Sugarcane productivity and economic viability in response to planting density.

Planting with higher density in sugarcane is one of the practices used to overcome low productivity. However, this planting material is equivalent to 25% of the total cost of production, being one of the main expenses for cultivation. In this sense, the present work aims to evaluate the productivity and economic viability of sugarcane as a function of planting density. The experiment was carried out at Usina Monte Alegre in the municipality of Mamanguape, Paraíba, Brazil, from March 2021 to January 2022 with the variety RB92579. Seven planting density were studied: T1: 7 gems m-1, T2: 10 gems m-1, T3: 12 gems m-1, T4: 11 gems m-1, T5: 15 gems m-1, T6: 17 gems m-1, T7: 24 gems m-1, in randomized blocks with four replications. Growth, productivity and economic viability were evaluated. The highest productivity of cane and sugar, 77.69 ton ha-1 and 10.390 ton ha-1, respectively, was with planting density of 17 and 24 gems-1. While the minimum productivity of cane (61.313 ton ha-1) and sugar (7.924 ton ha-1) was recorded at sowing density of 7 and 11 gems-1. However, cultivation density with 7 and 10 gems m-1 were the ones that provided the highest profitability around 50%, followed by density of 12, 15 and 17 gems m-1 with an average of 45% profit and 11 and 24 gems m-1 with the lowest proportion of profit on average 38%. The cultivation with 17 gems m-1 of cane provides in cane-plant, variety RB92579, greater productivity with a profit rate of 45%, being the most suitable.

A study of weeds as potential inoculum sources for a tomato-infecting begomovirus in central Brazil.

Tomato severe rugose virus (ToSRV) is the most important begomovirus species in Brazilian tomato production. Many weeds are associated with tomato, and some are hosts of begomoviruses. Only one species of weed, Nicandra physaloides, has been found to be infected with ToSRV. In this study, four weed species were investigated for their capacity to be infected by ToSRV and serve as a potential source of inoculum for tomato. Begomoviruses from naturally infected Crotalaria spp., Euphorbia heterophylla, N. physaloides, and Sida spp. were successfully transferred to tomato plants by biolistic inoculation. ToSRV was the major virus transferred to tomato. In contrast, other begomoviruses were transferred to weeds, such as Sida micrantha mosaic virus and Euphorbia yellow mosaic virus. Furthermore, a new strain of Sida micrantha mosaic virus is reported. We also confirmed that Crotalaria spp., E. heterophylla, and Sida spp. are infected with ToSRV but at low viral titers and in mixed infections with weed-infecting begomoviruses. Thus, it was demonstrated that weeds are potential sources of ToSRV for tomato in central Brazil.

Relationship of body mass index and waist-to-hip ratio with fibrinolytic activity measured as D-dimer.

BACKGROUND/AIMS: Increased coagulability or impaired fibrinolysis may partly explain how obesity increases cardiovascular disease risk. However, there has been some controversy regarding the relationship of anthropometric measures, like body mass index (BMI) and waist-to-hip ratio (WHR), and D-dimers. We aimed to determine the relationship of general and visceral obesity to D-dimer in a group of outpatients with different BMI and WHR ranges. METHODS: We performed a cross-sectional study with adult patients from an outpatient primary health service. BMI, WHR and triceps skin fold were measured. Blood samples were collected from all patients and D-dimer levels were obtained. RESULTS: A total of 66 patients were included in the analysis. The patients had a mean age of 54.6 ± 15.3 years. Fifty-three (80.3%) patients were female and 13 (19.7%) were male. The mean BMI, WHR and triceps skin fold were 30.1 ± 6.9 kg/m(2), 0.88 ± 0.08, 20.9 ± 7.6 mm, respectively. For all the study group, D-dimers were positively correlated only with WHR (r = 0.27, p = 0.038). D-Dimers values were not related to BMI and to triceps skin fold. D-Dimers were moderately correlated with WHR in women (r = 0.40, p = 0.021), but not in male patients (r = 0.18, p = 0.601). CONCLUSIONS: Our results suggest that abdominal obesity may lead to disturbances in hemostasis, at least in female patients.

Prevalence of sleepiness in a group of Brazilian lorry drivers.

OBJECTIVE: To determine the prevalence of sleepiness in a group of Brazilian lorry drivers. STUDY DESIGN: Cross-sectional study. METHODS: This study used a self-administrated questionnaire and the Epworth Sleepiness Scale (ESS). The questionnaire included questions regarding demographic features, professional data, sleep habits, night-time symptoms, excessive daytime sleepiness and history of previous automobile accidents. RESULTS: Four hundred and thirty-eight male drivers, aged 34.2+/-9.5 years (mean+/-SD), were included in the study. The mean number of hours spent driving each day was 9.2+/-2.6h, compared with 4.5+/-2.3h for the night shift. The median distance covered weekly was 1,200 km (range 70-6,000 km). The most common sleep complaints were insomnia (26.6%), loud snoring (45%) and witnessed apnoea (7.6%). Eighty-six of 392 (22%) drivers reported falling asleep while driving, and 11 (2.8%) subjects indicated falling asleep daily or almost daily. One hundred and seventy-one drivers (39%) had been involved in a traffic accident, and 21 of 128 drivers (16.4%) indicated sleepiness as a possible contributing factor. The ESS was higher than 10 points in 120 (28%) of the interviewees. CONCLUSIONS: Sleepiness is a prevailing symptom in lorry drivers and is probably related to accidents.

Bleomycin lung toxicity: who are the patients with increased risk?

Bleomycin is an antibiotic drug with anticancer properties produced by Streptomyces verticillus [Cheson BD. Pharmacology of cancer chemotherapy: miscellaneous chemotherapeutic agents. In De Vita Jr. VT, Hellmann S, Rosenberg AS, editors. Cancer principles and practice of oncology. Lippincott Willians & Wilkins; 2001. p. 452-459]. It was isolated in 1966 by Umezawa et al. and its mechanism of action is breaking the DNA double helix by the production of free radicals, which is oxygen and iron dependent [Cheson BD. Pharmacology of cancer chemotherapy: miscellaneous chemotherapeutic agents. In De Vita Jr. VT, Hellmann S, Rosenberg AS, editors. Cancer principles and practice of oncology. Lippincott Willians & Wilkins; 2001. p. 452-459; Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94]. Bleomycin may be inactivated by bleomycin hidrolase presents in normal and tumoral cells [Cheson BD. Pharmacology of cancer chemotherapy: miscellaneous chemotherapeutic agents. In De Vita Jr. VT, Hellmann S, Rosenberg AS, editors. Cancer principles and practice of oncology. Lippincott Willians & Wilkins; 2001. p. 452-459; Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94; Jules-Elysee K, White DA. Bleomycin-induced pulmonary toxicity. Clinics Chest Med 1990;11:1-20]. The complex bleomycin-Fe has been the most studied because bleomycin joins the DNA and Fe at the same time, and release of free radicals happens in the presence of molecular oxygen [Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94]. Bleomycin has a renal metabolism with 50% of dose eliminated in 4h after its administration and 70% in the next 24h. Its half-life (T 1/2) is not altered, although the creatinine clearance drops to 25-35 ml/min [Cheson BD. Pharmacology of cancer chemotherapy: miscellaneous chemotherapeutic agents. In De Vita Jr. VT, Hellmann S, Rosenberg AS, editors. Cancer principles and practice of oncology. Lippincott Willians & Wilkins; 2001. p. 452-459; Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94]. This drug has been used as cytostatic treatment of many malignant tumors, such as germ cell tumors, lymphomas, head and neck, and Kaposi's sarcomas [Chen XL, Li WB, Zhou AM et al. Role of endogenous peroxynitrite in pulmonary injury and fibrosis induced by bleomycin A5 in rats. Acta Pharmacol Sin 2003;24:697-702]. Minor important adverse effects are myelossupression, nauseas, vomiting, allergic reactions, mucositis, alopecia, erythema, hyperkeratosis, hypopigmentation, skin ulceration, and acute arthritis [Cheson BD. Pharmacology of cancer chemotherapy: miscellaneous chemotherapeutic agents. In De Vita Jr. VT, Hellmann S, Rosenberg AS, editors. Cancer principles and practice of oncology. Lippincott Willians & Wilkins; 2001. p. 452-459; Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94]. Fever is reported in 20-50% of patients and some of them present hyperthermia [Hay J, Shahzeidi S, Laurent G. Mechanisms of bleomycin-induced lung damage. Arch Toxicol 1991;65:81-94].

Factors associated with emergency department visits due to acute asthma

It is important to identify characteristics related to poor disease control and frequent visits to the emergency department (ED). The objective of the present study was to compare the characteristics of patients attending the adult ED for treatment of asthma exacerbation with those attending an asthma specialist clinic (AC) in the same hospital, and to determine the factors associated with frequent visits to the ED. We conducted a cross-sectional survey of consecutive patients (12 years and older) attending the ED (N = 86) and the AC (N = 86). Significantly more ED patients than AC patients reported ED visits in the past year (95.3 vs 48.8 percent; P < 0.001) and had difficulty performing work (81.4 vs 49.4 percent; P < 0.001. Significantly more AC than ED patents had been treated with inhaled corticosteroids (75.6 vs 18.6 percent; P < 0.001) used to increase or start steroid therapy when an attack was perceived (46.5 vs 20.9 percent; P < 0.001) and correctly used a metered-dose inhaler (50.0 vs 11.6 percent; P < 0.001). The history of hospital admissions (odds ratio, OR, 4.00) and use of inhaled corticosteroids (OR, 0.27) were associated with frequent visits to the ED. In conclusion, ED patients were more likely than AC patients to be dependent on the acute use of the ED, were significantly less knowledgeable about asthma management and were more likely to suffer more severe disease. ED patients should be considered an important target for asthma education. Facilitating the access to ambulatory care facilities might serve to reduce asthma morbidity.

Factors associated with emergency department visits due to acute asthma.

It is important to identify characteristics related to poor disease control and frequent visits to the emergency department (ED). The objective of the present study was to compare the characteristics of patients attending the adult ED for treatment of asthma exacerbation with those attending an asthma specialist clinic (AC) in the same hospital, and to determine the factors associated with frequent visits to the ED. We conducted a cross-sectional survey of consecutive patients (12 years and older) attending the ED (N = 86) and the AC (N = 86). Significantly more ED patients than AC patients reported ED visits in the past year (95.3 vs 48.8%; P < 0.001) and had difficulty performing work (81.4 vs 49.4%; P < 0.001. Significantly more AC than ED patents had been treated with inhaled corticosteroids (75.6 vs 18.6%; P < 0.001) used to increase or start steroid therapy when an attack was perceived (46.5 vs 20.9%; P < 0.001) and correctly used a metered-dose inhaler (50.0 vs 11.6%; P < 0.001). The history of hospital admissions (odds ratio, OR, 4.00) and use of inhaled corticosteroids (OR, 0.27) were associated with frequent visits to the ED. In conclusion, ED patients were more likely than AC patients to be dependent on the acute use of the ED, were significantly less knowledgeable about asthma management and were more likely to suffer more severe disease. ED patients should be considered an important target for asthma education. Facilitating the access to ambulatory care facilities might serve to reduce asthma morbidity.

Sildenafil no tratamento da hipertensão arterial pulmonar / Sildenafil in the treatment of arterial pulmonary hypertension

É abordado, de forma concisa, o papel do sildenafil, um inibidor das isoenzimas fosfodiesterases (PDE) tipos 5/6, para o tratamento da hipertensão arterial pulmonar. São apresentados alguns ensaios clínicos que têm justificado a indicação deste fármaco no manejo da HPP.

Lung clearance of 99mTc-DTPA in systemic lupus erythematosus.

The early demonstration of lung involvement in systemic lupus erythematosus (SLE) patients is a difficult but important task. In the present study we attempted to identify abnormalities in pulmonary clearance of 99mTc-DTPA in SLE, correlating their clearance data with clinical findings and disease activity. Forty-six consecutive SLE patients with and without active disease (LACC score) and 30 normal volunteers were studied. All subjects were submitted to pulmonary scintigraphy with 99mTc-DTPA to evaluate the pulmonary clearance, and to a chest X-ray, and SLE patients were submitted to tests of disease activity, spirometry, arterial blood gases and tests to assess acute-phase proteins. Pulmonary clearance was faster in SLE patients with active disease when compared to normal controls [half-life of 67.04 min (51.52-82.55 min) in active SLE versus 85.87 min (78.85-92.87 min) in controls, P<0.05] and there was a higher frequency of abnormal clearance rates in patients with active disease (11 of 26 patients, 42.3%) when compared with SLE patients without disease activity (2 of 20 patients, 10%) (P = 0.04). A significant correlation was observed between the clearance rates and cough (P<0.05), but not between the clearance rates and dyspnea symptoms or radiological findings, duration of SLE disease, antinuclear antibody titers and patterns, C-reactive protein or anti-double stranded DNA antibodies. We conclude that the pulmonary clearance of 99mTc-DTPA is increased in SLE patients with active disease.

Lung clearance of 99mTc-DTPA in systemic lupus erythematosus

The early demonstration of lung involvement in systemic lupus erythematosus (SLE) patients is a difficult but important task. In the present study we attempted to identify abnormalities in pulmonary clearance of 99mTc-DTPA in SLE, correlating their clearance data with clinical findings and disease activity. Forty-six consecutive SLE patients with and without active disease (LACC score) and 30 normal volunteers were studied. All subjects were submitted to pulmonary scintigraphy with 99mTc-DTPA to evaluate the pulmonary clearance, and to a chest X-ray, and SLE patients were submitted to tests of disease activity, spirometry, arterial blood gases and tests to assess acute-phase proteins. Pulmonary clearance was faster in SLE patients with active disease when compared to normal controls [half-life of 67.04 min (51.52-82.55 min) in active SLE versus 85.87 min (78.85-92.87 min) in controls, P<0.05] and there was a higher frequency of abnormal clearance rates in patients with active disease (11 of 26 patients, 42.3 percent) when compared with SLE patients without disease activity (2 of 20 patients, 10 percent) (P = 0.04). A significant correlation was observed between the clearance rates and cough (P<0.05), but not between the clearance rates and dyspnea symptoms or radiological findings, duration of SLE disease, antinuclear antibody titers and patterns, C-reactive protein or anti-double stranded DNA antibodies. We conclude that the pulmonary clearance of 99mTc-DTPA is increased in SLE patients with active disease

Early prediction of poor outcome in patients with acute asthma in the emergency room

Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50 percent of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9 percent) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1 percent) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h <=0 percent of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2

Early prediction of poor outcome in patients with acute asthma in the emergency room.

Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h < or =0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2.

[Randomized clinical trial of intravenous magnesium sulfate versus salbutamol in early management of severe acute asthma in children] / Estudo controlado do uso endovenoso de sulfato de magnésio ou de salbutamol no tratamento precoce da crise de asma aguda grave em crianças.

OBJECTIVE: To study the efficacy of intravenous magnesium sulfate and intravenous salbutamol in the treatment of severe asthma in children. METHODS: Randomized, double-blind, placebo-controlled clinical trial, including children above 2 years of age with severe acute asthma admitted to the observation ward of the Pediatric Intensive Care Unit of Hospital São Lucas. All patients received conventional treatment (oxygen, corticoids, beta-adrenergics) on admission, and later received one of the following solutions: a) IVMg (50 mg/kg); b) intravenous salbutamol (1 micro g/kg); c) saline solution. Clinical assessments, electrolyte concentration, and arterial blood gas analyses were recorded before intravenous infusion and one hour after that. RESULTS: Fifty patients participated in this study (of whom 53% were females, mean age = 4.5 years). There were no significant differences among the three groups. The group that received IVMg presented lower blood pressure during administration, which reached normal levels one hour afterwards, along with an increase in serum magnesium (P<0,001) and serum pH, and reduction of PaCO(2). The group that received intravenous salbutamol had lower respiratory rate (P=0.05) and higher blood pressure (P=0.01), and one hour after administration, these patients showed decreased respiratory rate (P=0.02); lower levels of serum potassium (P=0.009); higher pH, and reduced PaCO(2). This group required fewer nebulizations (P=0.009), fewer nebulizations per day (P<0.001) and less oxygen therapy than the IVMg and placebo groups. Acidosis was more persistent (P<0.01) in the placebo group. No difference as to the length of hospital stay was observed in any of the three groups. Artificial ventilation was necessary in 10% of the patients. CONCLUSIONS: The early intravenous administration of magnesium sulfate, especially salbutamol, achieved a rapid clinical response with excellent prognosis and no significant side effects.

Associação de carcinoma broncogênico com síndrome de Pancoast e síndrome da imunodeficiência adquirida / Association of bronchogenic carcinoma with Pancoast's syndrome and acquired immunodeficiency syndrome

É relatado o caso de um paciente portador da síndrome de Pancoast associada à síndrome da imunodeficiência adquirida. Esta apresentação é rara, visto que os tumores mais freqüentemente associados à SIDA são o sarcoma de Kaposi e o linfoma não-Hodgkin. O paciente, com passado de uso de drogas injetáveis, internou-se para investigação de massa em ápice pulmonar, com presença de síndrome de Pancoast, sendo solicitado anti-HIV, com resultado positivo, e tendo sido feito diagnóstico de Ca brônquico não-pequenas células

[The use of helium-oxygen mixture in the ventilation study of children with chronic obstructive lung disease] / Uso da mistura de hélio e oxigênio no estudo da ventilação de crianças com doença pulmonar obstrutiva crônica.

OBJECTIVE: To study the distribution of Tc-99m DTPA radioaerosol when heliox or oxygen are used in the nebulization of children and adolescents with chronic obstructive pulmonary disease during pulmonary ventilation scintigraphy. MATERIAL AND METHODS: Clinical randomized and controlled trial. Patients with chronic obstructive pulmonary disease (5 to 18 years old) who required pulmonary scintigraphy between March 1996 and September 1998 were included. Obstruction of the lower airway was measured by spirometry. Patients were randomized into two groups according to the gas used for nebulization during scintigraphy: heliox (80% helium and 20% oxygen) or oxygen. Scintigraphy studies were expressed as slope of the cumulative pulmonary radioactivity uptake curve and as the maximal cumulative radioactivity in the lung. The mean diameter of the Tc-99m DTPA particles generated by heliox and oxygen was measured by laser diffraction. RESULTS: Ten patients were allocated in each group. There were no statistical differences (P>0.05) in terms of gender, main diagnosis, signs of malnutrition, mean values of weight, height, body area, or spirometry results. The mean slope in the heliox group (5,039-/+1,652) was significantly different (P=0.018) from the mean slope of the oxygen group (3,410-/+1,100). The mean slope of patients with severe airflow obstruction in the heliox group was statically different (P=0.017) from the mean slope of patients with airflow obstruction in the oxygen group. In both groups, patients without evidence of airflow obstruction were similar in terms of mean slopes (P=0.507) and mean cumulative radiation in the lung (P=0.507). The mean diameter of heliox-generated Tc-99m DTPA particles was 2.13 m (-/+0.62). This was statistically different (P=0.004) from the mean diameter of oxygen-generated particles (0.88-/+0.99 m). CONCLUSIONS: Nebulization with heliox was more efficacious than nebulization with oxygen for distribution and dispersion of Tc-99m DTPA radioaerosol in the lungs of children and adolescents with chronic obstructive pulmonary disease submitted to ventilation scintigraphy. The benefits of heliox over oxygen are more evident in the presence of lower airway obstruction. Without airway obstruction, we did not observe any difference in the distribution and dispersion of radioaerosol in the lungs. Although the mean diameter of the Tc-99m DTPA particles generated by heliox and oxygen was significantly different, the particles generated by both gases were still within the recommended range (between 1 and 5 m). Therefore, this difference does not account for the effects of heliox observed in this study.

[Respiratory failure in the child] / Insuficiência respiratória na criança.

OBJECTIVE: To describe the main physiopathologic mechanism of the respiratory failure in the child, as well as to discuss some aspects of the differential diagnosis and treatment. SOURCE OF DATA: The main national and international textbooks and articles about respiratory failure in the child were used as sources of data for this research. RESULTS: Respiratory failure is defined as the incapacity to maintain a paO(2) over 50 mmHg associated or not to a paCO(2) over 50 mmHg in children breathing ambient air at sea level. This failure may be classified as hypoxemic or hypercapnic, or even as acute or chronic. The main alterations may be hypoventilation, ventilation perfusion mismatch and diffusion defect. It may be secondary to a central origin, upper or lower airway compromise, parenchyma disease, or due to pleural or thorax wall affection. The hypoxemia evaluation may be done by hemoglobin saturation, alveolar capillary gradient of oxygen (D[A-a]O(2)) or by the paO(2) / FiO(2) index. COMMENTS: The knowledge of the physiopathologic mechanisms that cause respiratory failure in the child is important to define the more efficient therapeutic strategy for each cause.

[Factors related to severe acute asthma in childhood - epidemiologic and clinical aspects]. / Fatores associados com asma aguda grave na infância - aspectos epidemiológicos e clínicos.

OBJECTIVE: To study the epidemiologic and clinical factors related to severe acute asthma in patients hospitalized in pediatric intensive care unit (PICU). STUDY PROFILE: Prospective, epidemiologic. All admissions were observed. PATIENTS AND METHODS: All children with severe asthma admitted to PICU-HSL-PUCRS between January, 1994, and December, 1994. Their parents were asked to answer a questionnaire about clinical history and precipitating factors of bronchospasm. Clinical evolution was observed in each patient. RESULTS: 31 children were admitted on 42 occasions to the PICU for the treatment of severe asthma (7.3% of all admissions). The male: female ratio was 1.2:1.0 and the age mean was 25 months. Respiratory viral infections were the main precipitating factor of asthma attacks (74%). Family history of asthma, atopy or tabagism were observed in 97% of the cases. A longer hospitalization period was associated with less than 1 year age (p=0.0005), family history of tabagism (OR= 2.3) and occurrence of pneumonitis (p= 0.03). The long stay in PICU was associated with previous PICU admission (p=0.03), family history of tabagism (OR=2.0) and occurrence of pneumonitis (p=0.02). The main complication observed, especially in patients under 1 year receiving public health care, was pneumonitis, that was diagnosed in 42% of these children. Patients assisted by a private doctor had a shorter hospitalization period and less pneumonitis complication. Mechanical ventilation was necessary in 10% of these patients. There was no death in our series. CONCLUSIONS: The incidence of severe acute asthma, associated with long staying in PICU and hospitalization, is related to low age (under 1 year), previous hospitalization due to bronchospasm, family history of asthma, atopy or tabagism, and ineffective medical care. These factors seem related to frequent crises causing more hospitalization indications. These children frequently present pneumonitis during their clinical evolution. Early and aggressive management in general benefit the clinical course of severe acute asthma. The mortality ratio for children with acute asthma who need PICU admissions is small.

Estudo da permeabilidade epitelial pulmonar em indivíduos sadios näo-tabagistas / Study of pulmonary epithelial permeability in non-smoker healthy individuals

Objetivo. Medir a permeabilidade epitelial pulmonar em indivíduos sadios nao-tabagistas, estabelecendo padrao de normalidade, e correlacionar os achados com a idade, sexo, peso, altura e superfície corporal. Material e Método. Foram estudados 24 voluntários sadios nao-tabagistas, utilizando a taxa de depuraçao pulmonar do (99m)Tc-DTPA como índice da permeabilidade epitelial pulmonar. Os dados obtidos foram correlacionados com sexo, idade, peso, altura e superfície corporal. Resultados. As médias encontradas para as taxas de depuraçao pulmonar do (99m)Tc-DTPA foram de 0,82 + 0,19 por cento min(-1), para o pulmao esquerdo, e de 0,88 + 0,23 por cento min(-1), para o pulmao direito. Nao se evidenciou relaçao estatísticamente significante com sexo, idade, peso, altura e superfície corporal. Conclusao. Os valores encontrados estao dentro da variaçao interindividual descrita pela literatura e passam a ser adotados como referenciais em nosso meio.

[Study of pulmonary epithelial permeability in healthy non-smokers]. / Estudo da permeabilidade epitelial pulmonar em indivíduos sadios não-tabagistas.

OBJECTIVE: To measure the pulmonary epithelial permeability in non-smoker healthy adult individuals, establishing the normal pattern in our milieu and to correlate the findings according to age, sex, weight, height and body surface area. METHOD: 24 healthy non-smokers using the rate of pulmonary depuration of 99mTc-DTPA as an index of pulmonary epithelial permeability were studied. The given information was correlated to sex, age, weight, height and body surface area. RESULTS: The averages found for the pulmonary depuration rate for 99mTc-DTPA were 0.82% +/- 0.19 min-1 for the left lung and of 0.88% +/- 0.23 min-1 for the right lung. No statistically significant relation with sex, age, weight, height and body surface area was found. CONCLUSION: The given data are within the interindividual variation described in the literature, in the studied age period, and must be considered as standard values among us.