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2.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(9): 975-979, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-32933629

RESUMO

OBJECTIVE: To study the clinical features of aerophagia in children. MEYJODS: A retrospective analysis was performed on the medical data of 46 children with aerophagia who were diagnosed and treated in Children's Hospital Affiliated to Nanjing Medical University from October 2011 to September 2019. RESULTS: Among these 46 children, 15 (33%) had Tourette syndrome. Abdominal distension was the most common symptom and was observed in 45 children (98%). The 24-hour esophageal multichannel intraluminal impedance monitoring showed a mean number of 341 times of air swallowing and a mean number of 212 times of gas reflux, and 95% of gas refluxes occurred in the upright body position. Compared with those without Tourette syndrome, the children with Tourette syndrome had a significantly higher incidence rate of air swallowing symptoms (67% vs 6%, P<0.001), but there were no significant differences in other symptoms and the results of 24-hour esophageal impedance. Dietary adjustment, psycho-behavioral therapy, and drug intervention significantly improved the scores of clinical symptoms and quality of life, among which psycho-behavioral therapy was an important intervention measure. CONCLUSIONS: Some children with aerophagia may have Tourette syndrome, and such children are more likely to have air swallowing symptoms. Psycho-behavioral therapy is one of the most important treatment methods, and children with aerophagia tend to have a good prognosis after treatment.


Assuntos
Aerofagia , Refluxo Gastroesofágico , Criança , Impedância Elétrica , Humanos , Qualidade de Vida , Estudos Retrospectivos
3.
Nat Commun ; 11(1): 4683, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943621

RESUMO

Wearable dry electrodes are needed for long-term biopotential recordings but are limited by their imperfect compliance with the skin, especially during body movements and sweat secretions, resulting in high interfacial impedance and motion artifacts. Herein, we report an intrinsically conductive polymer dry electrode with excellent self-adhesiveness, stretchability, and conductivity. It shows much lower skin-contact impedance and noise in static and dynamic measurement than the current dry electrodes and standard gel electrodes, enabling to acquire high-quality electrocardiogram (ECG), electromyogram (EMG) and electroencephalogram (EEG) signals in various conditions such as dry and wet skin and during body movement. Hence, this dry electrode can be used for long-term healthcare monitoring in complex daily conditions. We further investigated the capabilities of this electrode in a clinical setting and realized its ability to detect the arrhythmia features of atrial fibrillation accurately, and quantify muscle activity during deep tendon reflex testing and contraction against resistance.


Assuntos
Condutividade Elétrica , Epiderme , Monitorização Fisiológica/instrumentação , Movimento (Física) , Pele , Artefatos , Impedância Elétrica , Eletrocardiografia/instrumentação , Eletrocardiografia/métodos , Eletrodos , Eletroencefalografia/instrumentação , Eletroencefalografia/métodos , Eletromiografia/instrumentação , Eletromiografia/métodos , Desenho de Equipamento , Humanos , Monitorização Fisiológica/métodos , Polímeros/química , Sorbitol
4.
Geriatr Gerontol Int ; 20(10): 943-950, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32886830

RESUMO

AIM: To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. METHODS: In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. RESULTS: Calf circumference was positively correlated with BIA-measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2 . The optimal calf circumference cut-offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. CONCLUSIONS: Calf circumference is positively correlated with BIA- and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943-950.


Assuntos
Perna (Membro)/fisiologia , Músculo Esquelético/fisiologia , Sarcopenia/diagnóstico , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Índice de Massa Corporal , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sensibilidade e Especificidade
5.
Sensors (Basel) ; 20(18)2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32911861

RESUMO

Lung sounds acquired by stethoscopes are extensively used in diagnosing and differentiating respiratory diseases. Although an extensive know-how has been built to interpret these sounds and identify diseases associated with certain patterns, its effective use is limited to individual experience of practitioners. This user-dependency manifests itself as a factor impeding the digital transformation of this valuable diagnostic tool, which can improve patient outcomes by continuous long-term respiratory monitoring under real-life conditions. Particularly patients suffering from respiratory diseases with progressive nature, such as chronic obstructive pulmonary diseases, are expected to benefit from long-term monitoring. Recently, the COVID-19 pandemic has also shown the lack of respiratory monitoring systems which are ready to deploy in operational conditions while requiring minimal patient education. To address particularly the latter subject, in this article, we present a sound acquisition module which can be integrated into a dedicated garment; thus, minimizing the role of the patient for positioning the stethoscope and applying the appropriate pressure. We have implemented a diaphragm-less acousto-electric transducer by stacking a silicone rubber and a piezoelectric film to capture thoracic sounds with minimum attenuation. Furthermore, we benchmarked our device with an electronic stethoscope widely used in clinical practice to quantify its performance.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/instrumentação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Monitorização Ambulatorial/instrumentação , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Sons Respiratórios/diagnóstico , Sons Respiratórios/fisiopatologia , Estetoscópios , Dispositivos Eletrônicos Vestíveis , Acústica , Auscultação/instrumentação , Impedância Elétrica , Desenho de Equipamento , Humanos , Pandemias , Tecnologia de Sensoriamento Remoto/instrumentação , Processamento de Sinais Assistido por Computador , Transdutores , Tecnologia sem Fio/instrumentação
6.
Am J Phys Med Rehabil ; 99(10): 902-908, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32941253

RESUMO

OBJECTIVE: The aim of the study was to explore an individualized sonographic muscle thickness ratio and its cutoff values in the diagnosis of sarcopenia. DESIGN: A total of 326 community-dwelling adults were included in this cross-sectional study. Total skeletal muscle mass was evaluated by bioelectrical impedance analysis, and nine-site muscle thickness measurements using ultrasound. Isometric handgrip and knee extension strengths were assessed. Physical performance was evaluated by usual Gait Speed, Chair Stand Test, and Timed Up and Go Test. RESULTS: Because the anterior thigh muscle thickness was the most significantly decreasing measurement with aging and the most significantly related value with body mass and height; sonographic thigh adjustment ratio was calculated by dividing it with body mass index. Using the two standard deviation values of our healthy young adults, sonographic thigh adjustment ratio cutoff values were found as 1.4 and 1.0 for male and female subjects, respectively. Sonographic thigh adjustment ratio values were negatively correlated with Chair Stand Test and Timed Up and Go Test in both sexes (all P < 0.05) and positively correlated with gait speed in female subjects and knee extension strength in male subjects (both P < 0.05). CONCLUSIONS: Our results imply that regional (rather than total) muscle mass measurements should be taken into consideration for the diagnosis of sarcopenia.


Assuntos
Sarcopenia/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diagnóstico Diferencial , Impedância Elétrica , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia
7.
Int J Nanomedicine ; 15: 4877-4898, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32753869

RESUMO

Background: Although dynamics and uses of modified nanoparticles (NPs) as orally administered macromolecular drugs have been researched for many years, measures of molecule stability and aspects related to important transport-related mechanisms which have been assessed in vivo remain as relatively under characterized. Thus, our aim was to develop a novel type of oral-based delivery system for insulin and to overcome barriers to studying the stability, transport mechanisms, and efficacy in vivo of the delivery system. Methods: NPs we developed and tested were composed of insulin (INS), dicyandiamide-modified chitosan (DCDA-CS), cell-penetrating octaarginine (r8), and hydrophilic hyaluronic acid (HA) and were physically constructed by electrostatic self-assembly techniques. Results: Compared to free-insulin, levels of HA-DCDA-CS-r8-INS NPs were retained at more desirable measures of biological activity in our study. Further, our assessments of the mechanisms for NPs suggested that there were high measures of cellular uptake that mainly achieved through active transport via lipid rafts and the macropinocytosis pathway. Furthermore, investigations of NPs indicated their involvement in caveolae-mediated transport and in the DCDA-CS-mediated paracellular pathway, which contributed to increasing the efficiency of sequential transportation from the apical to basolateral areas. Accordingly, high efficiency of absorption of NPs in situ for intestinal loop models was realized. Consequently, there was a strong induction of a hypoglycemic effect in diabetic rats of NPs via orally based administrations when compared with measures related to free insulin. Conclusion: Overall, the dynamics underlying and influenced by HA-DCDA-CS-r8-INS may hold great promise for stability of insulin and could help overcome interference by the epithelial barrier, and thus showing a great potential to improve the efficacy of orally related treatments.


Assuntos
Quitosana/química , Ácido Hialurônico/química , Insulina/administração & dosagem , Nanopartículas Multifuncionais/química , Nanopartículas/química , Administração Oral , Animais , Transporte Biológico/efeitos dos fármacos , Células CACO-2 , Morte Celular/efeitos dos fármacos , Quitosana/síntese química , Diabetes Mellitus Experimental/tratamento farmacológico , Impedância Elétrica , Endocitose/efeitos dos fármacos , Guanidinas/síntese química , Guanidinas/química , Humanos , Ácido Hialurônico/síntese química , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/farmacologia , Insulina/uso terapêutico , Absorção Intestinal/efeitos dos fármacos , Masculino , Muco/metabolismo , Nanopartículas/ultraestrutura , Ratos , Solubilidade , Suínos
8.
PLoS One ; 15(8): e0238298, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857802

RESUMO

BACKGROUND: The spread of multi-drug resistant tuberculosis (MDR-TB) is a leading global public-health challenge. Because not all biological mechanisms of resistance are known, culture-based (phenotypic) drug-susceptibility testing (DST) provides important information that influences clinical decision-making. Current phenotypic tests typically require pre-culture to ensure bacterial loads are at a testable level (taking 2-4 weeks) followed by 10-14 days to confirm growth or lack thereof. METHODS AND FINDINGS: We present a 2-step method to obtain DST results within 3 days of sample collection. The first involves selectively concentrating live mycobacterial cells present in relatively large volumes of sputum (~2-10mL) using commercially available magnetic-nanoparticles (MNPs) into smaller volumes, thereby bypassing the need for pre-culture. The second involves using microchannel Electrical Impedance Spectroscopy (m-EIS) to monitor multiple aliquots of small volumes (~10µL) of suspension containing mycobacterial cells, MNPs, and candidate-drugs to determine whether cells grow, die, or remain static under the conditions tested. m-EIS yields an estimate for the solution "bulk capacitance" (Cb), a parameter that is proportional to the number of live bacteria in suspension. We are thus able to detect cell death (bactericidal action of the drug) in addition to cell-growth. We demonstrate proof-of-principle using M. bovis BCG and M. smegmatis suspended in artificial sputum. Loads of ~ 2000-10,000 CFU of mycobacteria were extracted from ~5mL of artificial sputum during the decontamination process with efficiencies of 84% -100%. Subsequently, suspensions containing ~105 CFU/mL of mycobacteria with 10 mg/mL of MNPs were monitored in the presence of bacteriostatic and bactericidal drugs at concentrations below, at, and above known MIC (Minimum Inhibitory Concentration) values. m-EIS data (ΔCb) showed data consistent with growth, death or stasis as expected and/or recorded using plate counts. Electrical signals of death were visible as early as 3 hours, and growth was seen in < 3 days for all samples, allowing us to perform DST in < 3 days. CONCLUSION: We demonstrated "proof of principle" that (a) live mycobacteria can be isolated from sputum using MNPs with high efficiency (almost all the bacteria that survive decontamination) and (b) that the efficacy of candidate drugs on the mycobacteria thus isolated (in suspensions containing MNPs) could be tested in real-time using m-EIS.


Assuntos
Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana/métodos , Mycobacterium/efeitos dos fármacos , Escarro/microbiologia , Espectroscopia Dielétrica , Impedância Elétrica , Nanopartículas de Magnetita , Testes de Sensibilidade Microbiana/instrumentação , Mycobacterium/isolamento & purificação , Estudo de Prova de Conceito
9.
Physiol Meas ; 41(8): 085008, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32736369

RESUMO

OBJECTIVE: Patients with the novel coronavirus disease (COVID-19) often have airway secretions that severely compromise ventilation. This study investigates electrical impedance tomography (EIT) monitoring of a therapeutic bronchoalveolar lavage (BAL) in a patient with COVID-19. APPROACH: A patient with COVID-19 developed acute respiratory distress syndrome requiring mechanical ventilation. He received regional BAL to remove mucus in the small airways (20 ml × 5). Regional ventilation changes before BAL, 30 min after and in the following days, were monitored with EIT. MAIN RESULTS: Regional ventilation worsened shortly after BAL and improved in the following days. The improvement of the oxygenation did not exactly match the ventilation improvement, which indicated a possible ventilation/perfusion mismatch. SIGNIFICANCE: Therapeutic BAL might improve regional ventilation for COVID-19 and EIT could be a useful tool at the bedside to monitor the ventilation treatment of COVID-19.


Assuntos
Betacoronavirus , Lavagem Broncoalveolar/métodos , Infecções por Coronavirus/terapia , Impedância Elétrica/uso terapêutico , Monitorização Fisiológica/métodos , Pneumonia Viral/terapia , Respiração Artificial/métodos , Idoso , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Humanos , Masculino , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Síndrome do Desconforto Respiratório do Adulto/diagnóstico por imagem , Síndrome do Desconforto Respiratório do Adulto/etiologia , Síndrome do Desconforto Respiratório do Adulto/terapia , Tomografia/métodos
10.
Int Heart J ; 61(4): 769-775, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32684606

RESUMO

The number of heart failure patients is increasing rapidly in Japan because of its large elderly population. As age increases, arterial stiffness and physical dysfunction progress. This study aimed to evaluate the association between the physical function and arterial stiffness in elderly heart failure patients.This retrospective, observational study includes data from 100 heart failure patients aged ≥ 65 years who were admitted to our hospital and underwent cardiac rehabilitation. The Cardio-Ankle Vascular Index (CAVI) was measured as an indicator of arterial stiffness. Body composition was assessed by bioelectrical impedance analysis. To determine the degree of physical function, we assessed handgrip strength, five-meter walk speed (5MWS), five-repetition sit-to-stand time (5RSST) and six-minute walk distance (6MWD). Sarcopenia was defined using Asian guidelines based on physical function and body composition.Among 100 patients, 47.0% of patients had sarcopenia. After adjustments for age, sex, atrial fibrillation, and ischemic cardiomyopathy, CAVI was significantly higher in with sarcopenia patients than those without sarcopenia. Age, handgrip strength, 5MWS, 5RSST, and 6MWD were associated with CAVI, and 6MWD was as an independent determinant factor of CAVI.6MWD was recognized as an accurate physical function indicator. These findings suggested that physical function and arterial stiffness complement each other. To restore cardiac dysfunction, improving both arterial stiffness and physical function might be useful.


Assuntos
Índice Vascular Coração-Tornozelo , Insuficiência Cardíaca/fisiopatologia , Sarcopenia/fisiopatologia , Rigidez Vascular , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Impedância Elétrica , Feminino , Insuficiência Cardíaca/complicações , Humanos , Masculino , Músculo Esquelético , Estudos Retrospectivos , Sarcopenia/complicações
11.
J Chromatogr A ; 1625: 461270, 2020 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-32709322

RESUMO

In sample pre-treatment, millifluidic electromembrane platforms have been developed to extract and pre-concentrate target molecules with good clean-up that minimize matrix effects. Optimal operation conditions are normally determined experimentally, repeating the extractions at different conditions and determining the efficiencies by an analytical technique. To shorten and simplify the optimization protocol, millifluidic platforms have been electrically characterized by impedance spectroscopy. The magnitude of the resistance of the electromembrane has been found very predictive of the migration capacity and extraction efficiency of three different parabens on real time. The optimal conditions (4 V of applied potential) (Electromembrane extraction low voltage) have been successfully applied in the extraction of parabens from urine samples, that not only improves the extraction efficiency (100% for all compounds) but also provides a very low current intensity (7 µA), which is very important in electromembrane to minimize electrolysis phenomena. The possibility to optimize one of the most critical and important parameters such as the voltage with a simple electrical model may accelerate the production of application-specific millifluidic electromembrane platforms in a short development time. The results showed that millifluidic electromembrane extraction based low voltage has a future potential as a simple, selective, and time-efficient sample preparation technique allowing a simple battery as power supply.


Assuntos
Impedância Elétrica , Membranas Artificiais , Microfluídica/instrumentação , Modelos Teóricos , Parabenos/isolamento & purificação , Adulto , Eletrólise , Feminino , Humanos , Limite de Detecção , Reprodutibilidade dos Testes , Reologia , Soluções
12.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(3): 210-215, 2020 Mar 08.
Artigo em Chinês | MEDLINE | ID: mdl-32621427

RESUMO

An intravascular ultrasound-enhanced thrombolysis excitation system with adjustable frequency, amplitude and duty cycle was designed based on FPGA (ZYNQ-7Z020). Firstly, the FPGA generated waveform amplitude binary data based on direct digital frequency synthesis (DDS) technology, and then the data was converted into burst signal through an external daughter card, which included D/A conversion circuit, active low-pass filter, power amplifier circuit and impedance matching circuit. The test results demonstrated that the output waveform reached the target with advantages of simple implementation and flexible control, the peak negative pressure generated from ultrasound transducer was doubled by means of an electrical impedance matching network. In vitro thrombus models were applied to verify the excitation system, it turned out that ultrasound cavitation effect generated could accelerate the penetration of urokinase and increase the thrombolysis rate by about 20%.


Assuntos
Amplificadores Eletrônicos , Terapia Trombolítica , Impedância Elétrica , Ultrassonografia , Ultrassonografia de Intervenção
13.
Anticancer Res ; 40(7): 3931-3937, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620634

RESUMO

BACKGROUND/AIM: Extracellular water-to-total body water ratio (ECW/TBW) measured by bioelectrical impedance analysis (BIA) reportedly predicts clinical outcomes of various diseases. The aim of this retrospective study was to examine the association between ECW/TBW and therapeutic durability of chemotherapy and/or immune checkpoint inhibitors in advanced lung cancer. PATIENTS AND METHODS: Patients with advanced lung cancer underwent BIA before chemotherapy and/or treatment with immune checkpoint inhibitors at our hospital between June 2018 and November 2019. RESULTS: Of 75 patients, 18 with ECW/TBW ≥0.4 were assigned to the overhydrated group (OH-G) and 57 patients ECW/TBW <0.4 were assigned to the non-overhydrated group (NOH-G). The median time-to-treatment failure was significantly shorter in the OH-G than in the NOH-G (p=0.003). Multivariate analysis revealed that ECW/TBW ≥0.4 predicted treatment failure [hazard ratio (HR)=2.508, 95% confidence interval (CI)=1.19-5.27; p=0.01]. CONCLUSION: The ECW/TBW may be an objective parameter for predicting therapeutic durability in advanced lung cancer.


Assuntos
Antineoplásicos/uso terapêutico , Água Corporal/metabolismo , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/metabolismo , Água/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Imunológicos/uso terapêutico , Composição Corporal , Impedância Elétrica , Espaço Extracelular/metabolismo , Humanos , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida
14.
Br J Anaesth ; 125(3): 373-382, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32665059

RESUMO

BACKGROUND: Robot-assisted laparoscopic radical prostatectomy requires general anaesthesia, extreme Trendelenburg positioning and capnoperitoneum. Together these promote impaired pulmonary gas exchange caused by atelectasis and may contribute to postoperative pulmonary complications. In morbidly obese patients, a recruitment manoeuvre (RM) followed by individualised PEEP improves intraoperative oxygenation and end-expiratory lung volume (EELV). We hypothesised that individualised PEEP with initial RM similarly improves intraoperative oxygenation and EELV in non-obese individuals undergoing robot-assisted prostatectomy. METHODS: Forty males (age, 49-76 yr; BMI <30 kg m-2) undergoing prostatectomy received volume-controlled ventilation (tidal volume 8 ml kg-1 predicted body weight). Participants were randomised to either (1) RM followed by individualised PEEP (RM/PEEPIND) optimised using electrical impedance tomography or (2) no RM with 5 cm H2O PEEP. The primary outcome was the ratio of arterial oxygen partial pressure to fractional inspired oxygen (Pao2/Fio2) before the last RM before extubation. Secondary outcomes included regional ventilation distribution and EELV which were measured before, during, and after anaesthesia. The cardiovascular effects of RM/PEEPIND were also assessed. RESULTS: In 20 males randomised to RM/PEEPIND, the median PEEPIND was 14 cm H2O [inter-quartile range, 8-20]. The Pao2/Fio2 was 10.0 kPa higher with RM/PEEPIND before extubation (95% confidence interval [CI], 2.6-17.3 kPa; P=0.001). RM/PEEPIND increased end-expiratory lung volume by 1.49 L (95% CI, 1.09-1.89 L; P<0.001). RM/PEEPIND also improved the regional ventilation of dependent lung regions. Vasopressor and fluid therapy was similar between groups, although 13 patients randomised to RM/PEEPIND required pharmacological therapy for bradycardia. CONCLUSION: In non-obese males, an individualised ventilation strategy improved intraoperative oxygenation, which was associated with higher end-expiratory lung volumes during robot-assisted laparoscopic prostatectomy. CLINICAL TRIAL REGISTRATION: DRKS00004199 (German clinical trials registry).


Assuntos
Impedância Elétrica , Respiração com Pressão Positiva/métodos , Prostatectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
15.
Nutr. hosp ; 37(3): 490-496, mayo-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193856

RESUMO

BACKGROUND: identifying children at risk of developing childhood sarcopenic obesity often requires specialized equipment and expensive testing procedures, so cheaper and quicker methods would be advantageous, especially in field-based settings. OBJECTIVE: the purpose of this study was to determine the relationships between the muscle-to-fat ratio (MFR) and relative handgrip strength, and to determine the ability of handgrip strength relative to body mass index (grip-to-BMI) to identify children who are at risk of developing sarcopenic obesity. MATERIAL AND METHOD: grip-to-BMI was measured in 4021 Macedonian children (6 to 10 yrs). Bioelectrical impedance was used to estimate body fat mass and skeletal muscle mass, from which the MFR was calculated. RESULTS: the area under the curve (AUC) was 0.771 (95 % CI, 0.752 to 0.789, p < 0.001) in girls 6-10 years old and 0.843 (95 % CI, 0.826 to 0.859, p < 0.001) in boys 6-10 years old. Calculated using the grip-to-BMI ratio, the OR (95 % CI) for girls to be at risk of sarcopenic obesity identified by MFR was 20.182 (10.728-37.966, p < 0.001) and was 16.863 (10.782-26.371, p < 0.001) for boys. CONCLUSION: the grip-to-BMI ratio can be used to predict the presence of sarcopenic obesity in children, which can play a role in pediatric health interventions


INTRODUCCIÓN: identificar a los niños en riesgo de desarrollar obesidad sarcopénica infantil a menudo requiere equipos especializados y procedimientos diagnósticos costosos, por lo que sería ventajoso disponer de métodos más baratos y rápidos, especialmente en entornos no experimentales. OBJETIVO: el propósito de este trabajo fue estudiar las relaciones en la asociación músculo-grasa (MFR) y la fuerza relativa de presión y determinar la capacidad de fuerza de prensión manual (FPM) en relación con el índice de masa corporal (IMC) para identificar a los niños que corren el riesgo de desarrollar obesidad sarcopénica. MATERIAL Y MÉTODOS: se midió FPM-IMC en 4021 niños macedonios (de 6 a 10 años). La impedancia bioeléctrica se utilizó para estimar la masa de grasa corporal y la masa del músculo esquelético, a partir de la cual se calculó la MFR. RESULTADOS: el área bajo la curva (ABC) fue de 0,771 (IC 95 %, 0,752-0,789, p < 0,001) en niñas de 6 a 10 años y de 0,843 (IC 95 %, 0,826-0.859, p < 0,001) en niños de 6 a 10 años. Se calculó la razón de ventajas (OR) para la relación FPM-IMC (IC del 95%) para las niñas con riesgo de obesidad sarcopénica identificado por MFR, que fue de 20,182 (10,728-37-966, p < 0-001) y 16,863 (10,782-26,371, p < 0,001) para niños. CONCLUSIÓN: la relación FPM-IMC puede utilizarse para predecir la presencia de obesidad sarcopénica en niños y niñas, lo que puede desempeñar un papel en las intervenciones de salud pediátrica


Assuntos
Humanos , Masculino , Feminino , Criança , Força da Mão/fisiologia , Obesidade/diagnóstico , Sarcopenia/diagnóstico , Tecido Adiposo , Composição Corporal , Índice de Massa Corporal , Obesidade/fisiopatologia , Sarcopenia/fisiopatologia , Impedância Elétrica , Músculo Esquelético/fisiologia , Sarcopenia
16.
ABCS health sci ; 45: [1-6], 02 jun 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1097558

RESUMO

INTRODUCTION: Pregnancy-related diseases have aggravated the situation of postpartum women, who end up using Mechanical Ventilation (MV) when admitted to Intensive Care Units (ICU). Although MV has benefits, it is associated with deleterious effects that can be minimized with the use of Electrical Impedance Tomography (EIT). OBJECTIVE: The aim was to analyze the epidemiological profile and ventilatory parameters of mothers, which developed HELLP Syndrome, sepsis and/or Acute Respiratory Distress Syndrome (ARDS), under MV and monitored with EIT. METHODS: The study was observational, cross-sectional, retrospective and prospective conducted between March and September 2018, using data collection forms filled from the database and sociodemographic, obstetric and ventilatory records of postpartum women admitted to adult ICU. RESULTS: The sample consisted of 13 postpartum women, 8 with sepsis (61.5%), 7 with HELLP syndrome (53.8%) and 4 with ARDS (30.8%). Five patients (38.5%) evolved with more than one of these conditions. Regarding the ventilatory parameters evaluated, VT 378.9 (±103.9) mL were observed and mean values found for PEEP 9.8 (±1.9) cmH2O and driving pressure 11.1 (±1.4) cmH2O are below recommendations in the literature, predicting lower mortality and morbidity index. CONCLUSION: The relevance of the driving pressure assessment in the MV setting was demonstrated, a parameter assessed by the EIT and directly related to static lung compliance (Cstat), PEEP, VT and optimization of regional pulmonary ventilation. It is highlighted the need for future research with greater clinical significance regarding the profile of postpartum women about the increasingly frequent diseases in this population.


INTRODUÇÃO: As doenças relacionadas à gravidez tem agravado o quadro de puérperas, que acabam fazendo uso de Ventilação Mecânica (VM) quando internadas em Unidades de Terapia Intensiva (UTI). A VM, apesar de trazer benefícios, está associada a efeitos deletérios que podem ser minimizados com o uso da Tomografia por Impedância Elétrica (TIE). OBJETIVO: Analisar o perfil epidemiológico e parâmetros ventilatórios de puérperas que evoluíram com Síndrome HELLP, Sepse e/ou Síndrome do Desconforto Respiratório Agudo (SDRA), sob VM e monitoradas com a TIE. MÉTODOS: Estudo observacional, transversal retrospectivo e prospectivo, realizado entre março e setembro de 2018, por meio de fichas de coletas preenchidas a partir de banco de dados/prontuários sociodemográficos, obstétricos e ventilatórios de puérperas internadas em UTI. RESULTADOS: Amostra composta por 13 puérperas, oito com Sepse (61,5%), sete com Síndrome HELLP (53,8%) e quatro com SDRA (30,8%), demonstrando que cinco (38,5%) pacientes evoluíram com mais de uma dessas patologias. Acerca dos parâmetros ventilatórios avaliados, observou-se VT 378.9 (± 103.9) e que valores médios encontrados para PEEP 9.8 (±1.9) e driving pressure 11.1 (±1.4) estão abaixo dos preconizados pela literatura, predizendo menores índices de mortalidade e morbidade. CONCLUSÃO: Demonstrou-se relevância da avaliação de driving pressure no cenário da VM, parâmetro avaliado por meio da TIE e diretamente relacionado à Cst, PEEP, VT e otimização da ventilação pulmonar regional. Destaca-se a necessidade de pesquisas futuras que apresentem maiores significâncias clínicas voltadas ao perfil de puérperas em relação às doenças cada vez mais frequentes nesta população.


Assuntos
Humanos , Feminino , Gravidez , Complicações Infecciosas na Gravidez , Síndrome do Desconforto Respiratório do Adulto , Síndrome HELLP , Período Pós-Parto , Respiração Artificial , Perfil de Saúde , Impedância Elétrica , Unidades de Terapia Intensiva
17.
Arch Endocrinol Metab ; 64(3): 257-268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555992

RESUMO

OBJECTIVE: To assess the utility of bioimpedance (BIA) and skinfolds thickness (SF) in body fat percentage measuring (%BF) compared to the reference method dual-energy x-ray absorptiometry (DXA) in Brazilian reproductive age women, as well as to estimate of inter- and intra-observer precision for SF. SUBJECTS AND METHODS: 170 women aged 18-37 years with BMI between 18 and 39.9 kg/m2 were selected for this cross-sectional study. Body density was evaluated through equations proposed by Jackson, Pollock and Ward (1980) (EqJPW) and Petroski (1995) (EqPET), and %BF was estimated by BIA, DXA and Siri's formula (1961). The SF were measured by two separate observers: A and B (to determine inter-observer variability), who measured the folds at three times with 10-minute interval between them (to determine intra-observer variability - we used only observer A). RESULTS: The %BF by DXA was higher than those measured by SF and BIA (p<0.01, for all) of 90 volunteers. The Lin coefficient of agreement was considered satisfactory for %BF values obtained by EqJPW and BIA (0.55) and moderate (0.76) for sum of SF (ΣSF) values obtained by EqJPW and EqPET. No agreement was observed for the values obtained by SF (EqJPW and EqPET), BIA and DXA. Analysis of inter- and intra-observer of 59 volunteers showed that different measures of SF thickness met acceptability standards, as well as the % BF. CONCLUSION: BIA and SF measurements may underestimate %BF compared with DXA. In addition, BIA and SF measurements are not interchangeable with DXA. However, our results suggest the equation proposed by Jackson, Pollock and Ward (three skinfolds) compared to BIA are interchangeable to quantify the %BF in Brazilian women in reproductive age. Furthermore, our results show acceptable accuracy for intra- and inter-observer skinfold measurements. Arch Endocrinol Metab. 2020;64(3):257-68.


Assuntos
Absorciometria de Fóton , Tecido Adiposo/anatomia & histologia , Antropometria/métodos , Composição Corporal , Impedância Elétrica , Pregas Cutâneas , Adolescente , Adulto , Análise de Variância , Estudos Transversais , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Adulto Jovem
18.
PLoS One ; 15(6): e0231604, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530912

RESUMO

BACKGROUND: Bioelectrical impedance vector analysis (BIVA) has been used for prediction of muscle performance. However, little is known about BIVA in Asian adults, and even less is known about using standing BIVA devices. Standing impedance analyzer allows quicker and more convenient way to gather data than conventional supine analyzer and is more suitable for clinical practice. This study aimed to investigate the relations between muscle function and BIVA parameters measured with a standing impedance analyzer in healthy Taiwanese adults. METHODS: A total of 406 healthy subjects (age 34.5 ± 17.3 years, body mass index 24.1 ± 4.1 kg/m2) were recruited for BIVA and handgrip strength (HGS) measurements. Impedance parameters, including resistance (R) and reactance (Xc), were measured and normalized to body size by dividing by height (H). The resulting phase angle (PhA) was calculated. HGS in the dominant, left, and right hands were referred to as HGSDH, HGSLH, and HGSRH, respectively. All subjects were divided into 5 grades according to HGS. RESULTS: Muscle strength in the dominant, right, and left arms was correlated with variables in the order of sex, weight, age, height, Xc/H, and R/H (all, p < 0.001). Using all 6 variables, the determination coefficients were 0.792, 0.782, and 0.745, respectively, whereas the standard errors of estimates were 56.89, 58.01, and 56.67 N for HGSDH, HGSLH, and HGSRH, respectively. HGS was positively correlated with PhA, and negatively correlated with Xc/H and R/H. CONCLUSIONS: BIVA parameters measured with a standing impedance analyzer and anthropometric variables can predict and discriminate muscle function with good performance in healthy Asian adults.


Assuntos
Músculo Esquelético/fisiologia , Adulto , Fatores Etários , Composição Corporal , Índice de Massa Corporal , Análise Discriminante , Impedância Elétrica , Feminino , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
19.
Eur J Paediatr Dent ; 21(2): 143-147, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32567946

RESUMO

AIM: The aim of the present study was to evaluate the anthropometric parameters and the body composition through bioelectrical impedance analysis on paediatric subjects with dental agenesis. MATERIALS AND METHODS: The study was conducted on 144 subjects (58.3% females and 41.7% males), aged 7-14 years (average age 10.22±2.53 years). Each patient underwent a dental check-up at the Paediatric Dentistry Unit, University of Rome Tor Vergata (Italy) and a nutritional evaluation, aimed at analysing the anthropometric characteristics and evaluating the indices of body composition through bioelectrical impedance analysis (BIA) at the Human Nutrition Unit, University of Rome Tor Vergata. The sample was divided into three groups: a group with single agenesis (Group 1), a group with multiple agenesis (Group 2) and a control group (Group A). Using the predictive equations, the following values were evaluated: resistance (R), reactance (Xc), phase angle (PHA), body cell mass index (BCMI), body cell mass (BCM), total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass (FM), fat free mass (FFM). STATISTICS: The Excel environment and the SAS System, version 9.3, were used for statistical analysis, providing a descriptive and parametric analysis of the sample. The values of the anthropometric parameters were expressed as mean ± standard deviation. For the statistical analysis of anthropometric parameters and body composition, analysis of variance (1-way ANOVA) was used, which allowed us to find differences and the Student's t-test to compare Groups 1, 2, and A. RESULTS: There is a significant difference in the resistance R value between the case group with single agenesis (Group 1) and the control group (Group A) (R, 710.28±72.46 vs 667.4±104.16, p=0.028), and the phase angle PHA between the case group with multiple agenesis (Group 2) and the control group (Group A) (PHA, 5.18±0.48 vs 5.85±1.05, p=0.028). The BCM% value shows a significant difference between both Group 1 and Group A (BCM%, 50.53 ± 3.29 vs 52.68 ± 4.74, p=0.016) and between Group 2 and Group A (BCM%, 49.25± 2.86 vs 52.68 ± 4.74, p=0.035). The TBW, ICW, ECW, FM, FFM values showed no significant differences between the various groups analysed. CONCLUSION: Body composition in subjects with dental agenesis presents a higher R, a consequently lower PHA and a lower BCM% compared to the control group. For the first time, the results highlighted the possible relationship between dental agenesis and body composition, measured through BIA.


Assuntos
Composição Corporal , Estado Nutricional , Adolescente , Índice de Massa Corporal , Criança , Impedância Elétrica , Feminino , Humanos , Itália , Masculino
20.
Nat Commun ; 11(1): 3024, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32541684

RESUMO

The canonical mechanistic model explaining potassium channel gating is of a conformational change that alternately dilates and constricts a collar-like intracellular entrance to the pore. It is based on the premise that K+ ions maintain a complete hydration shell while passing between the transmembrane cavity and cytosol, which must be accommodated. To put the canonical model to the test, we locked the conformation of a Kir K+ channel to prevent widening of the narrow collar. Unexpectedly, conduction was unimpaired in the locked channels. In parallel, we employed all-atom molecular dynamics to simulate K+ ions moving along the conduction pathway between the lower cavity and cytosol. During simulations, the constriction did not significantly widen. Instead, transient loss of some water molecules facilitated K+ permeation through the collar. The low free energy barrier to partial dehydration in the absence of conformational change indicates Kir channels are not gated by the canonical mechanism.


Assuntos
Canais de Potássio Corretores do Fluxo de Internalização Acoplados a Proteínas G/metabolismo , Potássio/metabolismo , Citosol/química , Citosol/metabolismo , Condutividade Elétrica , Impedância Elétrica , Canais de Potássio Corretores do Fluxo de Internalização Acoplados a Proteínas G/química , Canais de Potássio Corretores do Fluxo de Internalização Acoplados a Proteínas G/genética , Humanos , Transporte de Íons , Íons/química , Íons/metabolismo , Simulação de Dinâmica Molecular , Potássio/química , Conformação Proteica , Água/metabolismo
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