[Pulse Oximetry Values in Preterm infants at 34-36 weeks postmenstrual age]. / Valores de Oximetría de Pulso en Prematuros a las 34-36 semanas post-concepcional.

Pulse oximetry (SpO2) is essential for guiding oxygen therapy in preterm infants. Data on SpO2 values before discharge are limited. OBJECTIVE: To establish SpO2 values in asymptomatic premature infants at 34, 35, and 36 weeks of postmenstrual age (PMA). SUBJECTS AND METHOD: Longitudinal, multicen ter study carried out from May 2018 to May 2019 in three neonatal intensive care units in Santiago, Chile (altitude 579 m) which included premature infants born ≤ 32 weeks of gestational age, healthy, with clinical stability, and without respiratory morbidity at the moment of the study or until dis charge. The following parameters were analyzed: mean accumulated SpO2 and SD, minimum SpO2 value, SpO2 time percentage < 90%, SpO2 time percentage < 80%, DI4, and DI80. Continuous over night SpO2 was obtained with Masimo Radical-7 or Rad-8 (USA), mean artifact-free-recording-time (AFRT) ≥ 6 hours. RESULTS: 101 SpO2 recordings were registered in 44, 33, and 24 studies at 34, 35, and 36 weeks of PMA, respectively, from 62 preterm infants, twenty-eight (45%) were male, median gestational age at birth 30 weeks (range 26-32), and median birth weight 1480 g (range 785-2700g). Oximetry variables were mean AFRT (± SD) 8.6 (± 1.5) hours; median mean SpO2 96.9% (range 93.3-99.3%); median minimum SpO2 74% (range 51-89%); median time of SpO2 < 90% 2% (range 0-10.6%); median time of SpO2 < 80% 0.1% (range 0-1.3%); median desaturation event ≥ 4% (DI4) within ≥ 10 seconds per hour sampled 15 (range 3.5-62.5); and median desaturation event <80% (DI80) 0.58 (range 0-10.8). We found no differences in SpO2 values between the different PMA wee ks. CONCLUSIONS: We described SpO2 values in very preterm infants, asymptomatic at 34-36 PMA weeks. These values could be used as a reference for guiding oxygen therapy.

Technical Note: Comparative Study of Three Different Fecal Calprotectin Immunoassays: TriCAL Study.

OBJECTIVE: Calprotectin is a biomarker of gastrointestinal inflammation and disease activity. We aimed to evaluate the performance of a new fecal calprotectin (FC) test (CALiaGold®) in comparison with two other rapid FC immunoassays. METHODS: Fecal samples were analyzed with all three FC tests. Correlation between the FC tests was assessed. Agreement to discriminate FC-positive samples was also evaluated according to the manufacturers' cut-off values. RESULTS: A correlation coefficient of over 0.800 was found in all comparisons. Lower deviation of linearity was observed between immunoturbidimetric assays. Agreement on FC-positive sample detection was reduced in comparisons with the immunochromatographic assay. CONCLUSIONS: The CALiaGold® test showed good performance for FC assessment. Better correlation and agreement between immunoturbidimetric assays were confirmed.

Endocrine Modulation in Long-Term Karate Practitioners.

PURPOSE: Karate is a martial arts discipline which is widely practiced in the Western world as a form of self-defense, as well as a discipline to achieve physical and mental balance. However, little is known with respect to its specific psychobiological effects, particularly in relation to the influence that it may exert on the endocrine system. Thus, in the present study, we examined the effects of karate on several hormonal parameters of the Hypothalamic-Pituitary-Adrenal and Hypothalamic-Pituitary-Thyroid axes in long-time practitioners. METHODS: Twenty-two healthy volunteer subjects (12 experimental and 10 controls) participated in the study. Experimental subjects were karate players with a minimum of 3 years of practice in this discipline. Blood samples for the quantification of hormonal parameters were taken in both groups. The Mann-Whitney U test was performed for each variable in order to analyze the differences between groups. RESULTS: Statistically significant differences were found in cortisol and thyroid hormones, with the karate group showing lower levels of these hormones as compared to control. CONCLUSIONS: These findings, therefore, reveal that long-term karate practice is associated with a significant endocrine modulation, which suggests interesting psychobiological and clinical implications. Further research is needed to verify these preliminary results, as well as properly assessing its possible use as a psychosomatic intervention tool.

Definición de displasia broncopulmonar propuesta por la Comisión Neo SOCHINEP / Definition of bronchopulmonary dysplasia proposed by the Neo SOCHINEP Commission

La displasia broncopulmonar (DBP) es la enfermedad crónica más frecuente del recién nacido prematuro. Los avances en su prevención y tratamiento han permitido una mayor sobrevida de prematuros más pequeños, pero su incidencia se ha mantenido estable en el tiempo, con una fisiopatología y presentación clínica que abarca un amplio espectro y que difiere de la DBP descrita originalmente hace más de 50 años. Aún existen controversias en su definición, la que se ha establecido en base al tratamiento, específicamente al requerimiento de soporte respiratorio. Las definiciones más utilizadas son el requerimiento de oxígeno por 28 días y a las 36 semanas de edad gestacional corregida (EGC). Recientemente se ha propuesto definirla en base al requerimiento de ventilación mecánica a las 36 semanas de EGC, lo que identificaría a los prematuros con DBP más grave y mayor probabilidad de complicaciones respiratorias y neurológicas en los 2 primeros años de vida. Nuestro objetivo en la comisión de Neo-SOCHINEP es el de recomendar la definición y clasificación que nos parece más adecuada para identificar a los prematuros portadores de DBP, considerando los aspectos fisiopatológicos, del compromiso de la función pulmonar y consecuencias prácticas de la definición en nuestro medio. También proponemos la definición del requerimiento de oxígeno en el prematuro cuando esta en neonatología, las condiciones e interpretación de la saturometría contínua cuando está pronto al alta y el seguimiento de la oxigenoterapia posterior al alta.

Bronchopulmonary dysplasia (BPD) is the most frequent chronic disease of the premature newborn. Advances in its prevention and treatment have allowed a greater survival of smaller preterm infants, but its incidence has remained stable over time, with a pathophysiology and clinical presentation that covers a wide spectrum and differs from the BPD originally described more than 50 years ago. There are still controversies in its definition, which has been established based on the treatment, specifically the requirement of respiratory support. The most used definitions are the oxygen requirement for 28 days and at 36 weeks of postmenstrual age (PMA). It has recently been proposed a definition based on the requirement of mechanical ventilation at 36 weeks of PMA, which would identify premature infants with more severe BPD and a greater probability of respiratory and neurological complications in the first 2 years of life. Our objective in the Neo-SOCHINEP commission is to recommend the definition and classification that we believe is most appropriate to identify premature infants with BPD, considering the pathophysiological aspects, the compromised lung function, and practical consequences of the definition in our medium. We also propose the definition of the oxygen requirement in premature infants when they are in neonatology, the conditions and interpretation of continuous saturation when they are soon discharged, and the follow-up of post-discharge oxygen therapy.

Guía clínica para el diagnóstico y cuidado de niños/adolescentes con bronquiolitis obliterante post-infecciosa, 2009 / Clinical guidelines for the diagnosis and care of children and adolescents with post-infectious bronchiolitis obliterans, 2009

La bronquiolitis obliterante (BO) es un síndrome clínico poco frecuente en niños, caracterizado por la obstrucción crónica al flujo de aire asociado a cambios inflamatorios y distintos grados de fibrosis en la vía aérea pequeña. Si bien existen muchas etiologías, la causa mas frecuente se asocia a infeccionesrespiratorias virales, principalmente adenovirus. No existe un consenso para establecer su diagnóstico; sin embargo, se considera un espectro de síntomas persistentes asociados a un patrón en mosaico, bronquiectasias y atelectasias persistentes. El rol de la biopsia pulmonar ha sido cuestionado por subajo rendimiento, invasividad y complicaciones. No existe un tratamiento específico por lo que elmanejo es soporte. Probablemente la mejor estrategia constituya el empleo de antibióticos en forma agresiva, soporte kinésico y nutricional constante y una precoz rehabilitación pulmonar. Estas guías clínicas representan un esfuerzo multidisciplinario, basado en evidencias actuales para brindarherramientas prácticas para el diagnóstico y cuidado de niños y adolescentes con BO post infecciosa.

Ventilación mecánica prolongada con BiPAP a través de traqueostomía / Long-term noninvasive ventilation via tracheostomy

No existen reportes que describan el uso de equipos generadores de flujo con presión diferencial en 2 niveles (BiPAP) a través de traqueostomía para entregar ventilación mecánica prolongada (VMP) en niños. Este documento describe los criterios de selección, modalidad de uso y requerimientos tecnológicos como guía para implementar esta estrategia ventilatoria.

Infecciones respiratorias agudas en el lactante: diagnóstico etiológico desde la perspectiva clínica / Acute respiratory infection in infant: etiological diagnosis from the clinical perspective

La mejoría en la identificación etiológica de las infecciones respiratorias agudas bajas se debe a la incorporación rutinaria de métodos inmunológicos de diagnóstico rápido. El rendimiento se relaciona con la selección apropiada del paciente de acuerdo al cuadro clínico y la oportunidad de la solicitud, fundamentalmente en el caso de los virus respiratorios. La interpretación de aquellos casos en que las técnicas diagnósticas disponibles no permiten la demostración etiológica requiere considerar agentes microbiológicos de descripción reciente.