RESUMEN
Cow's milk protein allergy (CMPA) is the most frequent cause of food allergy in the first months of life. Despite the fact that there are different guidelines and recommendations on the management of children with CMPA, there continues to be great variability in diagnostic and therapeutic criteria in Latin America. The Food Allergy Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition summoned a group of Latin American experts to reach a consensus and formulate a document to unify diagnostic and therapeutic criteria for CMPA. Three teams were formed, each with a coordinator, and the members of each team developed a series of statements for their corresponding module: a) clinical manifestations and diagnosis; b) diagnostic tools, and c) treatment. A search of the medical literature was carried out to support the information presented in each module and 28 statements were then selected. The statements were discussed, after which they were evaluated by all the experts, utilizing the Delphi method. Their opinions on statement agreement or disagreement were anonymously issued. The final statements selected were those with above 75% agreement and their corresponding recommendations were formulated, resulting in the document presented herein.
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Gastroenterología , Hipersensibilidad a la Leche , Animales , Bovinos , Consenso , Femenino , Humanos , América Latina , Hipersensibilidad a la Leche/diagnóstico , Hipersensibilidad a la Leche/terapia , Proteínas de la Leche/efectos adversosRESUMEN
BACKGROUND: Hyperprolactinaemia (HyperPRL) induced by psychotropic drugs is a high-prevalence consequence which has repercussions in psychical and mental health in the psychiatric population, so this research had the objective to expand which sociodemographic and clinical features are associated with prolactin (PRL) elevation in patients treated with antidepressant and/or antipsychotic drugs. METHODS: An observational, cross-sectional, comparative and retrolective study was conducted on 300 patients who received clinical attention in a third level of psychiatric care unit in Mexico during 2017. These patients have been reported to show PRL levels greater than 25 ng/mL among women and greater than 20 ng/mL among men. In the same way, sociodemographic and clinical variables were collected, as well as psychiatric diagnosis and type of psychopharmacological treatment used by the patients. RESULTS: HyperPRL was more frequent in women (80.7%) than men (19.3%). The mean levels of PRL were 68.94 ± 62.28 ng/mL with higher levels in women (71.9 ± 67.3, p=.02). Regarding the treatment, 78.3%, 71.3% and 49.7% consumed antipsychotics, antidepressants, and both drugs, respectively. The relationship between hyperPRL (>100 n/mL) and typical antipsychotics was dose-dependent (33.23 ± 13.24 mg, p=.01). In the multivariate regression models according to the type of treatment, as well as the demographic and clinical features, hyperPRL was associated independently with the use of antipsychotic treatment, pituitary adenoma and hypertension (R2=0.05). CONCLUSIONS: HyperPRL is a complex clinical syndrome frequent in the psychiatric population with detrimental long-term consequences, as well as its relationship with the use of psychotropic drugs as in the case of antipsychotics. Effective actions should be implemented in the prevention, approach and treatment of this condition paying special attention to the accompanying medical comorbidities.
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Antipsicóticos , Hiperprolactinemia , Masculino , Humanos , Femenino , Hiperprolactinemia/inducido químicamente , Hiperprolactinemia/epidemiología , Antipsicóticos/efectos adversos , Estudios Transversales , Prolactina , Psicotrópicos/uso terapéuticoRESUMEN
BACKGROUND: Williams syndrome (WS) and autism spectrum disorder (ASD) are neurodevelopmental disorders that demonstrate overlapping genetic associations, dichotomous sociobehavioral phenotypes, and dichotomous pathological differences in neuronal distribution in key social brain areas, including the prefrontal cortex and the amygdala. The serotonergic system is critical to many processes underlying neurodevelopment and is additionally an important neuromodulator associated with behavioral variation. The amygdala is heavily innervated by serotonergic projections, suggesting that the serotonergic system is a significant mediator of neuronal activity. Disruptions to the serotonergic system, and atypical structure and function of the amygdala, are implicated in both WS and ASD. METHODS: We quantified the serotonergic axon density in the four major subdivisions of the amygdala in the postmortem brains of individuals diagnosed with ASD and WS and neurotypical (NT) brains. RESULTS: We found opposing directions of change in serotonergic innervation in the two disorders, with ASD displaying an increase in serotonergic axons compared to NT and WS displaying a decrease. Significant differences (p < 0.05) were observed between WS and ASD data sets across multiple amygdala nuclei. LIMITATIONS: This study is limited by the availability of human postmortem tissue. Small sample size is an unavoidable limitation of most postmortem human brain research and particularly postmortem research in rare disorders. CONCLUSIONS: Differential alterations to serotonergic innervation of the amygdala may contribute to differences in sociobehavioral phenotype in WS and ASD. These findings will inform future work identifying targets for future therapeutics in these and other disorders characterized by atypical social behavior.
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Amígdala del Cerebelo/patología , Trastorno del Espectro Autista/patología , Axones/patología , Serotonina , Síndrome de Williams/patología , Adolescente , Adulto , Anciano , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Dendritic cell-based (DC-based) vaccines are promising immunotherapies for cancer. However, several factors, such as the lack of efficient targeted delivery and the sources and types of DCs, have limited the efficacy of DCs and their clinical potential. We propose an alternative nanotechnology-based vaccine platform with antibacterial prophylactic abilities that uses gold glyconanoparticles coupled to listeriolysin O 91-99 peptide (GNP-LLO91-99), which acts as a novel adjuvant for cancer therapy. GNP-LLO91-99, when used to vaccinate mice, exhibited dual antitumour activities, namely, the inhibition of tumour migration and growth and adjuvant activity for recruiting and activating DCs, including those from melanoma patients. GNP-LLO91-99 nanoparticles caused tumour apoptosis and induced antigen- and melanoma-specific cytotoxic Th1 responses (P ≤ 0.5). We propose this adjuvant nanotherapy for preventing the progression of the first stages of melanoma.
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Toxinas Bacterianas/química , Vacunas contra el Cáncer/administración & dosificación , Células Dendríticas/inmunología , Proteínas de Choque Térmico/química , Proteínas Hemolisinas/química , Melanoma Experimental/terapia , Nanopartículas del Metal , Adyuvantes Inmunológicos/química , Animales , Células CHO , Línea Celular Tumoral , Cricetulus , Femenino , Oro , Humanos , Ratones , Ratones Endogámicos C57BL , PéptidosRESUMEN
In Catalonia, a screening protocol for cervical cancer, including human papillomavirus (HPV) DNA testing using the Digene Hybrid Capture 2 (HC2) assay, was implemented in 2006. In order to monitor interlaboratory reproducibility, a proficiency testing (PT) survey of the HPV samples was launched in 2008. The aim of this study was to explore the repeatability of the HC2 assay's performance. Participating laboratories provided 20 samples annually, 5 randomly chosen samples from each of the following relative light unit (RLU) intervals: <0.5, 0.5 to 0.99, 1 to 9.99, and ≥10. Kappa statistics were used to determine the agreement levels between the original and the PT readings. The nature and origin of the discrepant results were calculated by bootstrapping. A total of 946 specimens were retested. The kappa values were 0.91 for positive/negative categorical classification and 0.79 for the four RLU intervals studied. Sample retesting yielded systematically lower RLU values than the original test (P<0.005), independently of the time elapsed between the two determinations (median, 53 days), possibly due to freeze-thaw cycles. The probability for a sample to show clinically discrepant results upon retesting was a function of the RLU value; samples with RLU values in the 0.5 to 5 interval showed 10.80% probability to yield discrepant results (95% confidence interval [CI], 7.86 to 14.33) compared to 0.85% probability for samples outside this interval (95% CI, 0.17 to 1.69). Globally, the HC2 assay shows high interlaboratory concordance. We have identified differential confidence thresholds and suggested the guidelines for interlaboratory PT in the future, as analytical quality assessment of HPV DNA detection remains a central component of the screening program for cervical cancer prevention.
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Papillomaviridae/genética , Infecciones por Papillomavirus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , ADN Viral/genética , Detección Precoz del Cáncer/métodos , Femenino , Pruebas de ADN del Papillomavirus Humano/métodos , Humanos , Ensayos de Aptitud de Laboratorios/métodos , Infecciones por Papillomavirus/virología , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , España , Neoplasias del Cuello Uterino/virología , Frotis Vaginal/métodosRESUMEN
OBJECTIVE: To assess stakeholders' perceptions (i.e. patients, relatives, the public, and professionals) about results of the Valencian Community Cancer Plan (POCV). METHODS: Qualitative analysis (34 participants in 2 interview groups, and 37 participants in 4 focus groups) and quantitative analysis (470 opinion surveys) was combined in a descriptive study. RESULTS: The POCV's existence is highlighted as a positive factor. It has managed to send the message that "cancer can be cured" to the population. The key aims have been defined, criteria have been unified, and there have been achieved the Tumor Committees contribute most to make a multidisciplinary care. The plan is considered innovative, especially because the Genetic Counseling Program was included. Citizens leaders and patient associations find the Breast Cancer Program as the best known and the most valued, while the Colorectal Cancer Program is the least known. In both methodologies, qualitative groups and the online survey conducted on the professionals, it is concluded that the Tumor Committees, the vaginal cytology recommendation for cervical cancer prevention, and the message transmission that "cancer can be cured" are positively assessed. CONCLUSIONS: POCV 07-10 assessments are generally positive, with occasional exceptions that are clearly identified. The qualitative and quantitative information obtained in the different analyses is almost coincident.
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Organizaciones de Planificación en Salud/organización & administración , Promoción de la Salud/organización & administración , Neoplasias , Garantía de la Calidad de Atención de Salud/organización & administración , Adulto , Anciano , Actitud Frente a la Salud , Detección Precoz del Cáncer/psicología , Estudios de Evaluación como Asunto , Familia/psicología , Femenino , Grupos Focales , Educación en Salud , Personal de Salud/psicología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/diagnóstico , Neoplasias/prevención & control , Neoplasias/psicología , Pacientes/psicología , Opinión Pública , Investigación Cualitativa , España , Encuestas y CuestionariosRESUMEN
BACKGROUND: To determine recommended delays for treatment once there is well-founded clinical suspicion in care processes for breast and colorectal cancer, taking into account resources and the psychological well-being of the patients. METHOD: A qualitative study among professionals. The study was conducted in two phases. Firstly, during 4 sessions (N=19) we conducted a revision of the care processes of breast cancer and colorectal cancer and fixed desirable times. Secondly, through a modification of the Delphi technique (N=49), the proposed times for each care process were validated. RESULTS: Delphi response rates of 69% and 58% for colorectal and breast processes respectively. The recommended time in the case of non-invasive breast cancer was 5 to 6 weeks. If the cancer was invasive and nuclear medicine was used for sentinel node study or axillary clearance 5 to 7 weeks were recommended. In the case of cancer of the colon and rectum 7 to 13 weeks were considered necessary. CONCLUSIONS: Breast cancer treatment should be started before six weeks. In colorectal cancer up to three months could be required. An interdisciplinary review of care processes relying on professionals is useful for establishing realistic quality standards.
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Neoplasias de la Mama/terapia , Neoplasias Colorrectales/terapia , Garantía de la Calidad de Atención de Salud , Protocolos Clínicos , Femenino , Humanos , Guías de Práctica Clínica como Asunto , Factores de TiempoRESUMEN
PURPOSE: To evaluate short-term follow-up of nonpalpable probably benign lesions in a 2-year mammographic screening. MATERIALS AND METHODS: Of 13,790 women aged 45-65 years who underwent first-round screening, 795 (5.8%) underwent short-term mammographic follow-up (every 6 months for 2 years) of nonpalpable probably benign lesions (eg, masses, focal asymmetric densities, and calcifications) previously assessed at an additional imaging evaluation, including ultrasonography. When no changes were found at short-term mammographic follow-up, women were assigned to the 2-year screening interval. Needle localization and surgical biopsy were performed when the lesion progressed (was enlarged or had an increased number or size of calcifications or modification of their initial characteristics). The effectiveness of this approach was evaluated with statistical analysis. RESULTS: Of 795 lesions, 788 (99%) remained stable, and seven (1%) had changes prompting surgical biopsy. Two cancers (0.3%), one microinvasive intraductal carcinoma and one 7-mm invasive ductal carcinoma without positive nodes, were found. Four of the five benign histologic results were probably benign calcifications with progression at short-term follow-up. The sensitivity, specificity, accuracy, and positive and negative predictive values were 100%, 99%, 99%, 29%, and 100%, respectively. CONCLUSION: The benign nature of most nonpalpable probably benign lesions can be typified with short-term mammographic follow-up. This approach permitted identification of a few low-stage carcinomas, but progression in the probably benign calcifications was usually unrelated to malignancy.
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Enfermedades de la Mama/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Mamografía , Anciano , Biopsia , Enfermedades de la Mama/diagnóstico , Neoplasias de la Mama/diagnóstico , Calcinosis/diagnóstico , Calcinosis/diagnóstico por imagen , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Palpación , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Ultrasonografía MamariaRESUMEN
BACKGROUND: We have investigated a model of "preterminal ischemia" in order A) to assess the MRI findings and the repeatability of the anatomical changes as showed by MRI, and B) to compare the data so obtained with the humans. METHODS: Twenty rabbits were used. Under general anesthesia, the occlusion of 1) the two common carotid arteries (from 2 hours up to 24 hours) was performed in 8 cases, and of 2) the epi-aortic vessels at the aortic arch (from 2 hours up to 4 hours) was performed in 4 cases in general anesthesia. RESULTS: In the vessels occlusion group MRI study showed inconsistent, inconstant, predominantly ill defined, linear and/or spotlike hyperintense deep cerebral alterations, variable in location, unilateral and bilateral in 8 cases. Although in carotid occlusion the damage was already evident within the first two hours, aortic arch occlusion was unable to produce global brain lesional pattern even up to 4 hours. MRI study of the sham operated animals was negative. CONCLUSIONS: The selective vulnerability of mesial deep cerebral structures to hypoxia, different in location from the human's, and the more effective pre-Willisian compensation, suggests to look for different animals when dealing with preterminal ischemic models comparable to the humans' as studied with MRI.
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Isquemia Encefálica/patología , Círculo Arterial Cerebral/fisiología , Animales , Aorta Torácica/fisiología , Presión Sanguínea/fisiología , Arterias Carótidas/fisiología , Modelos Animales de Enfermedad , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Concentración de Iones de Hidrógeno , Imagen por Resonancia Magnética , Masculino , Conejos , Reproducibilidad de los ResultadosRESUMEN
The aim of the study was to compare biopsy specimens obtained by suction with those obtained by endoscopy morphometrically and histologically in order to evaluate their adequacy for histological interpretation. For this, 23 children with suspected enteropathy underwent upper gastrointestinal endoscopy. For histological evaluation, biopsies were assessed for orientation, depth, length, presence of Brunner's glands and/or lymphoid follicles and presence of artifact. The mucosa total height and villi height were evaluated for morphometric assessment. The results of all the analysed parameters were not statistically significant, except for the presence of Brunner's glands that were most evident in endoscopic biopsies. Although, the suction capsule biopsies and the endoscopic ones were appropriate for histological interpretation in 91.3% respectively, the difference was not statistically significant. Based on the morphometric analysis, the mucosa total height and the villi height values in both biopsy techniques were not statistically significant different. The small intestine mucosal biopsies obtained by endoscopy compared with those obtained by suction capsule were adequate for histological interpretation.
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Endoscopía Gastrointestinal , Enfermedades Intestinales/patología , Mucosa Intestinal/patología , Intestino Delgado/patología , Adolescente , Biopsia/métodos , Niño , Preescolar , Estudios de Evaluación como Asunto , Femenino , Humanos , Lactante , Masculino , Estudios ProspectivosRESUMEN
It is well known that Phaseolus species contains lectins of various specificities 1-4. Runner bean5 and different varieties of Ph.coccineus described by Ochoa et al6, are not specific to human blood groups. They react indistinctly with erythrocytes of the ABO system. However the lectin of Ph. lunatus (lima bean)7 is specific to the blood group type A, a classic example of that specificity. Sometime ago, we discovered a new lectin in a variety of edible bean of Ph. coccineus in the flora of the state of Oaxaca in Mexico, cultivated exclusively in the small community of Jamiltepec, near the Pacific coast, which presented strong hemagglutinating anti-A1 activity. In this report we describe a chromatographic technique for the isolation and purification of this lectin. The molecule is a tetramer with a molecular weight of 120 kDa. It requires Ca++ or Mg++ for activity, and it is inhibited by N-Acetylgalactosamine (GalNac) at concentration of 2.8 mM., NN' N' Triacetylchitotriose, 4-O(4-O-D-Galactopyranosyl) -D-Galatopyranosyl-D-Glucopyranose, and N' Diacetylchitobiose inhibited at moderate concentration (20mM). Conalbumin and ovoalbumin, also inhibited hemagglutination.
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Sistema del Grupo Sanguíneo ABO/metabolismo , Fabaceae/química , Lectinas/aislamiento & purificación , Plantas Medicinales , Animales , Cloruro de Calcio/farmacología , Cationes , Cromatografía en Gel , Electroforesis en Gel de Poliacrilamida , Glicoproteínas/farmacología , Hemaglutinación , Humanos , Concentración de Iones de Hidrógeno , Lectinas/química , Lectinas/metabolismo , México , Lectinas de PlantasRESUMEN
A 31-year-old man presented complaining of radicular (L4) pain. MRI and myelo-TC of the thoraco-lumbar spine showed the presence of an extradural CSF cyst extending from Th6 to L2, posterior to the cord. The patient underwent a Th12 laminectomy, the cyst was opened and drained. A recording electrode was placed epidurally, dorsal to the cyst, at the level of the Th12 vertebral body, and the potentials evoked by stimulation of the tibial and saphenous nerves were monitored during surgery. After cyst drainage the epidural potentials were significantly larger (x5) in amplitude and more defined in shape than those recorded in the presence of the cyst. Our case demonstrates the "filtering effect" of CSF on spinal somatosensory evoked potentials.
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Quistes Aracnoideos/cirugía , Líquido Cefalorraquídeo/fisiología , Potenciales Evocados Somatosensoriales/fisiología , Adulto , Quistes Aracnoideos/fisiopatología , Estimulación Eléctrica , Humanos , MasculinoRESUMEN
To study the effects of infusion of low doses of dopamine hydrochloride on cardiopulmonary and renal status in premature newborns with respiratory distress syndrome, 49 newborns were randomly assigned to three groups: group 1 (18 patients) received no dopamine and was the control group; group 2 (16 patients) was infused with a dose of dopamine measuring 1.0 micrograms/kg of body weight per minute for 72 hours; and group 3 (15 patients) was infused with a dose of dopamine measuring 2.5 micrograms/kg of body weight per minute for 72 hours. Birth weights, gestational ages, post-natal ages, and cardiopulmonary status of all groups at the start of the study were comparable. Continuous infusion of these low doses of dopamine for 3 days after birth did not significantly improve levels of blood gases, acid-base balance, or clinical outcome. In newborns with systemic hypotension, dopamine improved cardiovascular status and caused early return of blood pressure to the normal range. Infusion of low doses of dopamine produced mild to moderate natriuresis and insignificant increases in glomerular filtration rate and urine volume.
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Presión Sanguínea/efectos de los fármacos , Dopamina/administración & dosificación , Tasa de Filtración Glomerular/efectos de los fármacos , Síndrome de Dificultad Respiratoria del Recién Nacido/tratamiento farmacológico , Equilibrio Ácido-Base/efectos de los fármacos , Análisis de los Gases de la Sangre , Humanos , Recién Nacido , Infusiones Intravenosas , Natriuresis/fisiología , Estudios Prospectivos , Síndrome de Dificultad Respiratoria del Recién Nacido/mortalidad , Síndrome de Dificultad Respiratoria del Recién Nacido/fisiopatología , Tasa de SupervivenciaRESUMEN
Tracheal agenesis is a rare congenital anomaly. We report a case and review the cases previously reported. Clinical features that might indicate tracheal agenesis include antenatal polyhydramnios, severe respiratory distress, absence of an audible cry, failure to advance an endotracheal tube beyond the larynx, a palpable distal trachea, clinical improvement after esophageal intubation, and roentgenographic absence of a tracheal air column with an abnormal position of the carina. For immediate management of the affected infant, we recommend intubation of the esophagus with an endotracheal tube to provide an air passage, and determination of the level of the defect by careful use of contrast material and roentgenography. Infants having type I tracheal agenesis may benefit from immediate tracheostomy.
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Esófago , Intubación , Polihidramnios/complicaciones , Tráquea/anomalías , Fístula Bronquial/complicaciones , Fístula Esofágica/complicaciones , Femenino , Humanos , Recién Nacido , Embarazo , Radiografía , Tráquea/diagnóstico por imagen , Tráquea/cirugía , TraqueostomíaRESUMEN
An investigation into the use of psychometric assessment instruments to produce psychographic profiles which proved superior to the use of individual measures on drug accepting versus drug rejecting age generational gaps is appropriate when considering drug and alcohol education programs. Clinical studies show that polydrug abusers have many psychoneurotic and psychopathic traits which can be measured through valid personality tests. Cuevas (1989), employed the Western Personality Inventory (Manson 1963) to identify individuals whose behavior and personality structure indicated they were polydrug users or had serious polydrug problems. The instrument revealed that a combinative process utilizing comparison groups from known polydrug abusers as a discriminant analysis technique with controls provided a high degree of accuracy. A high degree of precision in prediction was maintained in validation trials on independent samples. The personality characteristics and traits were extracted from a combination of commonly ordered personality tests. Results of the investigation indicate that clinical usage of the screening procedure is readily available without sophisticated computer support or the need for trained psychometricians. Additional results identified the process as interventive, therefore providing a simple way to produce early didactic preventive instruction.
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Trastorno de Personalidad Antisocial/psicología , Trastornos Neuróticos/psicología , Inventario de Personalidad , Trastornos Relacionados con Sustancias/psicología , Adulto , Trastorno de Personalidad Antisocial/diagnóstico , Femenino , Humanos , Masculino , Trastornos Neuróticos/diagnóstico , Psicometría , Factores de Riesgo , Trastornos Relacionados con Sustancias/diagnósticoRESUMEN
Close to 15% of the karatasin proteinase activity in the fruit juice of Bromelia plumieri (karatas) is present outside dialysis Visking tubing in 7 days in 0.2 M acetate buffer (pH) 3.5 or 6.5) containing phenyl mercuric acetate. The small proteinase(s), distinct from the 85% activity in juice due to nondialysable karatasin with a reported Mr of 24,868, separates across Spectrapore (13 kDa) membranes but not across Spectrapore with 3.5 kDa average pore diameter. The dialyzed proteinase is named karatasin-D (K-D). Purified non-Dialysable karatasin can be dissociated to what seems to be K-D by incubation in a buffer solution, containing SDS and 2-mercaptoethanol with phenyl mercuric acetate, in dialysis experiments for 8 days at room temperature using Spectrapore 13 kDa tubing. Thus, native karatasin in B. plumieri fruit juice seem to be the result of association of 2 small molecular mass K-D subunits, linked together by disulfide bonds and electrostatic forces, in equilibrium with small amounts of free K-D molecules. The amino acid composition and partial sequence of karatasin up to the 14th position from the amino terminus have discrete analogies with papain and with stem bromelain.
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Cisteína Endopeptidasas , Endopeptidasas/aislamiento & purificación , Inhibidores de Proteasas/aislamiento & purificación , Secuencia de Aminoácidos , Cromatografía en Gel , Diálisis , Endopeptidasas/farmacología , Inmunodifusión , Cinética , Sustancias Macromoleculares , Datos de Secuencia Molecular , PlantasRESUMEN
El Síndrome Hipereosinofílico Esencial es una entidad nosológica rara caracterizada por la elevación del número de eosinófilos sanguíneos por encima de los 1.500 elementos por mm3 de manera persistente sin que se puedan demostrar ninguna de las causas conocidas de eosinofila y con una tendencia a infiltrar diferentes órganos, lo que le ortoga un carácter agresivo y un pronóstico sombrío. Los autores describen la evolución de un caso propio y analizan las características clínicas de este síndrome realizando una breve revisión de la lieratura
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Humanos , Masculino , Adolescente , Eosinofilia/diagnóstico , Cardiopatías , Eosinofilia/tratamiento farmacológico , PronósticoRESUMEN
To evaluate if chest physiotherapy is beneficial to premature infants with respiratory distress syndrome (RDS) during the first 24 hours of life, 20 infants were randomly assigned to two groups; 10 infants in Group I received routine chest physiotherapy and suction, and 10 infants in Group II received suction only. The birth weight, gestational age, postnatal age, Apgar scores, blood gases, acid-base status, and ventilatory requirements prior to study were comparable between the two groups. There were no significant differences between the groups in the amount of endotracheal secretions removed, the PO2/FIO2 ratio, blood gases, and pH during the study. The incidence of patent ductus arteriosus (PDA), bronchopulmonary dysplasia (BPD), Grade I and II intraventricular hemorrhage (IVH), and mortality was comparable. However, five of 10 Group I and zero of 10 Group II infants developed Grade III or IV IVH (P less than 0.05).