmediato de dos ejercicios con tracto vocal semiocluido en el contacto glótico de usuarios ocupacionales de la voz / Immediate effect of two semi-occluded vocal tract exercises in glottal contact of occupational voice users

Introducción. Los docentes son usuarios ocupacionales de la voz con alto riesgo de desarrollar patologías vocales a causa de su labor. Para enfrentar esta proble-mática, suelen usarse ejercicios con tracto vocal semiocluido (TVSO), estrategia de educación/rehabilitación empleada para generar un cambio en el patrón de vibración de los pliegues vocales, minimizando el riesgo de lesión vocal al reducir el estrés de colisión al que se someten los tejidos. Diversos reportes han indicado que este tratamiento tiene efectos en el cociente de cierre (CQ), medida indirecta del estrés de colisión.Objetivo. Examinar el efecto fisiológico de dos ejercicios con TVSO en la actividad laríngea de profesores con esfuerzo vocal constante pero sin patología vocal. Metodología. Se registraron muestras de 43 profesores antes, durante y después de la realización de dos ejercicios con TVSO (vibración lingual y fonación en tubos). Las muestras de electroglotografía se analizaron para obtener el CQ. Resultados y conclusión. Se observó una diferencia significativa al comparar los valores del CQ antes y durante la realización de ambos ejercicios. No se encontraron cambios en este parámetro después de ejecutar la actividad. Estos hallazgos concuer-dan con reportes previos en los cuales el CQ tiende a aumentar durante la fonación en tubos; contrariamente, la realización de la vibración lingual tiende a decrecer el valor del CQ. Es posible que este comportamiento se deba a los mecanismos biome-cánicos particulares de cada ejercicio

Introduction. Teachers are occupational voice users with high risk of developing vocal pathologies due to their work. To face this situation, it is common the use of semi-occluded vocal tract (SOVT) exercises, a strategy of voice education/rehabil-itation implemented to induce a change in the vibration pattern of the vocal folds, mitigating, therefore, the risk of vocal lesion by reducing the collision stress applied to tissues. A variety of reports have indicated that this treatment has effects in the closed quotient (CQ), an indirect measure of collision stress. Aim. The purpose of this study was to examine the physiological effect of two dif-ferent SOVT exercises in larynx activity of teachers with constant vocal effort but without vocal pathology. Methods. 43 samples of teachers were recorded before, during and after executing two SOVT exercises (tongue trill and tube phonation). Electroglottographic samples were analyzed in order to obtain CQ. Results and conclusion. Both exercises had a significant difference of CQ scores when before and during conditions were compared. Any difference was found on this parameter after executing the activity. These findings agree with previous reports where CQ tends to increase during phonation through resonance tubes; on the con-trary, execution of tongue trill tends to decrease CQ values. This behavior might be because of the particular biomechanical mechanisms of each exercise

Efeitos da estabulação sobre o trato respiratório de equinos em dois tipos diferentes de camas e a pasto / Stabling effects on equine respiratory tract using two different types of stable beds and pasture

As afecções do sistema respiratório são a segunda causa de queda de desempenho e afastamento dos equinos do esporte ou trabalho, as quais estão atrás somente das desordens musculoesqueléticas. A estabulação e a alimentação à base de fenos predispõem os equinos à inalação de grande número de agentes irritantes às vias aéreas. No intuito de avaliar a influência dos tipos de cama utilizados em baias, estudaram-se três grupos de cinco equinos cada, durante 45 dias. Dois grupos foram mantidos em cocheiras com forrações diferentes à base de madeira (maravalha de pínus autoclavada-MA e serragem-SE) e o terceiro grupo permaneceu no pasto. Foram realizadas avaliações quinzenais, que incluíram exame físico, hemograma, hemogasometria e lavado broncoalveolar. Ao exame físico, notou-se a presença de tosse e espirros em animais do grupo SE. No lavado broncoalveolar, a contagem de células nucleadas totais apresentou maiores valores nos animais a pasto, seguido do grupo SE e, por último, o MA. Concluiu-se que as duas camas testadas neste estudo não apresentaram diferença com relação à capacidade irritativa das vias aéreas superiores no período analisado.(AU)

Respiratory system affections in horses are the second cause of decrease in performance and removal from the sport or farm work, which are behind only the musculoskeletal disorders. Stabling and hay feeding predisposes horses' airways to inhalation of large numbers of irritating agents. To evaluate the influence of bed types used in bays, 3 groups of 5 horses each were studied for 45 days. Two groups were kept in stables with different wood beds - based rafters (autoclaved pine - MA and sawdust - SE) and the third group remained in the pasture. Biweekly evaluations with physical examination, hemogram, hemogasometry and bronchoalveolar lavage were performed. On physical examination, the presence of cough and sneezing was observed in animals of the SE group. In the bronchoalveolar lavage, the total nucleated cell count presented higher values in the animals in the pasture, followed by the SE group and finally the MA. It was concluded that the different beds used presented no difference with respect to the irritative capacity of the upper airways.(AU)

Imágenes diagnósticas en el estudio del compromiso pulmonar de la discinesia ciliar primaria en niños / Chest imaging in study of primary ciliary dyskinesia in children

The diagnosis of primary ciliary dyskinesia (PCD) is complex and requires high clinical suspicion. The findings in the diagnostic images are nonspecific and can be seen in other conditions of the airway. In this review, we will describe the findings of PCD in chest radiography and computed tomography, with emphasis on some of the characteristics that differentiate it from cystic fibrosis and we will review the role of CT in the monitoring of changes of the PCD, since the CT findings correlate very well with the structural changes that occur in the course of PCD, especially bronchiectasis. However, using serial CTs should be decided on a case-by-case basis to avoid unnecessary radiation because they are pediatric patients.

El diagnóstico de la Discinesia ciliar primaria (DCP) es complejo y requiere alta sospecha clínica. Los hallazgos en la imágenes diagnósticas son inespecíficos y se pueden ver en otras afecciones de la vía aérea. En esta revisión describiremos los hallazgos de la DCP en Radiología simple y en Tomografía computada (TC), con énfasis en algunas de las características que permiten diferenciarla de la Fibrosis quística (FQ) y revisaremos el rol de la TC en la monitorización de la DCP ya que los hallazgos en la TC se correlacionan muy bien con los cambios estructurales que ocurren en el curso de la DCP, en especial las bronquiectasias. Sin embargo usar TC seriadas se debe decidir caso por caso para evitar la radiación innecesaria por ser pacientes pediátricos.

Identificación molecular de Candida lusitaniae en infección de tracto respiratorio inferior / Molecular identification of Candida lusitaniae in lower respiratory tract infection

Candida lusitaniae es una levadura que ha sido descrita como un patógeno nosocomial emergente de baja frecuencia en infecciones profundas. La identificación oportuna de C. lusitaniae es importante porque puede desarrollar resistencia in vivo a la amfotericina B durante la terapia. Reportamos el aislamiento de C. lusitaniae como agente etiológico de infección de tracto respiratorio inferior en un paciente masculino. Los cultivos de orina y esputo fueron negativos para bacterias y positivos para esta levadura. Los aislamientos fueron identificados por métodos fenotípicos de rutina y confirmados por secuenciación y polimorfismos de longitud de fragmentos de restricción y PCR de la región espaciadora interna del DNA ribosómico.

The yeast Candida lusitaniae has been described as an emerging low frequency nosocomial pathogen in deep infections. Early identification of C. lusitaniae is important because it can readily develop in vivo resistance to amphotericin B during treatment. We report the isolation of C. lusitaniae as etiologic agent of a lower respiratory tract infection in a male patient. Urine and sputum cultures were negative for bacteria and positive for yeast. Isolates were identified by routine phenotypic methods and confirmed by ribosomal DNA internal spacer region restriction fragment length polymorphism PCR and sequencing.

Causes of death of thoroughbred racehorses at Octavio Dupont Veterinary Hospital, Brazilian Jockey Club, Rio de Janeiro / Causas de mortes de cavalos de corrida registradas no Hospital Veterinário Octávio Dupont, Jockey Clube Brasileiro, Rio de Janeiro

There are few studies that approach the epidemiology of deaths in racehorses in a broad manner. The majority focus on a specific affection or procedure. Brazil does not have a program instituted for the monitoring of deaths of horses. By means of a descriptive study in association with a multivariate analysis method, an epidemiologic profile was determined for deaths related to musculoskeletal (MS), gastrointestinal (GI), respiratory (RES) systems, neurologic origin (NEU) and sudden death (SD) for the years of 2002 to 2008, at the Octavio Dupont Veterinary Hospital-Rio de Janeiro (ODVH). Males comprised the majority of deaths and that deaths were related to, decreasing order, MS>GI>SD>NEU>RES, with respect to general mortality rate per large group of determined causes (TSPMr). The majority of deaths registered included horses aged four to five years (ID4-ID5). We observed the following correspondence relations: (3-year period = SM - ID>5 - SD; ID>5 - GI; ID4-5 - MS; SF - ID<4 - RES/ NEU); (4-year period = SM - ID>5 - GI; SF - ID<4 - NEU; ID4-5 - MS; GI - ID>5). The present study points out the importance and necessity of epidemiologic studies of lesions in horses, based on diagnosis for the recognition of predisposing factors and prevention.

Existem poucas pesquisas que abordam estudos epidemiológicos de mortes em cavalos de corrida de uma forma ampla. A maioria restringe-se a uma afecção ou procedimento específico. O Brasil não possui um programa de monitoramento de mortes instituído. Através de um estudo descritivo em associação a metodologia multivariada de análise, realizou-se um estudo epidemiológico de causa mortis relacionadas com afecções musculosqueléticas (MS), gastrointestinais (GI), sistema respiratório (RES), neurológico (NEU) e mortes súbitas (SD) durante os anos de 2002 a 2008 no Hospital Octavio Dupont, Rio de Janeiro. Os machos representaram o sexo mais afetado e a causa mortis relacionada com a taxa geral de mortalidade por grandes grupos de causas determinadas apresentou a seguinte ordem decrescentemente: MS>GI>SD>NEU>RES. A maioria dos óbitos registrados foi de cavalos na faixa etária de quatro a cinco anos (ID4-ID5). Seguidamente, observaram-se as seguintes relações de correspondência: (Triênio = SM-ID>5-SD; ID>5-GI; ID4-5-MS; SF-ID<4-RES/NEU); (Quatriênio = SM - ID>5 - GI; SF - ID<4 - NEU; ID4-5 - MS; GI - ID>5). O presente estudo aponta a importância e necessidade de estudos epidemiológicos sobre lesões em cavalos atletas, objetivando o diagnostico, reconhecimento de fatores predisponentes e prevenção.

Regulación de la respiración: organización morfofuncional de su sistema de control / Regulation of breathing: morphological and functional organization of its control system

La función principal y reguladora del sistema respiratorio es mantener las presiones normales de oxígeno y dióxido de carbono, así como la concentración de iones H+ o hidrogeniones, lo cual se consigue adecuando la ventilación pulmonar a las necesidades metabólicas orgánicas de consumo y producción de ambos gases, respectivamente. A pesar de las amplias variaciones en los requerimientos de captación de oxígeno y eliminación de dióxido de carbono, las presiones arteriales de ambos elementos se mantienen dentro de márgenes muy estrechos por una compleja regulación de la ventilación de los pulmones mediante determinados sistemas de control. Por tratarse de un tema muy complicado y disponerse ahora de nuevos conocimientos al respecto, se decidió describir en este breve artículo la organización morfofuncional general de los elementos que integran el sistema de control de la función respiratoria humana normal.

The regulating main function of the breathing system is to maintain the normal oxygen and carbon dioxide pressures, as well as the H+ or hydrogen ions concentration, which is achieving adapting the lung ventilation to the organic metabolic needs of consumption and production of both gases, respectively. In spite of the wide variations in the requirements of oxygen intake and of carbon dioxide elimination, the arterial pressures of both elements remain within very narrow margins due to a complex regulation of the lungs ventilation by means of certain control systems. As it is a very complicated topic and as there are now new knowledge on this respect, it was decided to describe in this brief work the general morphological and functional organization of the elements that form the control system of the normal human breathing function.

Diagnóstico de neumocistosis en pacientes oncológicos: por la técnica de inmunofluorescencia directa / Neumocistosis in oncological patients: diagnoses for immunofluorescense direct technique

El paciente con enfermedades oncológicas tiene un alto riesgo para desarrollar infecciones respiratorias, y neumonía por Pneumocystis jirovecii. En Venezuela existen pocos estudios sobre la neumocistosis en pacientes oncológicos. El objetivo de este trabajo fue detectar la presencia de Pneumocystis jirovecii en pacientes oncológicos a través de la técnica de inmunofluorescencia directa. Se recibieron, durante 10 meses, 31 muestras respiratorias (lavado broncoalveolar, esputo espontáneo e inducido, aspirados traqueales), de ellas 8 (25,5 por ciento) resultaron positivas. La distribución por tipo de cáncer fue la siguiente: 18 tumores sólidos y 13 leucemias y linfomas. La positividad entre los grupos estudiados no fue estadísticamente significativa (P>0,05). Los exámenes de laboratorio complementarios, relacionados tampoco fueron estadísticamente significativos (P>0,05). Es necesario incluir este diagnóstico en estudio microbiológico diferencial de infecciones del tracto respiratorio inferior en pacientes con cáncer, estos pacientes cursan con una sintomatología general inespecífica y tendrán una alta posibilidad de desarrollar neumocistosis.

The patient with malignancy disease has a high risk to develop respiratory infections for Pneumocystis jirovecii pneumonia. Investigations about pneumocystosis in oncological patients in Venezuela are scarce. The objective of this work was to detect Pneumocystis jirovecii in oncological patients by the method of direct immunofluorescence technique. Thirty one respiratory specimens (bronchoalveolar lavage, spontaneous and induced sputum, and tracheal aspirates) received in 10 months, 8 specimens of them (25.5) were positive the distribution by malignancy disease was the following: 18 solid tumors, and 13 leukemias, and lymphomas. No statistically significant differences were found between the studied groups and positive results (P>0.05). The complementary laboratory tests, related to the presence of Pneumocystis, were not statistically significant either P>0.05). Is necessary to include this diagnosis in the microbiological differential study of low respiratory tract infections in oncological patients, since these patients show unspecific symptoms, and have a high possibility to develop pneumocystosis.

Angioedema hereditário / Hereditary angioedema

O Angioedema Hereditário (AEH) é uma doença resultante de distúrbios nos sistemas complemento, da coagulação e calicreína-bradicinina. A doença manifesta-se por edema subcutâneo, dor abdominal e edema de laringe com morte por asfixia. Trauma, estresse e ciclo menstrual podem desencadear as crises. O AEH tipo I é descrito em 85% dos casos com níveis antigênicos e funcionais do inibidor da Cl esterase (C1-INH) reduzidos. No tipo II, o defeito é funcional com níveis de C1-INH normais. No tipo III, não existe alteração do C1-INH e associa-se a elevados níveis de estrogênio exógeno e/ou mutações no gene do fator XII da coagulação. Os níveis de C4 encontram-se reduzidos no HAE tipo I e II. A dosagem de C1q é utilizada para diferenciar o AEH dos casos adquiridos. Na profilaxia em longo prazo recomenda-se o uso de antifibrinoliticos ou andrógenos atenuados caso mais de uma crise grave ocorra ao mês e quando o tratamento para os ataques não forem eficazes ou disponíveis. Na profilaxia em curto prazo deve-se usar concentrados do C1-INH, não disponível no Brasil, substituído pelo plasma com eficácia limitada. Nas crises de AEH, o único medicamento disponível em nosso meio é o icatibanto, antagonista do receptor de bradicinina, administrado por via subcutânea. O ecalantide é um inibidor da calicreína usado nas crises também não disponível no Brasil. O AEH é uma doença subdiagnosticada que pode ser controlada evitando-se o óbito por asfixia. Novos tratamentos estão sendo disponibilizados que podem resultar numa melhor qualidade de vida dos pacientes.

Hereditary angioedema (HAE) is a disease caused by disturbs of complement, coagulation and kalikrein-bradikynin systems. The disease presents relapsing subcutaneous swelling, abdominal pain and laryngeal edema causing asphyxia. Trauma, stress and menses can precipitate the attacks. HAE Type I is described in 85% of the cases with reduced antigenic and functional levels of the C-1 esterase inhibitor (C1-INH). In Type II, the defect is functional and C1-INH levels are normal. In type III HAE, there is no impaired C1-INH but high doses of exogenous estrogens and/or mutations in Factor XII gene have been found. C4 levels are reduced in HAE Type I and II. Serum Clq is applied for differential diagnosis of acquired angioedema. Long term prophylaxis is recommended with antifibrinolytic agents or atenuated androgens whether there is more than one severe attack per month and the treatment for the attacks are nor efficacious or available. For short term prophylaxis, C1-INH concentrates should be used, however they are not available in Brazil and it is substituted by plasma with limited efficacy. During HAE attacks, the only drug available in Brasil is icatibant, a bradykinin antagonist receptor. Ecalantide is a kallikrein inhibitor to be used in attacks, not availabie in Brazil yet. Therefore, HAE is a misdiagnosed disease that may be controlled preventing the death due to asphyxia. New treatment options have been available that might result in a better quality of life within the patients.

Pathophysiology & genetics of obstructive sleep apnoea.

Obstructive sleep apnoea (OSA) is a highly prevalent condition with proven neurocognitive and cardiovascular consequences. OSA patients experience repetitive narrowing or collapse of the pharyngeal airway during sleep. Multiple factors likely underlie the pathophysiology of this condition with considerable inter-individual variation. Important risk factors for OSA include obesity, male gender, and ageing. However, the mechanisms underlying these major risk factors are not well understood. We briefly review the state-of-the-art knowledge regarding OSA pathogenesis in adults and highlight the potential role of genetics in influencing key OSA pathophysiological traits.

Wegener granulomatosis; diagnosis and management

To highlight the different clinical features, parameters of diagnosis and to see the effect of chemotherapy and steroids on this disease. Department of Otolaryngology Head and Neck Surgery Jinnah Hospital Lahore. From Dec 1998 to July 2001. Five cases of Wegener Granulomatosis were studied during the study period. Three patients had limited disease while two patients had generalized disease with renal involvement. All patients were started on azathiopurine [2mg/Kg/day] orcyclophoshamide [1-2mg/kg/day] along with steroids. After a months time the dose of steroid was reduced to alternate day. Weekly monitoring of white blood cell count with urine examination for RBCs or protein casts was done. Any patient with haematuria or TLC reduced to less than 3500 were immediately taken off from cyclophosphamide and azathiopurine was started. Patients having classic disease, dose of cyclophoshamide had to be increased from two to four milligram / per Kilogram per day to achieve a good response. The response to treatment was measured by noticing the resolution of pulmonary infiltrates reduced ESR and negative C-ANCA. We found nasal symptoms like nasal obstruction and epistaxis to be the most common symptom followed by fever, cough and deafness. Crusting, granulations and occasional perforation were usually found on nasal examination. Conductive deafness was most common ear finding. History, clinical examination, ESR, C-ANCA and a representative biopsy were all essential in diagnosing this condition. Azathiopurine and cyclophosphamide were the main chemotherapeutic agents used with prednisone to cause remission in all our patients except one who died two weeks after having been admitted in our institution. Surprisingly in contrast to the normal cause of high mortality reported in international literature in this disease to be renal failure, our patient died due to respiratory failure. Four out of five patients went into remission a year after regular treatment with this regime. The major complications occurring during hospital stay and their treatment were nausea, vomiting, sudden fall of TLC, and oral thrush. The common presentation of patient with Wegner's Granulomatosis is of upper respiratory tract symptoms like nasal obstruction and epistaxis followed by lower respiratory symptoms like cough, fever and Haemoptysis. A representative biopsy with positive C-ANCA and high ESR are hallmarks of diagnosing this condition. The most effective medical regime till today is cyclophosphamide and azathiopurine with alternate day prednisone for inducing remission

Análise do funcionamento do Shaker à diversos níveis de fluxo / Analysis of the functioning of the Shaker to diverse levels of flow

Introdução: A fisioterapia respiratória tem importante papel em patologias respiratórias hipersecretivas, auxiliando na mobilização e remoção das secreções brônquicas. Dentre os adjuntos terapêuticos, os dispositivos oscilatórios de alta freqüência são largamente utilizados na higiene brônquica. Assim, este estudo teve por objetivo avaliar os valores de pressão expiratória positiva (PEP) e freqüência obtidos pelo aparelho Shaker® quando submetido a fluxos variáveis (de 2 a 30 L/min). Metodologia: Para a coleta dos dados foi elaborado um circuito composto por dois fluxômetros de ar comprimido, o Shaker®e um microcomputador, com um software previamente calibrado para registrar os dados de PEP e frequência. Resultados: Os resultados indicaram valores de pressão mínima constantes, 2,5 cmH2O, e valores máximos que variaram de 12,5-47,5 cmH2O. A menor freqüência registrada foi de 16,41 Hz e a máxima de 27,48 Hz. Conclusão: Considerando os resultados obtidos, fluxos expiratórios elevados produzem altos níveis pressóricos com baixas freqüências, podendo resultar em menor efeito desobstrutivo e barotrauma. Logo, o paciente deve ser orientado quanto à utilização de fluxos baixos na terapia com o Shaker®, proporcionando uma técnica de higiene brônquica, eficaz e segura.

Exposição ocupacional à poeira do tabaco: efeitos sobre o sistema respiratório / Occupational exposure to tobacco dust: effects on the respiratory system

O Brasil, atualmente, é considerado como o maior exportador mundial do tabaco. Embora a exportação do produto favoreça a economia de diversas regiões, há uma crescente preocupação com a saúde dos trabalhadores envolvidos no processamentoe beneficiamento da Nicotiana tabacum. Este artigo tem como objetivo descrever a prevalência de sinais e sintomas respiratórios e as possíveis alterações na função pulmonar em trabalhadores expostos ocupacionalmente ao pó do tabaco. Esta descrição teve como base artigos científicos selecionados através da base eletrônica de dados MEDLINE. Verificamos que os sinais e sintomas respiratórios mais freqüentes nestes trabalhadores foram: tosse, dispnéia, opressão torácica, hipersecretividade,bem como anormalidades nas capacidades e volumes pulmonares (VEF1, CVF, FEM25%, FEM50% e PFE). Estes efeitos nocivos ao sistema respiratório merecem atenção e a adoção de medidas de prevenção que garantam melhores condições de saúde ao trabalhador.

Qualidade do ar e atendimentos médicos de emergência por sintomas respiratórios em crianças residentes em Jacarepaguá, Rio de Janeiro / Air quality and emergency medical consultations related to respiratory symptoms among children living in Jacarepaguá, Rio de Janeiro

Apesar da cidade do Rio de Janeiro ser uma das mais importantes metrópoles brasileiras são muito pouco conhecidos os efeitos da exposição aos poluentes atmosféricos na saúde da população carioca. Este trabalho foi idealizado para suprir uma parte desta carência. Os poluentes investigados foram PM10, SO2, NO2, CO e O3 e os desfechos envolveram os atendimentos pediátricos de emergência por sintomas respiratórios em três unidades públicas de saúde de Jacarepaguá, entre abril de 2002 e março de 2003. As variáveis de confusão foram a tendência temporal, sazonalidade, temperatura, umidade relativa do ar, precipitação de chuva e infecções respiratórias. Também foram ajustados os efeitos do calendário, isto é, determinados dias do ano que apresentaram comportamentos anormais como feriados e finais de semana. Houve inúmeras falhas no monitoramento de todos os poluentes e devido ao reduzido volume de dados, optou-se por não incluir o SO2 nas análises. Uma vez que os determinantes e as conseqüências clínicas dasexposições aos poluentes atmosféricos são bastante distintos nas vias aérias superiores e nas vias aéreas inferiores, um dos estudos verificou a associação dos poluentes do ar com transtornosnestes dois segmentos. Embora de pequena magnitude, somente o O3 apresentou resultado positivo e estatisticamente significativo, tanto com todos os atendimentos de emergência por queixas respiratórias como com os atendimentos motivados por sintomas nas vias aéreas inferiores. O efeito foi no mesmo dia da exposição (lag 0). No outro estudo, investigou-se a associação dos poluentes do ar com os atendimentos de emergência por sintomas de obstrução brônquica. Neste caso, as crianças foram categorizadads em três faixas etárias. Somente ascrianças com idades menores que 2 anos tiveram um resultado positivo e estatisticamente significativo, de expressiva magnitude com PM10...

Cyclospora cayetanensis oocysts in sputum of a patient with active pulmonary tuberculosis, case report in Ismailia, Egypt

Observation of acid fast C. cayetanensis oocysts were proved in a sputum sample of a 45 years-old male HIV negative patient who was admitted to Chest Hospital due to loss of weight, cough with expectoration of purulent sputum and dyspnea. The radiological picture suggested active pulmonary tuberculosis [TB]. Sputum samples which were positive for acid fast bacilli as proved by Ziehl-Neelsen stain technique showed large [8-10 pm] spherical acid-fast C. cayetanensis oocysts and their identification was confirmed by molecular techniques [Nested PCR]. The patient was successfully treated for TB since 4 years. However, this was the second time to report C. cayetanensis oocysts in human sputum. The first one was in Argentina. So, C. cayetanensis is a new respiratory system pathogen which must be considered in the differential diagnosis

Airway Inflammation and Allergen Specific IgE Production May Persist Longer Than Airway Hyperresponsiveness in Mice

During the preclinical study of new therapeutic modality, we evaluate whether the treatment can reverse the established asthma phenotypes in animal model. However, few have reported on the long term persistence of asthma phenotypes upon re-challenge with allergen (secondary challenge) in animal model. We evaluated the persistence of asthma phenotypes by secondary challenge at different times in previously challenged murine asthma model. BALB/c mice sensitized by intraperitoneal injections of 20 microgram of ovalbumin and 1 mg of alum on days 1 and 14 were challenged initially by the inhalation of 1% ovalbumin for 30 min on days 21, 22, and 23. Each group of mice was rechallenged at 5, 7, 9, or 12 weeks after the initial challenge. Airway hyperresponsiveness, BAL fluid, airway histology and serum ovalbumin-specific IgE level were evaluated. Airway eosinophilia, airway inflammation and serum ovalbumin-specific IgE production persisted upon secondary allergen challenges at least 12 weeks after the initial challenge. However, airway hyperresponsiveness persisted only until mice were rechallenged 7 weeks after the initial challenge. Airway inflammation and allergen specific IgE production may persist longer than airway hyperresponsiveness in a mouse asthma model of secondary allergen challenge.

Injuria por inhalación aguda y sus consecuencias / Injury due to acute inhalation its consequences

El autor comenta que en ciertas y esporádicas situaciones, el sistema respiratorio puede sufrir un daño agudo ocasionado por la inhalación de agentes tóxicos presentes en diversas formas físicas. Esto sucede más frecuentemente en el sitio de trabajo, aunque también ocurre en áreas residenciales, en sitios públicos, o en situaciones de guerra. Las manifestaciones de la injuria por inhalacion aguda son diversas, y abarcan desde la irritación leve hasta la fatalidad.

Respiratory mechanics and morphometric changes during anesthesia with ketamine in normal rats

Ketamine is believed to reduce airway and pulmonary tissue resistance. The aim of the present study was to determine the effects of ketamine on the resistive, elastic and viscoelastic/inhomogeneous mechanical properties of the respiratory system, lungs and chest wall, and to relate the mechanical data to findings from histological lung analysis in normal animals. Fifteen adult male Wistar rats were assigned randomly to two groups: control (N = 7) and ketamine (N = 8). All animals were sedated (diazepam, 5 mg, ip) and anesthetized with pentobarbital sodium (20 mg/kg, ip) or ketamine (30 mg/kg, ip). The rats were paralyzed and ventilated mechanically. Ketamine increased lung viscoelastic/inhomogeneous pressure (26 percent) compared to the control group. Dynamic and static elastances were similar in both groups, but the difference was greater in the ketamine than in the control group. Lung morphometry demonstrated dilation of alveolar ducts and increased areas of alveolar collapse in the ketamine group. In conclusion, ketamine did not act at the airway level but acted at the lung periphery increasing mechanical inhomogeneities possibly resulting from dilation of distal airways and alveolar collapse

Parental smoking and the risk of respiratory symptoms among school boys in Al-Khobar City, Saudi Arabia

The objective of this study was to measure the prevalence of parental smoking and its association with respiratory symptoms among 6-15 years old school boys in Al-Khobar city, Saudi Arabia. This is a cross-sectional study. The methodology included the distribution of a self-administered questionnaire, which was filled by the parents of 1482 school boys who satisfied the selection criteria of the study. The overall rate of smoking among parents of this sample was 18.2% [32% among fathers and 4% for mothers]. There was an increased risk between parental smoking and respiratory symptoms among asthmatic and non- asthmatic children. The magnitude of this risk was variable for different respiratory symptoms. Smoking rate among parents of asthmatic children was significantly higher than in those with normal children although the logistic regression model showed paternal smoking to be significantly associated with bronchial asthma in their children. Conclusions: There is an increased risk of respiratory symptoms among asthmatic and non- asthmatic children because of parental smoking. The smoking rate and trend among fathers and mothers were comparable to those reported earlier indicating an on-going problem. School children with smoking parent[s] may better be screened for bronchial asthma. Management of children presenting with respiratory symptoms should include inquiry about exposure to passive smoking. Tobacco smoking should be considered a public health problem with serious implications and its import should be banned