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1.
Medicine (Baltimore) ; 99(6): e19031, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028416

RESUMO

The study was designed to verify if mini-fluid challenge test is more reliable than dynamic fluid variables in predicting stroke volume (SV) and arterial pressure fluid responsiveness during spine surgery in prone position with low-tidal-volume ventilation.Fifty patients undergoing spine surgery in prone position were included. Fluid challenge with 500 mL of colloid over 15 minutes was given. Changes in SV and systolic blood pressure (SBP) after initial 100 mL were compared with SV, pulse pressure variation (PPV), SV variation (SVV), plethysmographic variability index (PVI), and dynamic arterial elastance (Eadyn) in predicting SV or arterial pressure fluid responsiveness (15% increase or greater).An increase in SV of 5% or more after 100 mL predicted SV fluid responsiveness with area under the receiver operating curve (AUROC) of 0.90 (95% confidence interval [CI], 0.82 to 0.99), which was significantly higher than that of PPV (0.71 [95% CI, 0.57 to 0.86]; P = .01), and SVV (0.72 [95% CI, 0.57 to 0.87]; P = .03). A more than 4% increase in SBP after 100 mL predicted arterial pressure fluid responsiveness with AUROC of 0.86 (95% CI, 0.71-1.00), which was significantly higher than that of Eadyn (0.52 [95% CI, 0.33 to 0.71]; P = .01).Changes in SV and SBP after 100 mL of colloid predicted SV and arterial pressure fluid responsiveness, respectively, during spine surgery in prone position with low-tidal-volume ventilation.


Assuntos
Pressão Sanguínea , Monitorização Intraoperatória/métodos , Posicionamento do Paciente , Medula Espinal/cirurgia , Volume Sistólico , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia/métodos , Decúbito Ventral , Estudos Prospectivos , Adulto Jovem
2.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(12): 1153-1158, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31874651

RESUMO

OBJECTIVE: To study the effect of bronchopulmonary dysplasia (BPD) on lung function in preterm infants. METHODS: According to the presence/absence or the severity of BPD, 72 preterm infants were divided into non-BPD group (n=44), mild BPD group (n=15) and moderate BPD group (n=13). Lung function was assessed by plethysmography on days 7, 14 and 28 after birth. RESULTS: The preterm infants in the three groups had gradual increases in tidal volume per kilogram (TV/kg), functional residual capacity (FRC), ratio of time to peak tidal expiratory flow to total expiratory time (%T-PF) and ratio of volume to peak tidal expiratory flow to total expiratory volume (%V-PF) on days 7, 14 and 28 after birth, while there were gradual reductions in effective airway resistance per kilogram (Reff/kg) and respiratory rate (RR) (P<0.05). Compared with the non-BPD group on days 7, 14 and 28 after birth, the mild and moderate BPD groups had significantly lower TV/kg, FRC, %T-PF, and %V-PF and significantly higher Reff/kg and RR (P<0.05). On day 7 after birth, the moderate BPD group had significantly higher airway resistance, Reff/kg and FRC/kg than the mild BPD group (P<0.05). CONCLUSIONS: There is a certain degree of pulmonary function impairment in preterm infants with BPD. Dynamic monitoring of lung function by plethysmography is useful for assessing lung development in the neonatal period in these infants.


Assuntos
Displasia Broncopulmonar , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Pulmão , Pletismografia , Testes de Função Respiratória
3.
Rev Assoc Med Bras (1992) ; 65(10): 1283-1289, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721960

RESUMO

Body composition assessment at the molecular level is relevant for the athletic population and its association with high performance is well recognized. The four-compartment molecular model (4C) is the reference method for fat mass (FM) and fat-free mass (FFM) estimation. However, its implementation in a real context is not feasible. Coaches and athletes need practical body composition methods for body composition assessment, and the bioelectrical impedance analysis method (BIA) is usually seen as a useful alternative. The aim of this study was to test the validity of BIA (Tanita, TBF-310) to determine the FM and FFM of elite judo athletes. A total of 29 males were evaluated in a period of weight stability using the reference method (4C) and the alternative method (Tanita, TBF-310). Regarding the 4C method, total-body water was assessed by deuterium dilution, bone mineral by DXA, and body volume by air displacement plethysmography. The slops and intercepts differed from 1 (0.39 and 1.11) and 0 (4.24 and -6.41) for FM and FFM, respectively. FM from Tanita TBF-310 overestimated the 4C method by 0.2 kg although no differences were found for FFM. Tanita TBF-310 explained 21% and 72% respectively in the estimation of absolute values of FM and FFM from the 4C method. Limits of agreement were significant, varying from -6.7 kg to 7.0 kg for FM and from -8.9 kg to 7.5 kg for FFM. In conclusion, TBF-310 Tanita is not a valid alternative method for estimating body composition in highly trained judo athletes.


Assuntos
Atletas , Composição Corporal , Artes Marciais/fisiologia , Modelos Moleculares , Pletismografia/instrumentação , Adolescente , Adulto , Impedância Elétrica , Humanos , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
4.
Nutr. hosp ; 36(5): 1189-1195, sept.-oct. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184644

RESUMO

High altitude mountaineering is characterized by high energetic requirements due to the environment in which the activity is developed: negative energy balance, extreme cold, high altitude and the assumption of potential risks can be found during the practice of this sport. High altitude mountaineering, as a result of the previous factors, induces changes in body composition which have never been studied previously in a systematic review. A search within four different databases (PubMed, SportDiscus, Scopus and Medline) was performed using the thesaurus terms "Mountaineering" and "Body composition". A second search was performed using the following terms "Altitude" and "Body composition". The selection criteria included studies with healthy adults which evaluated the effects of at least 14 days of uninterrupted stays at altitudes above 4,000 m. The studies included in the review assessed body composition through different methods such as anthropometry, bioimpedance, dual energy x-ray absorptiometry, hydrostatic weighing and air displacement plethysmography. The search was performed up to and including December 1st 2018. Eleven observational studies met the inclusion criteria. All studies reported weight loss, of which five reported significant reductions in lean mass and six reported reductions in fat mass. Also, three studies reported reductions in both fat mass and lean mass. Current evidence is limited to observational studies with important confounding factors affecting the final conclusions. Longitudinal studies with a better methodological design and control groups are needed in order to verify these results


El alpinismo a grandes altitudes se caracteriza por elevados requerimientos energéticos debido al ambiente en el que se desarrolla la actividad: los balances energéticos negativos, el frío extremo, la exposición a la altitud o niveles de estrés elevados se pueden observar en la práctica de este deporte. Debido a estos factores, el alpinismo de altitud induce cambios en la composición corporal que no se han estudiado previamente en una revisión sistemática. Se realizó una búsqueda en cuatro bases de datos (PubMed, SportDiscus, Scopus and Medline) con los términos Mesh "Mountaineering" y "Body composition". Una segunda búsqueda se realizó usando los términos "Altitude" y "Body composition". Los criterios de selección incluyeron estudios con adultos sanos que evaluaron los efectos de estancias de al menos 14 días ininterrumpidos en altitudes superiores a los 4.000 m. La composición corporal se analizó con diferentes métodos como antropometría, bioimpedancia, absorciometría dual de rayos x, pesada hidrostática y pletismografía por desplazamiento de aire. La búsqueda se realizó incluyendo estudios fechados hasta el 1 de diciembre de 2018. Once estudios observacionales cumplieron con los criterios de inclusión. Todos los estudios reportaron pérdida de peso, de los cuales cinco reportaron reducciones en masa magra; seis, reducciones en masa grasa; y tres, reducciones en ambas. La evidencia actual se limita a estudios observacionales con factores de confusión importantes que afectan a los resultados finales. Se necesitan estudios longitudinales con mejor diseño metodológico y grupo control para verificar estos resultados


Assuntos
Humanos , Montanhismo/fisiologia , Composição Corporal/fisiologia , Altitude , Necessidade Energética/fisiologia , Antropometria , Absorciometria de Fóton , Pletismografia , Necessidades Nutricionais , Análise Qualitativa
6.
Br J Radiol ; 92(1103): 20190300, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31430175

RESUMO

OBJECTIVE: To validate MRI fat measurement protocols using purpose built test objects and by comparison with air-displacement plethysmography (ADP) whole-body fat measurements in non-obese subjects. METHODS: Test objects of known fat concentration were used to quantify the accuracy of the MRI measurements. 10 participants with a body mass index in the range 18-30 underwent whole-body MRI using two different Dixon-based sequences (LAVA Flex and IDEAL IQ) to obtain an estimate of their whole-body fat mass. The MRI determined fat mass was compared to the fat mass determined by ADP. RESULTS: MRI test object measurements showed a high correlation to expected fat percentage (r > 0.98). The participant MRI and ADP results were highly correlated (r = 0.99) but on average (mean ± standard deviation) MRI determined a higher fat mass than ADP (3.8 ± 3.1 kg for LAVA Flex and 1.9 ± 3.2 kg for IDEAL IQ). There was no trend in the difference between MRI and ADP with total fat mass. CONCLUSION: The good agreement between MRI and ADP shows that Dixon-based MRI can be used effectively as a tool in physiological research for non-obese adults. ADVANCES IN KNOWLEDGE: This work found that for ten non-obese subjects body mass index had no effect on the MRI determination of whole-body fat mass.


Assuntos
Tecido Adiposo/anatomia & histologia , Índice de Massa Corporal , Adulto , Ar , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pletismografia/métodos
7.
Int Heart J ; 60(4): 854-861, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31257335

RESUMO

The aim of this single-arm pilot study was to determine the effects of whole-body vibration training (WBVT) on endothelial function in elderly patients with cardiovascular diseases, as well as its safety. A total of 20 elderly patients with stable cardiovascular diseases underwent WBVT, which consisted of five static resistance training exercises (squats, wide stance squats, toe-stands, squats + band, and front lunges). The parameters of WBVT included vertical vibrations, 30 Hz frequency, and a 3-mm peak-to-peak amplitude. Each vibration session lasted 30 seconds, with 120 seconds of rest between sessions. Before and after WBVT, the reactive hyperemia peripheral arterial tonometry index (RH-PAT index) and transcutaneous oxygen pressure (tcPO2) were recorded as a measure of endothelial function and peripheral blood circulation. Systolic blood pressure, diastolic blood pressure, heart rate, and arterial oxygen saturation of pulse oximetry (SpO2) were measured at each rest interval as well as before and after WBVT. All patients completed our WBVT protocol without adverse events. The RH-PAT index significantly increased following WBVT (1.42 to 2.06, P < 0.001). There were no significant changes in heart rate (P = 0.777), systolic blood pressure (P = 0.183), diastolic blood pressure (P = 0.925), or SpO2 (P = 0.248) during WBVT. In conclusion, we demonstrated the acute effects of WBVT on endothelial function, with no reports of adverse events. These findings support the need for further randomized controlled studies to investigate the long-term effects of WBVT.


Assuntos
Artérias/fisiopatologia , Doenças Cardiovasculares/terapia , Endotélio Vascular/fisiopatologia , Modalidades de Fisioterapia/instrumentação , Vasodilatação/fisiologia , Idoso , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/fisiopatologia , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Força Muscular/fisiologia , Projetos Piloto , Pletismografia , Estudos Retrospectivos , Resultado do Tratamento , Vibração
8.
Einstein (Sao Paulo) ; 17(3): eAO4419, 2019 May 30.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31166483

RESUMO

OBJECTIVE: To compare tissue composition, total and regional bone mineral content and bone mineral density, static hand grip and knee joint isokinetic strength between amateur soccer players and Control Group. METHODS: Cross-sectional study. Air displacement plethysmography was used to estimate body volume and, in turn, density. Body composition, bone mineral content and bone mineral density were assessed for the whole body and at standardized regions using dual energy X-ray absorptiometry. Static grip strength was assessed with an adjustable dynamometer, and peak torque derived from isokinetic strength dynamometer (concentric muscular knee actions at 60°/s). Magnitude of the differences between groups was examined using d-Cohen. RESULTS: Compared to healthy active adults, soccer players showed larger values of whole body bone mineral content (+651g; d=1.60; p<0.01). In addition, differences between groups were large for whole body bone mineral density (d=1.20 to 1.90; p<0.01): lumbar spine, i.e. L1-L4 (+19.4%), upper limbs (+8.6%) and lower limbs (+16.8%). Soccer players attained larger mean values in strength test given by static hand grip protocol (+5.6kg, d=0.99; p<0.01). CONCLUSION: Soccer adequately regulates body composition and is associated better bone health parameters (bone mineral content and density at whole-body and at particular sites exposed to mechanical loadings).


Assuntos
Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Articulação do Joelho/fisiologia , Força Muscular/fisiologia , Futebol/fisiologia , Absorciometria de Fóton , Adolescente , Adulto , Atletas , Estudos Transversais , Força da Mão/fisiologia , Humanos , Extremidade Inferior/fisiologia , Masculino , Dinamômetro de Força Muscular , Pletismografia/métodos , Valores de Referência , Estatísticas não Paramétricas , Extremidade Superior/fisiologia , Adulto Jovem
9.
J Bras Pneumol ; 45(3): e20180065, 2019 May 30.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31166555

RESUMO

OBJECTIVE: To derive reference values for healthy white Brazilian adults who have never smoked and to compare the obtained values with reference values derived by Crapo and by Neder. METHODS: Reference equations by quantile regressions were derived in 122 men and 122 women, non-obese, living in seven cities in Brazil. Age ranged from 21 to 92 years in women and from 25 to 88 years in men. Lung function tests were performed using SensorMedics automated body plethysmographies according ATS/ERS recommendations. Lower and upper limits were derived by specific equations for 5 and 95 percentiles. The results were compared to those suggested by Crapo in 1982, and Neder in 1999. RESULTS: Median values for total lung capacity (TLC) were influenced only by stature in men, and by stature and age in women. Residual volume was influenced by age and stature in both genders. Weight was directly related to inspiratory capacity and inversely with functional residual capacity and expiratory reserve volume in both genders. A comparison of observed TLC data with values predicted by Neder equations showed significant lower values by the present data. Mean values were similar between data from present study and those derived by Crapo. CONCLUSION: New predicted values for lung volumes were obtained in a sample of white Brazilians. The values differ from those derived by Neder, but are similar to those derived by Crapo.


Assuntos
Medidas de Volume Pulmonar/métodos , Pulmão/fisiologia , Pletismografia/métodos , Capacidade Pulmonar Total/fisiologia , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Testes de Função Respiratória , Fatores Sexuais , Adulto Jovem
10.
Vestn Oftalmol ; 135(2): 55-61, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31215535

RESUMO

PURPOSE: To evaluate the properties of the microvasculature of bulbar conjunctiva and to assess the function of endothelium of the main arteries in type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: The study included 35 patients with T1DM and initial nonproliferative diabetic retinopathy (NPDR). The control group consisted of 30 subjects. In addition to standard ophthalmic examination, all participants underwent digital bulbar capillaroscopy (DBC), pulse wave velocity (PWV) test, and plethysmography for assessment of endothelium function. RESULTS: According to DBC, in comparison to the control group, diabetic patients with even initial NPDR had disturbances of blood microcirculation manifested as increased average venous vessel width (p=0.04), reduced arterial capillary blood flow (p=0.02), increased blood sludging (p=0.001), and increased duration of blood stasis (p=0.03). Evaluation of vessel endothelium in T1DM patients with NPDR showed increased PWV (p=0.03). CONCLUSION: Diabetic patients with NPDR showed marked changes of capillary blood flow alongside signs of endothelial dysfunction. The most significant change was increased venous vessel width.


Assuntos
Diabetes Mellitus Tipo 1 , Retinopatia Diabética , Endotélio , Humanos , Microcirculação , Angioscopia Microscópica , Pletismografia , Análise de Onda de Pulso
11.
Am J Clin Nutr ; 109(5): 1353-1360, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31051509

RESUMO

BACKGROUND: Air-displacement plethysmography (ADP) is a good candidate for monitoring body composition in newborns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first 6 mo of life. OBJECTIVE: Using pooled data from 4 studies, we aimed to produce new charts for assessment according to gestational age at birth (30 + 1 to 41 + 6 wk) and postnatal age at measurement (1-27 wk). METHODS: The sample comprised 222 preterm infants born in the United States who were measured at birth; 1029 term infants born in Ireland who were measured at birth; and 149 term infants born in the United States and 57 term infants born in Italy who were measured at birth, 1 and 2 wk, and 1, 2, 3, 4, 5, and 6 mo of age. Infants whose birth weights were <3rd or >97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. RESULTS: For each sex and measure (e.g., fat mass), the new charts comprised 2 panels. The first showed centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reached term. The second showed centiles according to postnatal age, allowing all infants to be monitored to age 27 wk. The LMS values underlying the charts were presented, enabling researchers and clinicians to convert measurements to centiles and z scores. CONCLUSIONS: The new charts provide a single tool for the assessment of body composition, according to ADP, in infants across the first 6 mo of life and will help enhance early-life nutritional management.


Assuntos
Tecido Adiposo , Peso ao Nascer , Composição Corporal , Compartimentos de Líquidos Corporais , Idade Gestacional , Recém-Nascido Prematuro , Pletismografia/métodos , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Lactente , Recém-Nascido , Irlanda , Itália , Masculino , Valores de Referência
12.
Int Rev Psychiatry ; 31(2): 126-140, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31074664

RESUMO

Penile plethysmography (PPG) is the primary physiologic assessment method used to gauge sexual responses in adult men. Depending on the country or jurisdiction of assessment, stimuli used to elicit arousal can include videos, still images, and audio materials. It can depict a variety consenting and non-consenting sexual scenarios as well as neutral, non-sexual scenarios. Models in visual stimuli can be clothed, semi-clothed, or nude. Variation in stimuli modality and the type of sexual interest being tested can have a large impact on PPG outcomes. This paper reviews research on types of PPG stimuli, the different sexual interests being assessed, reliability and validity, and the impact of anonymizing models depicted in assessment materials. Innovations in stimuli development in three labs located in Canada, the United States, and the Czech Republic are also discussed. The work done in these three labs and the broader range of research on assessment stimuli are presented to highlight the need for a unified, multi-site, standardized approach to assess problematic sexual interests and their change in response to treatment.


Assuntos
Nível de Alerta/fisiologia , Transtornos Parafílicos/diagnóstico , Fotografação , Comportamento Sexual/psicologia , Gravação de Videoteipe , Adulto , Canadá , República Tcheca , Humanos , Masculino , Transtornos Parafílicos/psicologia , Pênis/irrigação sanguínea , Pletismografia/normas , Comportamento Sexual/fisiologia , Estados Unidos
13.
PLoS One ; 14(5): e0207978, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31091240

RESUMO

BACKGROUND: Being born small for gestational age (SGA) or large for gestational age (LGA) has short and long term metabolic consequences. There is a growing interest in the extent to which body composition, both in the short and the long term, differs in infants born at the extremes of these birth weights. METHODS: Body composition in 25 SGA and 25 LGA infants were assessed during the first days of life and at 3-4 months of age using air displacement plethysmography. RESULTS: SGA infants had significantly lower body fat (%) at birth compared to LGA infants. SGA infants increased their body weight and length at a significantly higher rate between birth and 3-4 months than LGA infants. Fat mass (g) in SGA infants increased 23 times between birth and 3-4 months of age compared to 2.8 times for LGA infants. At 3-4 months of age LGA infants reached a threshold in body fat (%) while SGA infants were still gaining body fat (%). CONCLUSION: Several significant differences have been identified between SGA and LGA infants, indicating that the effects of intrauterine life continues to play an important role in body composition and growth during the first 3-4 months of life.


Assuntos
Composição Corporal , Desenvolvimento Infantil , Criança Pós-Termo , Recém-Nascido Pequeno para a Idade Gestacional , Antropometria , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Masculino , Pletismografia , Gravidez , Suécia , Ganho de Peso
14.
J Nutr Sci ; 8: e19, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143445

RESUMO

Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m2 were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium (2H) diluted water (D2O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D2O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D2O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI -0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D2O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.


Assuntos
Antirretrovirais/efeitos adversos , Composição Corporal/efeitos dos fármacos , Suplementos Nutricionais , Infecções por HIV/complicações , Força da Mão , Adolescente , Adulto , Idoso , Antirretrovirais/uso terapêutico , Índice de Massa Corporal , Contagem de Linfócito CD4 , Deutério , Impedância Elétrica , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lipídeos/administração & dosagem , Lipídeos/uso terapêutico , Masculino , Desnutrição/complicações , Desnutrição/dietoterapia , Pessoa de Meia-Idade , Minerais/administração & dosagem , Minerais/uso terapêutico , Pletismografia , Tanzânia , Resultado do Tratamento , Vitaminas/administração & dosagem , Vitaminas/uso terapêutico , Adulto Jovem , Zâmbia
15.
Ter Arkh ; 91(1): 60-63, 2019 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-31090373

RESUMO

AIM: To assess the functional status of the small Airways in patients with bronchial asthma associated with obesity, by body plethysmography. MATERIALS AND METHODS: 65 patients with bronchial asthma of mild severity, partially controlled course, including 30 patients with normal body weight and 35 patients with obesity of I degree were examined. Control group-30 healthy volunteers. Examined forced vital capacity (FVC), forced expiratory volume in first second (FEV1) ratio of FEV1 to FVC (FEV1/FVC), maximum volumetric exhalation rate after 25.50 and 75% FVC (MEF75, MEF50, MEF25), average flow velocity in the exhalation interval 25-75% of FVC (MMEF25-75). Method bodyplethysmography was evaluated in bronchial resistance, functional residual capacity (FRC), residual volume of the lungs (RV), total lung capacity (TLC), the percentage of RV/TLC. RESULTS: Patients with bronchial asthma with obesity showed a reduction of indicators of bronchial obstruction: FEV1 of 14% (p=0.02), FEV1/FVC by 14% (p=0.001), MEF75 30% (p=0.001), MEF50 by 35% (p=0.001), MEF25 by 44% (p=0.003), MMEF25-75 by 38% (p=0.001). The increase of bronchial resistance on inhalation in 2 times (p=0.001), on exhalation in 3.3 times (p=0.003) was found, which is typical for generalized bronchial obstruction at the proximal level. An increase in RV by 24% (p=0.03), TLC - by 9% (p=0.03), RV/TLC - by 18% (p=0.03), indicating the presence of "air traps" and dysfunction of the small respiratory tract. CONCLUSION: In patients with asthma of mild severity associated with obesity, both the central bronchis and the distal lung are affected, which are manifested by generalized bronchial obstruction, the formation of "air traps" and dysfunction of the small respiratory tract.


Assuntos
Asma/fisiopatologia , Obesidade/complicações , Capacidade Pulmonar Total/fisiologia , Asma/complicações , Estudos de Casos e Controles , Volume Expiratório Forçado/fisiologia , Humanos , Pletismografia/métodos , Capacidade Vital/fisiologia
16.
Int Rev Psychiatry ; 31(2): 114-125, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30938553

RESUMO

This article provides a comparison and comprehensive analysis of varied approaches to the assessment of sexual interest and behaviours at different international sexual behaviour assessment labs. The assessment protocols are described for four sexual behaviour laboratories: the Royal Ottawa Mental Health Centre's Sexual Behaviours Clinic in Canada; the Medical University of South Carolina's Sexual Behaviours Clinic and Laboratory in the US; the Laboratory of Evolutionary Sexology and Psychopathology in the Czech Republic; and the Laboratory of Forensic Sexology in Russia. An overview of examinee demographics and types of cases assessed is provided for each lab. Assessment protocols, including psychometric measures and objective measures of sexual interest and arousal, such as penile plethysmography or eye-tracking, are also reviewed. The differences across labs may lead to interesting and productive cross-cultural investigations and studies about the efficacy of specific assessment methods.


Assuntos
Comparação Transcultural , Internacionalidade , Transtornos Parafílicos/diagnóstico , Pletismografia , Comportamento Sexual/psicologia , República Tcheca , Psiquiatria Legal/legislação & jurisprudência , Humanos , Masculino , América do Norte , Transtornos Parafílicos/psicologia , Pênis/irrigação sanguínea , Psicometria , Federação Russa
17.
PLoS One ; 14(3): e0213773, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30889207

RESUMO

BACKGROUND: Chest physiotherapy can be an alternative to increase lung volumes through pulmonary expansion therapies, but there is still inconsistency in the literature in order to determine which device can promote a greater volume increase at the expense of a better ventilatory pattern. Therefore, the aim of this study was to evaluate and compare the chest wall kinematics of healthy subjects submitted to the use of three different devices for pulmonary reexpansion. METHODS: Chest wall compartmental and operational volumes, breathing pattern and thoracoabdominal asynchrony were evaluated in 12 healthy individuals through optoelectronic plethysmography during quiet breathing, pulmonary reexpansion and recovery. Three different devices (volume-oriented incentive spirometer-IS-v; positive expiratory pressure-PEP; and incentive spirometer volume and pressure oriented-IS-vp) were administered in a random order with at least 48h between the devices. RESULTS: A greater volume variation in the chest wall and its compartments was observed when the IS-vp was used in comparison with the other devices (p<0.05). Furthermore, the IS-vp mobilizes a greater amount of volume accompanied by greater synchronism between the compartments when compared to IS-v (p <0.05). CONCLUSION: The IS-vp may be able to increase total and compartmental chest wall volumes, as well as improve synchrony among compartments when compared to IS-v and PEP devices, thus constituting an important tool for treating patients with restrictive ventilatory pattern.


Assuntos
Pletismografia/métodos , Espirometria/métodos , Volume de Ventilação Pulmonar/fisiologia , Adolescente , Adulto , Estudos Cross-Over , Feminino , Humanos , Masculino , Respiração , Músculos Respiratórios/fisiologia , Parede Torácica/fisiologia , Adulto Jovem
18.
Br J Anaesth ; 123(2): e328-e332, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30916030

RESUMO

BACKGROUND: Reported outcome benefits after surgical pleth index (SPI, GE Healthcare, Helsinki, Finland) guided anaesthesia are conflicting. One potential explanation may be the lack of evidence for the selection of meaningful SPI target values. A recently published trial found an SPI cut-off of 30 as a 'best-fit' to predict moderate-to-severe acute postoperative pain. This prospective trial was designed to validate this target and to investigate the influence of patient age on SPI in this context. METHODS: After ethics approval, 200 patients undergoing non-emergency surgery were enrolled. Data related to SPI, heart rate (HR), and mean arterial pressure (MAP) were recorded for the last 5 min of surgery, just before arousal. After admission to recovery, pain scores (numeric rating scale [NRS], 0-10) were obtained every 5 min for 15 min. RESULTS: The data of 196 patients were analysed. Receiver-operating curve analysis showed a cut-off SPI value of 29 to be the optimum intraoperative target to discriminate between NRS 0-3 and 4-10. This confirms the 'best fit' cut-off for SPI published previously. Though still superior to HR and MAP, the sensitivity and specificity of the SPI were only poor. Age had no influence on the predictive accuracy of SPI. CONCLUSIONS: An SPI of approximately 30 was confirmed as having the best sensitivity/specificity to predict moderate-to-severe pain in the postanaesthesia care unit. However, the predictive accuracy was overall poor and not influenced by patient age. CLINICAL TRIAL REGISTRATION: ACTRN12617001475336.


Assuntos
Frequência Cardíaca/fisiologia , Monitorização Intraoperatória/métodos , Dor Pós-Operatória/diagnóstico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/fisiopatologia , Pletismografia , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Adulto Jovem
19.
Nutr Hosp ; 36(1): 73-79, 2019 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-30834758

RESUMO

Introduction: Introduction: nutritional status is an important predictor of prognosis in chronic kidney disease (CKD), including pre-dialysis. Anthropometric measures universally used for the diagnosis of obesity in the general population may not present the same performance in individuals with CKD. Objective: to verify the sensitivity and specificity of body mass index (BMI) in relation to the percentage of body fat (%BF) obtained by dual energy X-ray absorptiometry (DEXA) and air displacement plethysmography (PDA) for patients with non-dialysis chronic kidney disease. Methods: BMI was obtained. DEXA and ADP were used to determine %BF and they were considered as gold standard methods. Results: a total of 78 patients were evaluated, with a mean age of 54.4 ± 13.9 years old. There was a higher prevalence of overweight/obesity (55.2%), according to BMI, and high %BF, according to DEXA (69.2%) and ADP (53.8%). BMI showed a statistically significant correlation with the %BF obtained by both methods and in both sexes (p < 0.05). To detect high %BF, a BMI of 25 kg/m2 had better sensitivity and specificity values for DEXA (73.3% and 66.7%, respectively) and ADP (77.3% and 52.9%, respectively) in men, and for DEXA (79.9% and 46.7%, respectively) in women. However, a BMI of 26 kg/m2 for ADP in women would be more accurate (70.0% and 73.7%, respectively). Conclusion: the prevalence of patients with excess body fat was high. The conventional cut-off points for BMI were not adequate in these patients and suggested that BMI ≥ 25 kg/m2 were more accurate for diagnosing obesity.


Assuntos
Índice de Massa Corporal , Obesidade/diagnóstico , Insuficiência Renal Crônica/complicações , Absorciometria de Fóton , Adiposidade , Adulto , Idoso , Estudos Transversais , Impedância Elétrica , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Pletismografia , Padrões de Referência , Sensibilidade e Especificidade
20.
Eur J Vasc Endovasc Surg ; 57(4): 570-577, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30898493

RESUMO

OBJECTIVES: Reflux assessment with ultrasound (U/S) is usually qualitative. Quantitative measurements of superficial venous insufficiency (SVI) include the venous arterial flow index (VAFI), recirculation index (RCI), venous filling index (VFI), and the postural diameter change (PDC) of the saphenous trunk. The aim was to investigate their relationship. MATERIALS AND METHODS: This was an observational study performed on patients with varicose veins and hospital employees. Four haemodynamic parameters were measured in 21 legs from 16 subjects. Legs were divided into no reflux (n = 7) and reflux (n = 14). The VAFI is the U/S ratio of common femoral vein volume flow divided by the common femoral artery volume flow, performed supine. The RCI is the U/S ratio of reflux volume over antegrade volume within the saphenous trunk after calf compression, standing. The VFI is the rate of calf volume increase on dependency measured in mL/s, using air plethysmography. The PDC is the percentage reduction of the saphenous trunk diameter from standing to lying, using U/S. RESULTS: The clinical part of the CEAP classification was: C0 = 3, C1 = 4, C2 = 5, C3 = 1, C4a = 1, C4b = 6, C5 = 1. All four tests demonstrated significant differences between the two groups with minimal overlap (Mann Whitney U test): VAFI (p = .028), RCI (p < .0005), VFI (p = .001), and PDC (p = .014). Furthermore, significant correlations were observed with the tests: VAFI vs. RCI (r = .532, p = .015), VFI (r = .489, p = .025) and PDC (r = -.474, p = .030); RCI vs. VFI (r = .446, p = .043) and PDC (r = -.527, p = .014). CONCLUSIONS: Superficial venous drainage insufficiency should not be confined to an U/S assessment of the presence of reflux, which is qualitative. Quantitative data may be provided using the VAFI, RCI, VFI, and PDC. Understanding why there are significant correlations among these parameters and the preferred objective reference test requires further work.


Assuntos
Hemodinâmica , Pletismografia , Veia Safena/diagnóstico por imagem , Ultrassonografia/métodos , Varizes/diagnóstico por imagem , Insuficiência Venosa/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Veia Safena/fisiopatologia , Índice de Gravidade de Doença , Varizes/fisiopatologia , Insuficiência Venosa/fisiopatologia
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