Validation of the two-minute step test in obese with comorbibities and morbidly obese patients.

Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.

Validation of the two-minute step test in obese with comorbibities and morbidly obese patients

Cardiopulmonary fitness assessment is a valuable resource to obtain quantitative indicators of an individual's physical performance. The cardiopulmonary exercise test (CPX), considered the gold standard test for this evaluation, is costly and difficult to be accessed by the general population. In order to make this evaluation more accessible, and to better reflect the performance of daily life activities, alternative tests were proposed. Morbidly obese patients present limitations that impair physical performance assessment and could benefit from a test of shorter duration, provided it is validated. This observational study aimed to validate the two-minute step test (2MST) as a tool to evaluate functional capacity (FC) in obese with comorbidities and morbidly obese patients, compared the 2MST with CPX as a measure of physical performance, and developed a predictive equation to estimate peak oxygen uptake (VO2) in the 2MST. The CPX and the 2MST were performed and metabolic and ventilatory parameters were recorded in 31 obese individuals (BMI>35 kg/m2). Pearson correlation and multiple linear regression analyses were performed to evaluate the peak VO2 best predictors. Bland-Altman analysis was performed to assess the agreement between the two methods. Peak VO2 measured by CPX and 2MST showed a strong correlation (r=0.70, P<0.001) and there was a moderate correlation between peak VO2 of the 2MST and the number of up-and-down step cycles (UDS) (r=0.55; P=0.01). The reference equation obtained was: VO2 (mL·kg-1·min-1) = 13.341 + 0.138 × total UDS - (0.183 × BMI), with an estimated standard error of 1.3 mL·kg-1·min-1. The 2MST is a viable, practical, and easily accessible test for FC. UDS and BMI can predict peak VO2 satisfactorily.

Socioeconomic status influences physical fitness in European adolescents independently of body fat and physical activity: the HELENA study.

INTRODUCTION: The influence of socioeconomic status on health-related fitness is not clear. AIM: To examine the influence of socioeconomic status on health-related fitness in adolescents. METHODS: A total of 3,259 adolescents (15.0 +/- 1.3 y) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) participated in the study. Socioeconomic status was assessed by the family affluence scale (FAS). Speed-agility, muscular strength and cardiorespiratory fitness were assessed. Covariates included total body fat, physical activity and pubertal status. RESULTS: Adolescents with high FAS had significantly higher fitness levels than their peers of lower FAS categories except for speed-agility and handgrip in boys. Overall, the associations observed presented a medium to large effect size. CONCLUSION: These results suggest that socioeconomic status is positively associated with physical fitness in European adolescents independently of total body fat and habitual physical activity.

[Langerhans's cell histiocytosis in otorhinolaryngology]. / Histiocitosis de células de Langerhans en O.R.L.

Langerhans's cell histiocytosis (LCH) is an uncommon disease characterized by an accumulation of abnormal histiocytes, together lymphocytes and eosinophils in various organs and tissues. The head and neck are frequent sites of initial presentation. We present two cases of LCH with otorhinolaryngologic symptoms. Current recommendations for diagnosis, evaluation and treatment of LCH are also discussed.

[Salivary gland myoepithelioma]. / Mioepitelioma en glándulas salivares.

Myoepithelioma is a rare salivary gland tumor (less than 1%) which are usually located in parotid gland and minor salivary glands. Histology and immunohistochemical features of this tumors are reviewed. We report 2 cases arising in parotid and hard palate.

[Burkitt lymphoma of a palatine tonsil]. / Linfoma de Burkitt en amígdala palatina.

Non-Hodgkin lymphoma (NHL) comprise 7-10% of all malignant tumors in childhood. Early systems of classification (Rappaport, Luke-Collins) have been improved with the Working Formulation. NHL are classified into low, intermediate and high-grade disease. Head and neck manifestations of Burkitt's lymphoma are encountered in less than a quarter of the reported cases and usually present as cervical adenopathy. Parapharyngeal space and extranodal disease are unusual sites of involvement. We present a case of tonsillar lymphoma diagnosed with fine-needle biopsy and confirmed with excisional biopsy. Accurate staging (stage IV) and chemotherapy regimen was promptly begun. We review the clinical aspects, pathologic features and treatment of this disease.

[Subglottal stenosis as the initial manifestation in Wegener's disease]. / Estenosis subglótica como primera manifestación de la enfermedad de Wegener.

A 21-year-old man with 3-month history of hoarseness and dyspnea was suspected to have Wegener's granulomatosis with initially appearing in the trachea. In spite of unspecific biopsies, the clinicopathological picture and the high titles of anticytoplasmic autoantibodies (ACPA) confirmed the diagnosis. The early treatment with cyclophosphamide impeded the evolution to graver systemic forms of the disease.

[Graphic recording of the maxillary ostium permeability]. / Registro gráfico de la permeabilidad del óstium maxilar.

Currently we practise salpingography for evaluating Eustachian tube permeability. In a similar mode, we describe a technique of graphic search, with impedianciometry, of patency in the osteomeatal complex, after puncture and placing Foley's catheter in the maxillary sinus. In several cases without opening, we make topical treatment though catheter. For this technique, we propose the term of infundibulography.

[Castleman's lymphoma of the neck]. / Enfermedad de Castleman en el cuello.

We present a case of Castleman's disease (hyaline-vascular type) localized in the neck, confirmed by histopathological examination. A review of the illness is also reported.

[The butterfly-like type of myringoplasty. Our experience]. / Miringoplastia tipo mariposa: nuestra experiencia.

The attempts for closing tympanic perforations has been a matter of concern between the otologists since past times. BANZER, in 1640, tried to seal them with pork bladder; YEARSLEY, in 1850, was the first to use a fragment of cotton wool to patch them up; BERTHOLD, in 1878, used skin grafts; and BLAKE, in 1887, did the same with papier patches. From 1950 onwards, owing to the spreading of optical devices, the utilization of several materials become generalized. Although independently of the followed technique high rates of closures were recorded, it seems advisable to stablish a procedure joining good results and the easiness of placement of the piece and, specially, to avoid the general anesthesia. In our Department the butterfly-like method of myringoplasties is practised in certain cases. The procedure is based in that of STROUD. The results are not better as those gained through classics but it is worth because of the advantages of application and the accuracy of placement.

[Complications of therapeutic embolization of juvenile angiofibroma of the nasopharynx]. / Complicaciones en embolización terapéutica del angiofibroma de nasofaringe juvenil.

We report two cases of major complications in therapeutic embolization of juvenile angiofibromas. We discuss no permanent and major complications of this procedure. A brief review of this illness is also presented.