Efficacy and Safety of Tranexamic Acid for the Control of Surgical Bleeding in Patients Under Liposuction.

Liposuction remains one of the most frequently performed cosmetic surgical procedures and its popularity is increasing every year. However, since its inception, justified concerns regarding patient safety have placed limits on the volume of fat that can be aspirated, influenced by hemodynamic fluctuations and blood loss during liposuction. Tranexamic acid (TXA) is an antifibrinolytic agent that competitively inhibits the conversion of plasminogen to plasmin, thus preventing the binding and degradation of fibrin. Despite the existence of evidence of the effectiveness of TXA in orthopedic and cardiac surgeries, there is little evidence of its use in liposuction. The objective of this study was to evaluate the efficacy and safety of tranexamic acid in the control of surgical bleeding in patients undergoing liposuction, through a prospective, open, randomized and controlled clinical trial. Two groups of 25 participants each were formed to whom the application of TXA in a tumescent solution prior to liposuction or liposuction with the traditional technique was randomly assigned. The results showed a decrease in blood loss reflected by the differences in the final hematocrit values, as well as decrease in the same per aspirated volume (p = 0.003). No adverse events were found related with the TXA application and no blood transfusions were required in this group, in contrast to the control group where the need for blood transfusion was present in 20% of the intervened participants. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Detrimental conditions affecting Xestospongia muta across shallow and mesophotic coral reefs off the southwest coast of Puerto Rico.

Sponges are fundamental components of coral reef communities and, unfortunately, like other major benthic members, they too have been impacted by epizootic and panzootic events. We report on the prevalence of disease-like conditions affecting populations of the giant barrel sponge Xestospongia muta across shallow and mesophotic coral reefs off La Parguera Natural Reserve (LPNR) and Mona Island Marine Reserve (MIMR) in Puerto Rico. Four different conditions affecting X. muta were observed during our surveys, of which 3 have been previously reported: cyclic spotted bleaching (CSB; apparently non-lethal), Xestospongia-tissue wasting disease (X-TWD; apparently lethal), and sponge orange band disease (SOB; sparsely associated with X-TWD infected individuals). Additionally, we describe a fourth condition, Xestospongia-tissue hardening condition (X-THC), a previously unreported disease recently observed along the insular shelf margin off LPNR and MIMR. Within LPNR, a total of 764 specimens of X. muta were inspected and measured. Of these, 590 sponges (72.2%) had CSB, 25 (3.27%) had signs of X-TWD, 7 (0.92%) had SOB, and the remaining 142 (18.6%) were apparently healthy. Three colonies inhabiting upper mesophotic depths on the LPNR insular shelf showed signs of CSB and X-TWD. At MIMR, video-transect surveys revealed a total of 514 colonies, of which 40 (7.78%) had signs of CSB and/or XTWD, 14 (2.72%) were affected by X-THC, while the remaining 460 (89.5%) showed no external signs of disease and appeared healthy. The presence of 4 concomitant disease-like conditions in barrel sponges of Puerto Rico is alarming, and indicative of the deteriorating status of Caribbean coral reefs.

Investigation of the role of IL17A gene variants in Chagas disease.

Human host genetic factors have been suggested to be determinants of the prevalence and clinical forms of Chagas disease. In this regard, IL-17A is believed to control parasitemia and protect against heart disease. In this work, we assessed whether IL17A gene polymorphisms are related to infection and/or development of the cardiac form of Chagas disease by genotyping for five IL17A SNPs (rs4711998, rs8193036, rs3819024, rs2275913 and rs7747909) in 1171 individuals from a Colombian region endemic for Chagas disease, classified as seronegative (n=595), seropositive asymptomatic (n=175) and chronic Chagas cardiomyopathy (n=401). Our results showed that SNP rs8193036, which is located upstream of the coding region of the gene, was slightly associated with protection against T. cruzi infection (P=0.0170, P(FDR)=0.0851, odds ratio (OR)=0.80, confidence interval (CI)=0.66-0.96) and associated with protection against the development of cardiomyopathy (P=0.0065, P(FDR)=0.0324, OR=0.75, CI=0.60-0.92). This finding suggests that this IL17A polymorphism could be associated with Trypanosoma cruzi infection and the development of chronic cardiomyopathy due to differential expression of cytokine IL-17A.

Study of association of CTLA4 gene variants to non-anterior uveitis.

This study was undertaken to investigate the possible genetic association of functional CTLA4 polymorphisms with susceptibility to non-anterior uveitis. Four hundred and seventeen patients with endogenous non-anterior uveitis and 1517 healthy controls of Spanish Caucasian origin were genotyped for the CTLA4 polymorphisms rs733618, rs5742909 and rs231775, using predesigned TaqMan(©) allele discrimination assays. PLINK software was used for the statistical analyses. No significant associations between the CTLA4 polymorphisms and susceptibility to global non-anterior uveitis were found. It was also the case when the potential association of these genetic variants with the anatomical localization of the disease, such as intermediate, posterior or panuveitis, was assessed. Our results do not support a relevant role of these CTLA4 polymorphisms in the non-anterior uveitis genetic predisposition.

[Effects of high frequency chest wall oscillatory (HFCWO) therapy on gas exchange and ventilation in healthy participants]. / Efectos en población sana de la terapia con oscilación de alta frecuencia sobre la pared torácica (HFCWO) a nivel de la dinámica de gases pulmonares y de la mecánica respiratoria.

INTRODUCTION: Chest physiotherapy is an essential part of the treatment of respiratory diseases with increased respiratory secretion and ineffective cough. To date, there have been no studies on the effect of high frequency chest wall oscillatory (HFCWO) therapy on respiratory muscle strength, ventilation and gas exchange. The aim of this study was therefore to assess these three factors in healthy participants. METHODS: Respiratory muscle strength was measured before and immediately after HFCWO therapy in 25 healthy participants. During the treatment, we continuously measured ventilation parameters, gas exchange, oxygen saturation and heart rate. All participants underwent HFCWO sessions twice (with 24hours difference) with the same procedure. Symptoms during the session and discomfort were measured with the visual analog scale (VAS). RESULTS: HFCWO therapy produced a change in breathing pattern with increased ventilation associated with altered gas exchange. Heart rate also increased, with no changes in oxygenation. There was no effect, either beneficial or deleterious, on the strength of respiratory muscles. Up to 20% of participants reported substantial discomfort (VAS≥5/10) during the session. CONCLUSIONS: This study shows that, during the application of HFCWO therapy in healthy participants, ventilation and heart rate increased. However, there were undesirable effects on gas exchange with a high degree of intolerance among volunteers, with no effects on respiratory muscle strength.

Epidemiologic analysis of the laboratory-confirmed cases of influenza A(H1N1)v in Colombia.

From 2 May to 16 July 2009, a total of 183 laboratory-confirmed cases of influenza A(H1N1)v were reported in Colombia, 117 (63.9%) of these had travelled outside the country. Hospital admission was necessary in 26 (14.21%) cases and seven patients died (fatality-case ratio: 3.8%). The infection affected younger age-groups and the symptoms most frequently reported were cough, fever and sore throat. Our findings are consistent with recent reports from other countries.

Nutrient composition and digestibility of energy and nutrients in wheat middlings and red dog fed to growing pigs.

This experiment was designed to determine nutrient composition and apparent total tract digestibility (ATTD) of GE, DM, OM, and NDF and the concentration of DE and ME in 10 sources of wheat middlings and in 1 source of red dog that were obtained from different flour mills in the United States. Twelve growing pigs (initial BW: 31.0 ± 1.0 kg) were randomly allotted to a 12 × 8 Youden square design with 12 dietary treatments and eight 14 d periods. Pigs were individually housed in metabolism crates for total collection of feces and urine. A basal diet based on corn and soybean meal, and 11 diets containing corn, soybean meal, and 39.4% of one of the 10 sources of wheat middlings or of red dog were formulated. The ATTD of GE, DM, OM, and NDF in all diets was calculated using the direct procedure, and the ATTD of GE, DM, OM, and NDF in each source of wheat middlings or red dog was calculated by difference. Values for DE and ME were calculated as well. The average concentration of CP was 17.67% in wheat midlings and 17.0% in red dog, and the concentration of acid hydrolyzed ether extract (AEE) and total dietary fiber (TDF) was 2.44 and 13.90% in red dog, but 4.07 and 36.45% in wheat middlings. Red dog also contained more starch (42.98%) than wheat middlings (20.28%). Red dog had greater bulk density (498.5 g/L) and smaller particle size (146 µm) compared with wheat middlings (315.1 g/L and 783 µm). The average ATTD of GE, DM, OM, and NDF in wheat middlings (67.2%, 71.2%, 72.9%, and 53.0%, respectively) was less (P < 0.05) than in red dog (79.35%, 82.9%, 86.6%, and 58.7%, respectively). The average concentrations of DE and ME in wheat middlings were 2,990 and 2,893 kcal/kg DM, and these values were less (P < 0.05) than the DE and ME in red dog (3,408 and 3,292 kcal/kg DM). In conclusion, wheat middlings contains more fiber and less starch than red dog and the ATTD of GE and nutrients is greater in red dog than in wheat middlings. As a consequence, concentrations of DE and ME are greater in red dog than in wheat middlings.

Tiroides Ectópica Lingual: caso Clínico / Lingual Ectopic Thyroid: a clinical case

La tiroides ectópica lingual es una patología muy poco frecuente, producida por la detención en el descenso normal de la glándula durante el desarrollo embrio-nario. La localización lingual de tejido tiroideo es la más común entre las tiroides ectópicas o aberrantes. Esta enfermedad puede ser asintomática pero, cuan-do los signos y síntomas están presentes, guardan estrecha correlación con la localización de la lesión y son proporcionales a su tamaño. El diagnóstico debe realizarse clínicamente y con el complemento de es-tudios por imágenes y endocrinológicos. En los aná-lisis de laboratorio se debe incluir dosaje de las hor-monas TSH, T4 libre y T3, vinculadas con la función tiroidea. Las biopsias deben evitarse ya que causan desequilibrio en la producción hormonal de la glándu-la y peligro de profusas hemorragias. En este artículo se desarrolla una descripción de las generalidades de la tiroides ectópica lingual, y se presenta un caso clínico de un niño con un tumor lingual, que fue deri-vado por su médica pediatra a cirugía para realizar una biopsia. Asimismo, se comenta la importancia que tiene para el odontólogo conocer esta patología a fin de poder evitar sus posibles complicaciones (AU)

Lingual thyroid is a rare disorder produced by a failure in the descent of thyroid gland to its normal position during embryological development. Lingual localization of thyroid tissue is the most common among the ectopic or aberrant thyroids. This condition can be asymptomatic, although when symptoms take place, they are connected to the lesion location and depend on its size. Diagnosis should be made clinically and complemented with imaging and endocrine studies. Laboratory analysis must include dosage of TSH, free T4 and T3, thyroid function-linked hormones. Due to the possible imbalance in the gland hormone production and the risk of massive bleeding, biopsy should be avoided. In this article, a brief description of lingual ectopic thyroid generalities is developed and a clinical case of a 7-years old child is provided. Additionally, dentistry importance of knowing this condition is commented, in order to prevent its possible complications (AU)

Molusco contagioso: actualización y casos clínicos / Molluscum contagiosum: an update and clinical cases

El molusco contagioso es una patología viral benigna muy frecuente, exclusiva del ser humano, y causada por un virus no clasificado del grupo de los Poxvirus. Las manifestaciones clínicas de la enfermedad inclu-yen lesiones en la piel, que pueden variar desde una pequeña pápula a un nódulo de mayor tamaño, pre-sentándose en forma solitaria o múltiple, dependien-do del estado inmunitario del paciente y del tiempo de evolución del proceso morboso. El estudio histo-patológico es importante para el diagnóstico, aunque en numerosas ocasiones éste se define clínicamen-te. Además del patrón histológico tradicional, y más frecuente, que exhibe hiperplasia e hipertrofia de la epidermis, se han descripto variantes poco usuales, cuyas características dependen, entre otros factores, de la sobreinfección y de la respuesta inmunitaria del paciente. En este trabajo se describen los rasgos ge-nerales del molusco contagioso y luego se presentan varios casos clínicos, uno de los cuales exhibe ma-nifestación inusual en la semimucosa del labio. Por último, se realizan comentarios referentes a la im-portancia que tiene para el odontólogo conocer esta patología y estar capacitado para detectarla, de modo de evitar sus complicaciones y su diseminación (AU)

Molluscum contagiosum is a very common benign viral pathologythat affects exclusively humans and is caused by an unclassified virus of the Poxvirus family. Clinical manifestations include skin lesions such as papule or nodule, which may range from a small papule to a larger nodule, presenting either solitary or multiple, depending on the immune status of the patient and the time of evolution of the morbid process. Histopathological study is important for the diagnosis, although in numerous occasions it is defined clinically. Classical and more frequent histology pattern exhibits hyperplasia and hypertrophy of the epidermis; however, distinct characteristics may occur depending on factors like superinfection and immune response of patients. This article describes general aspects of molluscum contagiosum and exposes several clinical cases, one of which exhibits an unusual manifestation in the semimucosa of the lip. Finally, comments are made regarding the importance for dentists to learn about the existence of this pathology and be able to recognize it in order to avoid its complications and spread (AU)

Analysis of association of FOXO3 gene with Trypanosoma cruzi infection and chronic Chagasic cardiomyopathy.

FOXO3, a member of the Forkhead family of proteins, plays a role in controlling immune response. FOXO3 gene variant rs12212067 has been associated to differential severity of infectious diseases like malaria. In this study, we assessed whether this FOXO3 gene polymorphism is related to susceptibility to infection by Trypanosoma cruzi and/or chronic Chagasic cardiomyopathy. A total of 1171 individuals from a Colombian region endemic for Chagas disease, classified as seronegative (n = 595), seropositive asymptomatic (n = 175) and chronic Chagasic cardiomyopathy (n = 401) were genotyped for the FOXO3 rs12212067 using TaqMan allelic discrimination. Our results showed no statistically significantly differences between allelic and genotypic frequencies of rs12212067 in seronegative individuals compared with seropositive individuals. Similarly, we observed no evidence of association when asymptomatic individuals were compared with chronic Chagasic cardiomyopathy patients. Our data suggest that the FOXO3 genetic variant rs12212067 do not play an important role in Chagas disease.

Characterization of RIPK3-mediated phosphorylation of the activation loop of MLKL during necroptosis.

Mixed lineage kinase domain-like pseudokinase (MLKL) mediates necroptosis by translocating to the plasma membrane and inducing its rupture. The activation of MLKL occurs in a multimolecular complex (the 'necrosome'), which is comprised of MLKL, receptor-interacting serine/threonine kinase (RIPK)-3 (RIPK3) and, in some cases, RIPK1. Within this complex, RIPK3 phosphorylates the activation loop of MLKL, promoting conformational changes and allowing the formation of MLKL oligomers, which migrate to the plasma membrane. Previous studies suggested that RIPK3 could phosphorylate the murine MLKL activation loop at Ser345, Ser347 and Thr349. Moreover, substitution of the Ser345 for an aspartic acid creates a constitutively active MLKL, independent of RIPK3 function. Here we examine the role of each of these residues and found that the phosphorylation of Ser345 is critical for RIPK3-mediated necroptosis, Ser347 has a minor accessory role and Thr349 seems to be irrelevant. We generated a specific monoclonal antibody to detect phospho-Ser345 in murine cells. Using this antibody, a series of MLKL mutants and a novel RIPK3 inhibitor, we demonstrate that the phosphorylation of Ser345 is not required for the interaction between RIPK3 and MLKL in the necrosome, but is essential for MLKL translocation, accumulation in the plasma membrane, and consequent necroptosis.

Point mutations induced by 1,2-epoxy-3-butene N1 deoxyinosine adducts.

The National Toxicology Program has recently classified 1,3-butadiene (BD) as a human carcinogen. BD is metabolized to the intermediates 1,2-epoxy-3-butene (EB), 1,2:3,4-diepoxybutane (DEB), and 1,2-dihydroxy-3,4-epoxybutane. All three metabolites have been implicated in producing specific types of DNA damage and as genotoxic agents in mice, rat, and human cells. This study has focused on EB-induced N1 deoxyinosine lesions that are formed by deamination of deoxyadenosine following reaction of the epoxide at the N(1) position. The R and S stereoisomers of this lesion were incorporated site-specifically within the context of an 11-mer oligodeoxynucleotide, incorporated into M13mp7L2 single-stranded DNA, and transfected into E. coli. Both stereoisomers modestly reduced plaque-forming ability, indicating that neither lesion presents a base modification that cannot be bypassed. The resulting plaques were assessed for point mutations using differential hybridization and DNA sequence analyses. The overall mutagenic spectrum revealed that the N1 adducts were highly mutagenic (approximately 90% per replication cycle), causing a predominance of A --> G transitions.

Risk taking in young Hispanic children.

INTRODUCTION: The purpose of this study was to examine risk taking and daring behavior in preschool-age Hispanic children. The study sought to describe aspects of children's personality, behavior, and culture that may inform us of their propensity to take risks that lead to injuries. METHOD: Forty-five children (4 to 5 years of age) and their parents, drawn from a primary care practice, participated in the study. Instruments completed by the families included the Acculturation Scale. Child Shyness Report, Injury Report, and the Injury Behavior Checklist. Children were interviewed about risk taking and daring behavior using a projective technique (Child Sensation Seeking Profile). RESULTS: These children, irrespective of gender and socioeconomic status, reported similar rates of daring and risk taking behavior. Injury behaviors were not predicted by personality profiles of shyness or the child's self-report of risk taking and daring behavior. Actual injuries increased with higher levels of acculturation, but children's injury behaviors reported by parents were low in comparison with other populations. Discrepancies were observed between parental perception and report of children's injury behavior and children's expressed preferences in some domains of daring and risky behavior. DISCUSSION: Primary care providers must consider ethnic differences in rates and causes of injury when developing interventions and injury prevention programs. PNPs can use these findings to better meet the health promotion goals of Healthy Children 2000.

[Permanent AV junction (Coumel type) reciprocal tachycardia]. / Taquicardia reciprocante permanente de la unión AV (tipo Coumel).

UNLABELLED: Permanent auriculo-ventricular junctional reciprocating tachycardia is a special form of tachycardia usually incessant, secondary to an slow retrograde conduction pathway. OBJECTIVE: To establish the clinical, electrophysiological characteristics and therapy results in patients with this diagnosis. METHOD: Descriptive study. RESULTS: Nine patients with average age 28.1 +/- 19.2 years, six women. Seven patients presented with dyspnea or palpitations. The left ventricular ejection fraction before treatment was 43.3 +/- 19.5%. The electrocardiographic findings were: heart rate of 139.2 +/- 16.7 bpm, QRS 78.9 +/- 16.2 ms and RP'/P'R relation of 1.8 +/- 0.5. The location of the accessory pathways was: right postero-septal in seven (77.7%), left lateral in one (11.15%) and left postero-lateral in one (11.15%). Radiofrequency ablation was performed in eight patients with an 87.5% success rate, two cases were taken to surgery with successful treatment, one of them after percutaneous ablation failure. Those with systolic left ventricular dysfunction recover their function in the follow-up. Any case has recurred. CONCLUSIONS: In our center, permanent auriculo-ventricular junctional reciprocating tachycardia is an infrequent arrhythmia, predominantly in women and associated with reversible left ventricular dysfunction. Right postero-septal was the most frequent localization of the pathway. Radiofrequency ablation was performed successfully in 87.5% of cases.

Effects and barriers to deployment of telehealth wellness programs for chronic patients across 3 European countries.

BACKGROUND: Benefits of cardiopulmonary rehabilitation (CPR) in patients with chronic obstructive pulmonary disease (COPD) are well established, but long-term sustainability of training-induced effects and its translation into healthy lifestyles are unsolved issues. It is hypothesized that Integrated Care Services supported by Information and Communication Technologies (ICS-ICT) can overcome such limitations. In the current study, we explored 3 ICS-ICT deployment experiences conducted in Barcelona, Trondheim and Athens. METHODS: In the 3 sites, a total of 154 patients completed an 8-week supervised CPR program. Thereafter, they were allocated either to an ICS-ICT group or to usual care (CPR + UC) during a follow-up period of at least 12 months with assessment of 6-min walking test (6MWT) as main outcome variable at all time points in the 3 sites. Because real deployment was prioritized, the interventions were adapted to site heterogeneities. RESULTS: In the ICS-ICT group from Barcelona (n = 77), the use of the personal health folder (PHF) was the cornerstone technological tool to empower COPD patients for self-management showing high applicability and user-acceptance. Long-term sustainability of training-induced increase in exercise capacity was observed in ICS-ICT compared to the control group (p = 0.01). Likewise, ICS-ICT enhanced the activities domain of the SGRQ (p < 0.01) and daily physical activity (p = 0.03), not seen in controls. No effects of ICS-ICT were observed in Trondheim (n = 37), nor in Athens (n = 40), due to technological and/or organizational limitations. CONCLUSIONS: The study results suggest the potential of the ICS-ICT Barcelona's approach to enhance COPD management. Moreover, it allowed identification of the factors limiting transferability to the other sites. The research prompts the need for large multicenter trials specifically designed to assess effectiveness, efficiencies and transferability of this type of intervention.

Nutritional status among hospitalized children with mixed diagnoses at a referral teaching hospital in Manizales, Colombia.

INTRODUCTION: Despite advances in the treatment of malnutrition in pediatric hospitals, this remains a problem that must be recognized and to call the attention of academia and health authorities to be handled in time. OBJECTIVE: To evaluate the nutritional status of hospitalized children at a referral teaching hospital and to describe the current prevalence of malnutrition. METHODS: The study was conducted during the months of February, March and April 2010 at the University Hospital Rafael Henao Toro Colombian Red Cross in Manizales, Colombia, South America. We evaluated all patients admitted to a day of each month by calculating the Z score of the, weight for age, height or length for age, body mass index, mid-arm circumference, triceps and subscapular folds for children under 5 years and height for age and body mass index for school children and adolescents. RESULTS: A total of 174 children (age 1-216 mo) were evaluated during the 3-days survey. There were 52.8% children less than 60 months old, 17.2% between 61 and 120 months and 29.9% over 121 months. There were 44.3% females and 55.7% males. Children from the urban residence were 83.3% and 16.6% were rural. The overall prevalence of underweight was 27%, stunting 22.4%, wasting 16.6% and overweight and obesity 6.3%. Males less than five years old were more affected than older children. Rural children were more affected than urban children. The prevalence of overweight children was greater in children 61-120 months than other ages. CONCLUSION: Given the observed levels of malnutrition, it takes up a system for early identification of children hospitalized with nutritional risk in order to provide adequate and timely support and prevent hospital-acquired malnutrition. This requires the use of previously validated pediatric protocols.

A systematic review of fast food access studies.

The frequent consumption of energy-dense fast food is associated with increased body mass index. This systematic review aims to examine the methodology and current evidence on fast food access and its associations with outcomes. Six databases were searched using terms relating to fast food. Only peer-reviewed studies published in English during a 10-year period, with data collection and analysis regarding fast food access were included. Forty articles met the aforementioned criteria. Nearly half of the studies (n = 16) used their own set of features to define fast food. Studies predominantly examined the relationship between fast food access and socioeconomic factors (n = 21) and 76% indicated fast food restaurants were more prevalent in low-income areas compared with middle- to higher-income areas. Ten of 12 studies found fast food restaurants were more prevalent in areas with higher concentrations of ethnic minority groups in comparison with Caucasians. Six adult studies found higher body mass index was associated with living in areas with increased exposure to fast food; four studies, however, did not find associations. Further work is needed to understand if and how fast food access impacts dietary intake and health outcomes; and if fast food access has disparate socioeconomic, race/ethnicity and age associations.

Efectos en población sana de la terapia con oscilación de alta frecuencia sobre la pared torácica (HFCWO) a nivel de la dinámica de gases pulmonares y de la mecánica respiratoria / Effects of high frequency chest wall oscillatory (HFCWO) therapy on gas exchange and ventilation in healthy participants

Introducción La fisioterapia respiratoria es parte imprescindible del tratamiento de las patologías hipersecretoras o con compromiso de la capacidad tusígena. Hasta el momento se desconoce el efecto del dispositivo de terapia de oscilación de alta frecuencia en la pared torácica (HFCWO) sobre la fuerza de los músculos respiratorios y los efectos sobre la mecánica respiratoria y la dinámica de los gases respiratorios. Por ello, el objetivo de este estudio fue describir estos tres aspectos en sujetos sanos. Métodos Se midió la fuerza de los músculos respiratorios en 25 sujetos antes e inmediatamente después de terapia con HFCWO. Durante la sesión, se midieron continuamente los parámetros de ventilación, la dinámica de los gases respiratorios y la frecuencia cardiaca. Se llevaron a cabo dos sesiones idénticas por sujeto, separadas 24h. Se registraron los síntomas durante la sesión y las molestias experimentadas mediante escala analógica visual (EVA). Resultados La terapia con HFCWO produce un incremento de la ventilación asociado con una alteración de la dinámica de los gases respiratorios. También se aumenta la frecuencia cardiaca, sin modificación de la oxigenación tisular. No se observaron efectos sobre la fuerza de los músculos respiratorios. Hasta un 20% de los participantes indicó molestias importantes (EVA≥5/10) durante la sesión. Conclusiones Durante la aplicación de HFCWO en sujetos sanos se produce incremento en la ventilación y ritmo cardiaco. Sin embargo, aparecen efectos indeseables sobre la dinámica de los gases respiratorios y un grado elevado de intolerancia por parte de los voluntarios y no hay efectos sobre la fuerza de los músculos respiratorios (AU)

Introduction Chest physiotherapy is an essential part of the treatment of respiratory diseases with increased respiratory secretion and ineffective cough. To date, there have been no studies on the effect of high frequency chest wall oscillatory (HFCWO) therapy on respiratory muscle strength, ventilation and gas exchange. The aim of this study was therefore to assess these three factors in healthy participants. Methods Respiratory muscle strength was measured before and immediately after HFCWO therapy in 25 healthy participants. During the treatment, we continuously measured ventilation parameters, gas exchange, oxygen saturation and heart rate. All participants underwent HFCWO sessions twice (with 24hours difference) with the same procedure. Symptoms during the session and discomfort were measured with the visual analog scale (VAS). Results HFCWO therapy produced a change in breathing pattern with increased ventilation associated with altered gas exchange. Heart rate also increased, with no changes in oxygenation. There was no effect, either beneficial or deleterious, on the strength of respiratory muscles. Up to 20% of participants reported substantial discomfort (VAS≥5/10) during the session. Conclusions This study shows that, during the application of HFCWO therapy in healthy participants, ventilation and heart rate increased. However, there were undesirable effects on gas exchange with a high degree of intolerance among volunteers, with no effects on respiratory muscle strength (AU)