ABSTRACT
La Oscilometría de Impulso (IOS) es una técnica no invasiva que evalúa las propiedades mecánicas de todo el sistema respiratorio durante la respiración tranquila. Mide la impedancia total del sistema respiratorio, evaluando la resistencia total de la vía aérea, la resistencia de la vía aérea alta y las propiedades elásticas del pulmón. Detecta el compromiso de la vía aérea periférica en forma muy precoz, antes que la espirometría, y es útil en niños pequeños porque no requiere maniobras de espiración forzada. Permite evaluar la respuesta broncodilatadora y broncoconstrictora a través de pruebas de provocación bronquial para el diagnóstico de hiperreactividad bronquial. La IOS tiene un rol en la evaluación temprana y seguimiento de la función pulmonar en niños con enfermedades respiratorias crónicas, principalmente asma bronquial, displasia broncopulmonar y fibrosis quística. Este artículo revisa los aspectos fisiológicos, técnicos y aplicación clínica de la IOS, considerando las últimas recomendaciones para la estandarización del examen y las limitaciones que dificultan su interpretación .
Impulse Oscillometry (IOS) is a non-invasive technique that assesses the mechanical properties of the entire respiratory system during quiet breathing. It measures the total impedance of the respiratory system by evaluating total airway resistance, upper airway resistance, and elastic properties of the lung. It detects peripheral airway compromise very early, before spirometry, and is useful in young children because it does not require forced expiration maneuvers. It allows evaluating the bronchodilator and bronchoconstrictor response through bronchial provocation tests for the diagnosis of bronchial hyperreactivity. The IOS has a role in the early evaluation and monitoring of lung function in children with chronic respiratory diseases, mainly bronchial asthma, bronchopulmonary dysplasia and cystic fibrosis. This article reviews the physiological, technical, and clinical application aspects, considering the latest recommendations for the standardization of the test and the limitations that hinder its interpretation.
Subject(s)
Humans , Child , Oscillometry/methods , Respiratory Function Tests/methods , Respiratory Tract Diseases/physiopathology , Respiratory Physiological Phenomena , Respiratory Tract Diseases/diagnosis , Airway Resistance/physiologyABSTRACT
BACKGROUND: Cryolipolysis is a non-invasive method capable of reducing the thickness of the fat layer. OBJECTIVE: To evaluate the effects of cryolipolysis with the use of plate applicators in the treatment of abdominal fat in women. MATERIALS AND METHODS: The sample was composed of 15 participants, who were evaluated before and at the end of the intervention. Three applications of cryolipolysis were performed in the infraumbilical portion of the abdominal region. The volunteers were divided into three groups G-1 (temperature of -2°C), G-2 (temperature of -3°C) and G3 (temperature of -4°C). RESULTS: There was a reduction in plicometry measurements in groups G2 and G3, in the comparison between the initial and final moments (p <0.05), and a reduction in perimetry and ultrasound (p < 0.05) in all groups. It was found that the G3 group was subject to higher risk of first degree burns and redness when compared to the other groups. CONCLUSION: It is suggested that plate cryolipolysis is a possibly effective resource for reducing adiposity, as shown in the evaluation of perimetry, plicometry, and ultrasound results, and in the photographic analysis.
Subject(s)
Abdominal Fat , Adiposity , Cryotherapy , Lipolysis , Female , Humans , Overweight/therapy , Treatment Outcome , UltrasonographyABSTRACT
BACKGROUND: Cryolipolysis with plates is a method of applying cooling without a vacuum system, which can be used in regions with less chance of forming a "crease." OBJECTIVE: To investigate the effects of cryolipolysis using a plate-shaped applicator (Crioplac) in the treatment of fat. MATERIALS AND METHODS: This is an experimental study in which women aged 25 to 45 years with adiposity located in the abdomen participated. Two applications of 75 min were made, using 04 plates in the abdomen regions, with -4 degree C being programmed as a temperature parameter. Anthropometric and ultrasound assessments were performed, and a satisfaction questionnaire on the validated treatment was conducted. The reassessments were performed 30 and 60 days after the first intervention. RESULTS: A reduction in adiposity was observed in the measurements of perimetry, plicometry and abdominal ultrasound (p<0.05). It was found that about 62.5% of the volunteers reported an improvement in water retention, about 62.5% reported the presence of loose clothing, and 31.3% reported satisfaction with the results obtained. It was observed that 18.5% of the volunteers reported that the treatment was excellent. CONCLUSION: The Crioplace method proved to be effective in reducing adiposity, with a high clinical satisfaction with the reduction in body measurements.
Subject(s)
Adiposity , Lipectomy , Adult , Cryopreservation , Cryotherapy/methods , Female , Humans , Lipectomy/methods , Middle Aged , Treatment OutcomeABSTRACT
Resumen La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.
Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.
ABSTRACT
BACKGROUND: Plate cryolipolysis is a method of applying cooling without a vacuum system, which can be used in regions with less possibility of skin suction or fibrosis. OBJECTIVE: To investigate the effects of cryolipolysis with the use of plate-shaped applicators (CrioPlaceTM) for localized fat treatment. METHODS: The sample consisted of men aged 20 to 45 years with complaints of localized adiposity in the abdominal region and flanks. Two plates were positioned in the flank and abdomen regions, respectively. They received two 60-min applications in the temperature of -2°C. The anthropometric, thermographic and ultrasound assessments were performed, and a satisfaction questionnaire was applied after treatment. The re-evaluations occurred 30 and 60 days after the first intervention. RESULT: A reduction in adiposity was observed in flank region plicometry (p<0.05) and abdominal and flank ultrasound (p < 0.05). About 66.7% of the volunteers reported less water retention, about 41.7% reported that their clothes were looser, and 100% reported overall satisfaction. Fifty percent rated the treatment as excellent and 58.3% felt improvement in overall aesthetics. CONCLUSION: The CrioPlaceTM method was effective in reducing localized adiposity, with clinical satisfaction of measurement reduction, both in plicometry and ultrasound analyses, with highlights to the flank region results.
Subject(s)
Adiposity , Cryotherapy/instrumentation , Lipolysis , Adult , Cryotherapy/methods , Humans , Male , Middle Aged , Treatment Outcome , Young AdultABSTRACT
Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.
La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.
Subject(s)
Humans , Child , Adult , Delivery of Health Care, Integrated , Cystic Fibrosis/diagnosis , Cystic Fibrosis/therapy , Chile , Nutritional Status , Cystic Fibrosis/rehabilitation , Consensus , Health ResourcesABSTRACT
Impulse oscillometry (IOS) is an emerging tool in the study of pulmonary function in respiratory diseases. In this review we compare its usefulness with that of forced spirometry in children. Although these techniques measure different mechanical properties of the respiratory system, -the first, resistance, and the second, flow- they are, undoubtedly, complementary tests.. This review includes a brief description of some comparative studies since 1973, year of the first publication about children; then, with the advent of technology, its application in the mid-80s and 90s made it possible to include reference values in order to establish functional diagnoses. IOS measures airway, pulmonary and thoracic resistance, which is a primary function of the mechanics of ventilation, whereas spirometry measures the flow, which is a secondary function. This principle allows us to understand why IOS indices are more sensitive than those of spirometry
La Oscilometría de Impulso (IOS) es una herramienta emergente en el estudio de la función pulmonar y en esta revisión se compara su utilidad con la espirometría forzada en niños. Aunque ambas técnicas miden diferentes propiedades mecánicas del sistema respiratorio, resistencias la primera y flujos la segunda, tienen un carácter complementario incuestionable. Esta revisión describe brevemente algunos trabajos comparativos a partir de 1973, fecha de la primera publicación en niños y luego con el advenimiento tecnológico, su aplicación a mediados de los 80 y 90 permite incluir valores de referencia para poder establecer diagnósticos funcionales. La IOS se caracteriza por medir resistencia de la vía aérea y toracopulmonar y que desde el punto de vista de la mecánica respiratoria ésta es una función primaria versus los flujos, medidos por espirometría, que son una función secundaria, este principio es el que permite entender porque sus índices son más sensibles que los de la espirometría
Subject(s)
Humans , Child , Oscillometry/methods , Respiratory Tract Diseases/diagnosis , Spirometry/methods , Respiratory Function Tests/methods , Respiratory Tract Diseases/physiopathology , Vital Capacity , Airway Resistance , Forced Expiratory VolumeABSTRACT
ããBACKGROUND: The cryolipolysis is on the spotlight as a non-invasive method which reduces fat layer thickness with no damage to surrounding tissues. OBJECTIVE: This study aims to verify the effectiveness of cryolipolysis in the reduction of localized adiposity in women. MATERIALS AND METHODS: This is an experimental study, without a control group, with pre- and post- treatment evaluation through a single application on the lower abdominal area. SETTING: Research conducted in the period from July to December 2015 at the University Potiguar. PARTICIPANTS: A group of 15 women, age between 25-50 years. The cryolipolysis was used in the following parameters: temperature (-7 degree C); suction power (30 kPa), and application time (60 min). MEASUREMENTS: After the cryolipolysis was performed, a follow-up of 2 months was conducted to verify the changes related to weight, body circumference, fat layer thickness, which were evaluated by ultrasonography and photogrammetry. RESULTS: From data analysis, the reductions observed on perimeter (p=0.03) and ultrasonography (p=0.03) showed significant results, considering p <0.05. As of body weight results (p=0.57), the average value varied during the study; however, at the end of the research, no significant weight increase or decrease was reported, as it is known that this method does not interfere with this variable. Additionally, quantitative data were satisfactory. The photogrammetry analysis showed that cryolipolysis positively affected subjects' results. CONCLUSION: A change in body contouring, especially in individuals with lower body mass, reinforces the idea that the parameters must be suitable for individual needs.
Subject(s)
Abdominal Fat/physiology , Adiposity/physiology , Cryotherapy/methods , Lipectomy/methods , Abdominal Fat/diagnostic imaging , Adult , Body Mass Index , Body Weight , Female , Fibrosis , Follow-Up Studies , Humans , Inflammation/pathology , Middle Aged , Photogrammetry , Treatment Outcome , UltrasonographyABSTRACT
Determinou-se o efeito da contagem de células somáticas do leite sobre o rendimento e a composição físico-química do queijo muçarela. Foram selecionadas vacas com contagem de células somáticas (CCS) <200.000 células/mL; CCS >200.000 a <400.000 células/mL; CCS >400.000 células/mL a <750.000 células/mL e CCS >750.000 células/mL e que não receberam tratamento com antimicrobianos nos dias que antecederam a obtenção do leite utilizado no processamento. Os queijos foram avaliados por meio das análises de pH, acidez, umidade, proteína, gordura, extrato seco total e desengordurado. Os queijos elaborados do leite com alta CCS >750.000 cél./mL apresentaram menor teor de proteína, maior umidade e menor rendimento industrial. Conclui-se que a elevação da CCS cursou com alterações na qualidade do queijo muçarela, o que reflete em sua composição nutricional e microbiológica, pois ocorre um incremento na atividade de água, fator intrínseco indispensável para o crescimento microbiano e consequente redução da vida de prateleira...
The effect of somatic cell count (SCC) on the yield and composition of mozzarella cheese was evaluated. Cows with different levels of SCC in their milk (<200.000 cells/mL; >200.000 to <400.000 cells/mL; >400.000 cells/mL to <750.000 cells/mL and >750.000 cells/mL) were selected. The animals had no antimicrobial treatment prior to or on milk sampling day. The mozzarella cheese quality was evaluated analyzing pH, acidity, moisture and protein content, fat, total solids and nonfat solids. The trial was replicated four times and the experimental design was analyzed through randomized blocks. The mozzarella cheese from milk with high SCC (>750.000 cells/mL) had lower protein content, higher moisture content and lower industrial yield, compared to cheese from milk with lower levels of SCC. High numbers of SCC impaired mozzarella cheese quality, which was reflected in its nutritional and microbiological composition. We observed an increase in water activity, an intrinsic and essential factor for microbial growth...
Subject(s)
Animals , Female , Cattle , Cattle , Food Quality , Mastitis , Cheese/analysis , Food AnalysisABSTRACT
Determinou-se o efeito da contagem de células somáticas do leite sobre o rendimento e a composição físico-química do queijo muçarela. Foram selecionadas vacas com contagem de células somáticas (CCS) <200.000 células/mL; CCS >200.000 a <400.000 células/mL; CCS >400.000 células/mL a <750.000 células/mL e CCS >750.000 células/mL e que não receberam tratamento com antimicrobianos nos dias que antecederam a obtenção do leite utilizado no processamento. Os queijos foram avaliados por meio das análises de pH, acidez, umidade, proteína, gordura, extrato seco total e desengordurado. Os queijos elaborados do leite com alta CCS >750.000 cél./mL apresentaram menor teor de proteína, maior umidade e menor rendimento industrial. Conclui-se que a elevação da CCS cursou com alterações na qualidade do queijo muçarela, o que reflete em sua composição nutricional e microbiológica, pois ocorre um incremento na atividade de água, fator intrínseco indispensável para o crescimento microbiano e consequente redução da vida de prateleira.(AU)
The effect of somatic cell count (SCC) on the yield and composition of mozzarella cheese was evaluated. Cows with different levels of SCC in their milk (<200.000 cells/mL; >200.000 to <400.000 cells/mL; >400.000 cells/mL to <750.000 cells/mL and >750.000 cells/mL) were selected. The animals had no antimicrobial treatment prior to or on milk sampling day. The mozzarella cheese quality was evaluated analyzing pH, acidity, moisture and protein content, fat, total solids and nonfat solids. The trial was replicated four times and the experimental design was analyzed through randomized blocks. The mozzarella cheese from milk with high SCC (>750.000 cells/mL) had lower protein content, higher moisture content and lower industrial yield, compared to cheese from milk with lower levels of SCC. High numbers of SCC impaired mozzarella cheese quality, which was reflected in its nutritional and microbiological composition. We observed an increase in water activity, an intrinsic and essential factor for microbial growth.(AU)
Subject(s)
Animals , Female , Cattle , Cheese/analysis , Cattle/physiopathology , Mastitis , Food Quality , Food AnalysisABSTRACT
Background: FEVí is not easily obtained in preschool children. Objective: To evaluate the utility ofFEV0í5 vs FEVí in the spirometry of asthmatic preschool children. Material and Methods: spirometry was performed to 39 asthmatic children and 77 controls. Each child performed maneuvers during 15 minutes without nose clip and if required a computer-animation program was used. An acceptable curve was defined as a register with evident peak expiratory flow (PEF) without sudden cessation of air flow at more than 20 percent> of the previously measured PEF. Results: 94 percent> and 90 percent of healthy and asthmatics performed at least two acceptable curves. Median age in healthy children was 4.7 years-old (2.5 to 5.9) and 3.8 years-old (2.3 to 5.2) in asthmatics. FEVí was obtained in 51.3 percent of controls and in 43 percent of asthmatics. In contrast FEV0.S was obtained in all the children. A significant bronchodilator response was observed in FEV0.S in 49 percent> of asthmatics. Conclusions: FEVo.5 was more useful than FEVí in interpreting spirometry in 3 to 5 years old children with asthma.
Introducción: El VEFí no siempre puede obtenerse en preescolares. Objetivo: Evaluar la utilidad del VEF0íí versus VEFí en la espirometría de preescolares asmáticos. Material y Método: Se realizó una espirometría a 39 niños asmáticos y 77 controles sanos. Cada niño efectuó todas las curvas posibles en 15 minutos, sin clip nasal y con programas de incentivo según necesidad. Se consideraron aceptables curvas con flujo espiratorio máximo (PEF) evidente y sin finalización brusca en flujos > al 20 por ciento del PEF. Resultados: lograron 2 curvas aceptables 94 por ciento de los niños sanos y 90 por ciento de los asmáticos. la edad promedio fue 4,7 años (2,5-5,9) en sanos y 3,8 años (2,3-5,2) en asmáticos. Se obtuvo VEFí en el 51,3 por ciento de los sanos y en 43 por ciento de los asmáticos. Todos lograron VEF0íí. Se observó respuesta broncodilatadora significativa en VEF0íí en el 49 por ciento> de los asmáticos. Conclusiones: El VEF0íí tiene mayor utilidad que el VEFí en la interpretación de la espirometría en niños de 3 a 5 años con asma.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Asthma/physiopathology , Spirometry/methods , Forced Expiratory Volume , Age and Sex Distribution , Case-Control Studies , Vital Capacity/physiology , Chile/epidemiology , Spirometry/instrumentation , Reproducibility of Results , Weight by HeightABSTRACT
Forty-eight primiparous and pregnant Holstein cows at 202 (+/-59) days in milk and average daily milk production (DMP) of 22 (+/-5.3) kg at the beginning of the trial were used to study the possibility of identifying animals that are more responsive to recombinant bovine somatotropin (rbST). Animals were housed in free-stall barns, milked three times a day and fed a total mixed ration. Animals were injected with one dose (500 mg each) of rbST every 21 days during a 105-day total period (five doses in all). Daily milk production was recorded to measure average apparent response (AAR) and peak of apparent response (PAR). Average apparent response was defined as the average increase in milk production, expressed as kilogram per cow per day, for days 0-18 after dosing, as compared to the average production calculated for days -1, -2, -3, 19, 20 and 21 after dosing. Peak of apparent response was calculated as the increase in milk production for each day from 0 to 18 days after dosing as compared to the average production for days -1, -2 and -3. There was a positive linear correlation (r = 0.608; p = 0.0001) between AAR for the first 21 days and AAR for the total 105-day period (AATR). A correlation coefficient was calculated between each individual PAR value and AATR. The highest correlation coefficient (r = 0.511; p = 0.0002) was observed for days 8, 9 and 10, and therefore these days were considered the best estimates for calculating AAR when DMP records are not available. Also, high somatic cells count had a negative impact on milk yield response to treatment (p = 0.0162).
Subject(s)
Cattle/physiology , Growth Hormone/pharmacology , Lactation/drug effects , Milk/cytology , Milk/metabolism , Animals , Cell Count/veterinary , Female , Linear Models , Pregnancy , Recombinant Proteins , Time FactorsABSTRACT
Spirometry has been standardized to be carried out in children not younger than 6 years-old. However, several studies have shown that it is feasible to obtain acceptable and reproducible forced expiratory maneuvers in preschool children by adjusting the requirements to that group of age. Our aims were to evaluate the spirometry efficiency in preschool children using a modified standardization, and to propose new acceptability and reproducibility criteria for spirometry in this group of age. Eigthy healthy children (2.5 to 5.9 years old) were randomly selected through an informed consent followed by a survey and a physical examination. Each child was invited to do as many as possible forced expiratory curves in a Jaegger spirometer during a period not longer than 15 minutes. Curves with a clear peak expiratory flow (PEF), with a rapid rise and without a sudden ending of the expiratory flow from a point greater than 20 percent of PEF, were considered acceptable.The mean age of the 80 children was 4.7 years old and 31 of them were males Three children did not want to do the test. From the 77 that did the test, 72 (93.5 percent) were able to get at least two acceptable curves. These 72 children correspond to 85.7 percent of children younger than 4 years old, 90.3 percent of children from 4 to 5 y.o and 100 percent of children from 5 to 6 y.o. We concluded that spirometry is a feasible and efficient test in preschool children if the standardization requirements are suited to them. We propose to use a new set of acceptability and reproducibility criteria for spirometry in this group of age.
La espirometría se ha estandarizado para ser efectuada en niños de 6 ó más años de edad. Sin embargo, diversos estudios han demostrado que es factible obtener maniobras de expiración forzada aceptables y reproducibles en preescolares, si se ajustan los requerimientos de la estandarización a este grupo etáreo. Nuestros objetivos fueron evaluar el rendimiento de la espirometría en preescolares usando una estandarización modificada y proponer nuevos criterios de aceptabilidad y reproducibilidad para la espirometría en este grupo etáreo. Se seleccionaron aleatoriamente a través de un consentimiento informado y luego por una encuesta y examen físico 80 preescolares sanos de 2,5 a 5,9 años de edad. Cada niño fue invitado a realizar en un espirómetro Jaegger el máximo número de maniobras de espiración forzada que pudiera en un lapso no mayor de 15 min. Se consideraron aceptables las curvas con un trazado nítido del flujo espiratorio máximo (PEF), con elevación rápida y sin una terminación súbita del flujo espiratorio desde un nivel mayor al 20 por ciento del PEF. La edad promedio de los 80 niños fue 4,7 años y 31 eran de sexo masculino. Tres niños no quisieron efectuar la prueba. De los 77 que realizaron la prueba 72 (93,5 por ciento) lograron realizar al menos dos curvas aceptables. Estos 72 niños correspondieron al 85,7 por ciento de niños menores de 4 años de edad, al 90,3 por ciento de niños entre 4 y 5 años y al 100 por ciento de los niños entre 5 y 6 años de edad. Concluimos que si los requerimientos de estandarización son adaptados para la edad preescolar, la espirometría es una prueba factible y eficiente en preescolares. Proponemos usar un nuevo conjunto de criterios de aceptabilidad y reproducibilidad para la espirometría en este grupo etáreo.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Spirometry/standards , Lung/physiology , Reference Values , Chile , Vital Capacity/physiology , Data Collection , Forced Expiratory Volume , Maximal Expiratory Flow Rate , Multivariate Analysis , Respiratory Function Tests/standards , Regression Analysis , Reproducibility of ResultsABSTRACT
Los pacientes con secuela de Adenovirus (SADV) presentan un patrón funcional respiratorio de obstrucción difusa de la vía aérea, y en algunas ocasiones restricción. En la espirometría generalmente no se demuestra respuesta broncodilatadora (RBD) significativa, e incluso se ha observado disminución de los flujos. Esta respuesta puede ser diferente si se mide Resistencia con técnicas realizadas a volumen corriente, como la Oscilometría de Impulso (IOS). El objetivo de este trabajo evaluar la respuesta broncodilatadora en pacientes con SADV a través de la IOS, comparado con la espirometría. En 19 pacientes con SADV en condición basal, se realizó una IOS y espirometría antes y 10 min después de la inhalación de 200 mcg de salbutamol, con un equipo Jaeger Master-Screen IOS, cumpliendo con los criterios de aceptabilidad y reproducibilidad determinados internacionalmente. Se consideró cambio significativo en la espirometría a 15% en VEF1, 30% en FEF25-75, FEF50 y FEF75; y en la IOS a 30% en la Resistencia a 5 htz (Rrs5) e Impedancia Total (Zrs) y 20% en Frecuencia de Resonancia (Fres). La edad promedio fue de 10 años (rango 2-16), 11 varones. Debido a la edad, no se pudo realizar espirometría a 2 niños. El promedio del porcentaje del predictivo de VEF1, CVF y Rrs5 basal fueron de 74%, 59% y 136%. El porcentaje de cambio postbroncodilatador fue de (X% ± SD) 3,4 ± 7 en VEF1, 8,6 ± 19 en FEF25-75, 11,5 ± 19 en FEF50, 10,4 ± 21 en FEF75, 27 ± 19 en Rrs5, 19 ± 12 en Fres y 21 ± 20 en Zrs. En los 17 niños que realizaron ambos exámenes, se encontró RBD significativa en 13 (76,4%) y 5 (29,4%) al ser evaluada con IOS y espirometría respectivamente. Si se evalúa sólo el VEF1, se encuentra RBD significativa en sólo 2 pacientes. La evaluación de la RBD con IOS en pacientes con SADV, demuestra que la mayoría de ellos se benefician con el broncodilatador, lo que generalmente no se observa con la espirometría.
Post Adenovirus infection (PADV) patients always have a diffuse airway obstruction, and sometimes a restrictive component too. Bronchodilator response is hardly present in the spirometry, and even it has been observed decrease of the flows. This response can be different if we measured Resistance during the tidal volume, like Impulse Oscillometry, instead of forced techniques like spirometry. The aim of this work was to evaluate the IOS bronchodilator response in PADV patients, compared with the spiromerty. Spiromety and IOS were measured correlatively using a Master Screen IOS in 19 PADV patients in baseline condition, before and after 10 minutes of reciving 200 mcg of salbutamol. Only the tests that complying with international approved acceptability and reproducibility criteria were accepted for the study. A change in the spirometry of 15% in FEV1, 30% in FEF25-75, FEF50 and FEF75; and a change in the IOS of 30% in the Resistance to 5 htz (Rrs5) and Total Impedance (Zrs) and 20% in Resonance Frequency (Fres) was consired a significant bronchodilator response. The mean age of the 19 PADV patients was 10 years (range 2-16), 11 were male. Because the short age spirometry could not be accomplished in 2 children. The baseline mean of the FEV1, CVF and Rrs5 of the predictive were 74%, 59% and 136%. The bronchodilator response was (X% ± SD) 3,4 ± 7 in FEV1, 8,6 ± 19 in FEF25-75, 11,5 ± 19 in FEF50, 10,4 ± 21 in FEF75, 27 ± 19 in Rrs5, 19 ± 12 in Fres and 21 ± 20 in Zrs. In 17 children that accomplished both exams, a significant bronchodilator response was found in 13 during the IOS (76,4%) and 5 during the spirometry (29,4%). A significant bronchodilator response in FEV1 was found in only 2 patients. Most of the PADV patients have a significant bronchodilator response, that it is demonstrated when it is measured with IOS, and generally is not observed with the spirometry.
ABSTRACT
La espirometría forzada constituye la prueba de función pulmonar más usada en el estudio de las enfermedades respiratorias, en esta revisión se describen las condiciones técnicas que permiten su realización en forma adecuada para una interpretación precisa del estado funcional respiratorio, particularmente en pediatría. Este artículo incluye aspectos como la estandarización, parámetros para curvas volumen-tiempo y flujo-volumen, requisitos técnicos, e informe espirométrico.
Subject(s)
Humans , Child , Diagnostic Techniques, Respiratory System , Lung/physiology , Maximal Expiratory Flow-Volume Curves , Spirometry , Respiratory Function TestsABSTRACT
La oscilometría de impulso (IOS) es una técnica a través de la cual se mide la resistencia (Rrs) y la reactancia respiratoria (Xrs) a varias frecuencias simultáneas, a través de la interpretación de impulsos oscilatorios sobrepuestos a la ventilación corriente. Es un método que se realiza en forma rápida, no invasiva, y requiere una cooperación mínima por parte del paciente. Tres de los índices más sensibles para evaluar obstrucción periférica son la resistencia y la reactancia a 5 hertz (Rrs5 y Xrs5), y la frecuencia de resonancia (FR). El objetivo de este trabajo fue correlacionar distintos índices de la espirometría y la oscilometría de impulso (IOS), en niños asmáticos. Durante 6 meses, desde diciembre de 1999, se realiza en forma correlativa IOS y espirometría a todo niño asmático mayor de 6 años de la Unidad de Respiratorio Infantil del Hospital Padre Hurtado, con un equipo Jaeger Masterscreen IOS. Para el análisis de los resultados sólo fueron aceptadas aquellas curvas que cumplieron con los criterios de aceptabilidad y reproducibilidad determinados internacionalmente. Se obtuvo 98 pruebas aceptables para los exámenes en 40 niñas y 58 niños, con una edad promedio de 9,3 años(6 a 15 años). Se correlacionó VEF1, FEF25-75, FEF25, FEF50, y FEF75 con Xrs5, Rrs5 y FR. Los coeficientes de correlación encontrados oscilaron entre 0,5 y 0,73 (p < 0,001 en todas las correlaciones). Las correlaciones mayores entre Rrs5 y VEF1 (r = 0,73); y entre R5 y FEF25. (r = 0,7). Los índices espirométricos y la IOS tienen una buena correalación en este grupo de niños asmáticos, la cual es mayor entre Rrs5 y VEF1 y entre Rrs5 y FEF25
Subject(s)
Humans , Male , Adolescent , Female , Asthma , Oscillometry , Spirometry , Forced Expiratory Flow Rates , Forced Expiratory Volume , Airway Resistance/physiologyABSTRACT
2,3-Dimercaptosuccinic acid (DMSA) is an orally effective orphan drug that is more specific and has a wider therapeutic index than other currently available drugs used for lead intoxication. Its investigational use in the United States has been limited to the treatment of men with occupational plumbism. Twenty-one children with blood lead concentrations of 31 to 49 micrograms/dl, who also had a positive calcium disodium edetate (CaNa2EDTA) mobilization test result, were hospitalized for 7 days. Fifteen children were randomly assigned to three groups that received either 350, 700, or 1050 mg/m2/day, respectively, of DMSA in three divided doses daily. A fourth group of six children received conventional treatment with 1000 mg/m2/day of intravenously administered CaNa2EDTA in two divided doses daily. The 1050 mg/m2/day dose of DMSA was significantly more effective than lower doses of DMSA or intravenously administered CaNa2EDTA in reducing blood lead levels and restoring erythrocyte delta-aminolevulinic acid dehydratase activity. Intravenously administered CaNa2EDTA significantly increased the urinary excretion of several essential minerals (zinc, copper, iron, and calcium), whereas DMSA did not. The DMSA was well tolerated and appears extremely promising as a drug that will simplify the management of childhood lead poisoning.