ABSTRACT
OBJECTIVES: To compare three radiological scores in the study of fecal impaction in children with constipation. To investigate whether these radiological scores are useful in the assessment of fecal disimpaction therapy and if they present a relation with total colonic transit time. METHODS: The Barr, Blethyn and Leech scores were measured by three observers, independently, in 123 abdominal radiographs. Interobserver agreement in the diagnosis of fecal impaction was calculated for the three scores. In 30 radiographs, the analysis of the scores was performed before and after fecal disimpaction. Total colonic transit time was calculated in 59 radiographs with the use of radiopaque markers. RESULTS: The agreement between pairs of observers was assessed by the kappa coefficient and was good for the Barr (0.56, 0.59 and 0.69) and Leech scores (0.53, 0.58 and 0.61). The Blethyn score presented lower kappa coefficients (0.26, 0.32 and 0.36). In the comparison of methods, Leech and Barr showed a good correlation. After fecal disimpaction, there was a statistically significant reduction (p < 0.001) of scores, most significantly with the Barr score. There was no relation between radiographic scores and colonic transit time. CONCLUSIONS: There is no relation between fecal impaction assessed by radiography of the abdomen and total colonic transit time. Plain radiographs may be a useful tool for the diagnosis of fecal impaction. The Barr score can be considered a good method of analysis, especially to assess the response to treatment of fecal impaction.
Subject(s)
Constipation/diagnostic imaging , Fecal Impaction/diagnostic imaging , Gastrointestinal Transit , Child , Colon/diagnostic imaging , Constipation/physiopathology , Defecography , Fecal Impaction/physiopathology , Fecal Impaction/therapy , Female , Humans , Male , Observer Variation , Radiography, Abdominal/methodsSubject(s)
Humans , Male , Female , Coma , Protein-Energy Malnutrition/diagnosis , Protein-Energy Malnutrition/therapy , Emergencies , Fluid Therapy , Hydrotherapy , Heart Failure , Pediatrics , VenezuelaABSTRACT
Los objetivos del trabajo son: Identificar la presencia de alteraciones celulares en la vías aéreas producidas por oxigenoterapia e intentar determinar en los casos de oxigenotoxicidad la relación con FiO2, presión en las vías aéreas, PEEP y tiempo de exposición. El análisis reporta 14 pacientes con signos de oxigenotoxicidad (78 por ciento) siendo el hallazgo más significativo a nivel microscópico: hipoplasia de células alveolares tipo I, metaplasia escamosa y células reactivas. 43 por ciento de los pacientes evidenciaron signos de oxigenotoxicidad en las primeras 48 horas de oxigenoterapia, no lográndose establecer relación con Fio2, PEEP y PIM. En todos los pacientes en etapa neonatal (22 por ciento) se evidenció toxicidad por oxígeno, llamándose a la reflexión en relación al uso indiscriminado de oxigenoterapia