RESUMO
PURPOSE: The use of angiography in postmortem CT angiography (PMCTA) has several advantages. In adults, femoral vascular access is well established. Due to the small and specific anatomy in fetuses and infants, the technique has to be adapted, especially regarding the vascular access. The aim of this study was to evaluate vascular access for pediatric PMCTA (pedPMCTA). MATERIALS AND METHODS: Ten pedPMCTAs were performed in stillbirths, babies, and one toddler. A femoral approach by cannulation of the femoral artery and vein, an umbilical approach by cannulation of the umbilical vessels, and an intraosseous approach by an intraosseous needle were evaluated by handling and resulting imaging. RESULTS: The insertion of a cannula with a size of 18-20 G in the femoral vessels was possible in babies. An umbilical access with peripheral venous cannulas with a size of 14-20 G was feasible in stillbirths and newborns. An intraosseous access is advisable as equal alternative to umbilical and in cases where a femoral access is not possible. The most significant problem with the vascular access is the extravasation of contrast media, but this can be reduced significantly with practice. CONCLUSION: When performing pedPMCTA, an umbilical vascular access is recommended if an umbilical cord with open vessels is still present. Otherwise, a bone marrow access should be preferred in the presence of an arteriovenous shunt or if only the venous system needs to be shown. If that is not the case, the femoral access with the possibility to separate venous and arterial scan should be used.
RESUMO
Background: This paper sought to evaluate individual exposure to air pollution by quantifying the carbon in alveolar macrophages (AMs) and its relationship to lung function. We also examined the proximity of participants' residences to the Presidente Dutra highway (PDH) in adolescents with asthma from Taubaté, São Paulo, Brazil. Methods: This descriptive study examined fifty 13- to 14-year-old adolescents with asthma identified by the International Study of Asthma and Allergies in Childhood (ISAAC) in Taubaté. These adolescents underwent spirometry and sputum induction via the inhalation of 3% hypertonic saline (HSS). Sputum was collected after each nebulisation, and forced expiratory flow in one second (FEV1) was measured. The collected sputum was stored and transported to the laboratory; it was then processed and analysed for ultrafine particles (≤100 nm). This analysis was correlated with the residence location and FEV1 of each adolescent. Results: A total of 39 adolescents completed the study. The comparison of the carbon fraction within macrophages (CA/MA) showed no differences according to residence in relation to the PDH (p=0.758). After adjustment, a mixed linear model with FEV1 as the dependent variable and CA/MA, location, and evaluation condition as the predictors found that the interactions among the variables were not significant. Conclusions:T he amount of carbon present within the AMs of adolescents with asthma was not correlated with either lung function or residence location. Evaluations of the topograghy and local climatic conditions in Taubaté should be considered in future studies (AU)
No disponible
