[Antibiotic therapy and effects of respiratory physiotherapy techniques in cystic fibrosis patients treated for acute lung exacerbations: an experimental study]. / Efectos de la antibioterapia y la técnica fisioterápica respiratoria en pacientes con fibrosis quística tratados por exacerbación pulmonar aguda: estudio experimental.

INTRODUCTION: Intravenous antibiotics in combination with intensive respiratory physiotherapy were evaluated for acute lung exacerbations in chronic infections of Pseudomonas aeruginosa in cystic fibrosis patients. Forced expiratory technique (FET) was assessed during hospital stay and discharge. The aim of this study was 1) to evaluate the immediate effects of FET and of 2) Intravenous antibiotics in combination with daily respiratory physiotherapy (IA+RPT) on parameters of lung function, body anthropometry and clinical scores of cystic fibrosis patients with acute lung exacerbation with chronic infection by Pseudomonas aeruginosa, during hospital stay and at hospital discharge after clearing the infection. PATIENTS AND METHOD: Eighteen patients between 7-28 years old were included in a prospective non-controlled clinical study. Body anthropometry values, Cystic Fibrosis Clinical Score (CFCS) exacerbation, Cystic Fibrosis Foundation Score (CFFS), and severity scores (SS) were evaluated before and after admission. Oxygen saturation (SpO(2)), heart (HR) and respiratory rate (RR) were evaluated before and after FET. RESULTS: CFCS (32.4+7.2) and CFFS (6.4+1.7) had decreased at hospital discharge for 18.9+3.3 and 0.3+0.5, respectively (p<0.001). IA+ RPT reduced RR means (p=0.003) and increased SpO(2) (p=0.006), forced expiration volume at 1min (FEV(1)) (p=0.021) and nutritional values (p=0.002). During admission, FET immediately improved HR (p=0.028), RR (p=0.001) and SpO(2) (p=0.015), despite significant maximum voluntary ventilation reduction (p=0.028); after the infection was treated the FET did not significantly alter parameters. CONCLUSION: IA+RPT improved clinical conditions of cystic fibrosis patients. FET improved cardiorespiratory variables of patients at risk for infection.

Idiopathic male pseudohermaphroditism is associated with prenatal growth retardation.

UNLABELLED: About 50% of intersex cases are due to male pseudohermaphroditism, and of these cases, 50% are not clarified aetiologically. The association of idiopathic male pseudohermaphroditism and prenatal growth retardation has been recently reported. The aim of this study was to verify whether there was a difference in weight and/or length at birth between idiopathic and non-idiopathic male pseudohermaphroditism patients. A total of 70 patients with male pseudohermaphroditism were recruited; 35 non-idiopathic and 35 idiopathic. Birth weight and length were converted to z scores, and the severity of genital ambiguity was classified according to Prader grades: less virilized (Prader 1 to 3) and more virilized (Prader 4 or 5). Data were analysed using a Mann-Whitney test, odds ratio and logistic regression analysis. Birth weight (P = 0.028) and length (P = 0.01) z scores were lower in the idiopathic male pseudohermaphroditism group compared to the non-idiopathic group and were also significantly decreased among the less virilized patients, both in the sample as a whole (weight z score, P = 0.002; length z score, P = 0.0008) and in the group of idiopathic patients (weight z score, P = 0.013; length z score, P = 0.007). According to logistic regression analysis, only birth length z score significantly predicted the severity of the genital ambiguity in patients with idiopathic male pseudohermaphroditism ( P = 0.0007). CONCLUSION: There is an association between prenatal growth retardation and male pseudohermaphroditism which may be due to genetic factors not clarified yet or to environmental factors which act early in gestation.

Efectos de la antibioterapia y la técnica fisioterápica respiratoria en pacientes con fibrosis quística tratados por exacerbación pulmonar aguda: estudio experimental / Antibiotic Therapy and Effects of Respiratory Physiotherapy Techniques in Cystic Fibrosis Patients Treated for Acute Lung Exacerbations: an Experimental Study

IntroducciónSe evaluó el tratamiento con antibióticos intravenosos en combinación con la fisioterapia respiratoria intensiva para las exacerbaciones pulmonares agudas de las infecciones crónicas por Pseudomonas aeruginosa en pacientes con fibrosis quística. Durante la hospitalización y el alta se evaluó la técnica de espiración forzada (TEF). El objetivo de este estudio fue 1) valorar los efectos inmediatos de la TEF y de 2) los antibióticos intravenosos combinados con la fisioterapia respiratoria diaria (AI+FTR) sobre los parámetros de función pulmonar, antropometría corporal y puntuaciones clínicas de pacientes con fibrosis quística y exacerbaciones pulmonares agudas de una infección crónica por Pseudomonas aeruginosa en la hospitalización y el momento del alta hospitalaria tras remisión de la infección.Pacientes y métodosEn un estudio clínico prospectivo, no controlado, se incluyeron 18 pacientes, de 7–28 años de edad. Antes y después de la hospitalización se evaluaron los valores antropométricos corporales, exacerbación de la puntuación Cystic Fibrosis Clinical Score, Cystic Fibrosis Foundation Score y puntuaciones de gravedad (PG). Antes y después de la TEF, se evaluaron la saturación de oxígeno (SpO2), FC y FR.ResultadosEn el momento del alta hospitalaria, la Cystic Fibrosis Clinical Score (32,4+7,2) y Cystic Fibrosis Foundation Score (6,4+1,7) habían disminuido 18,9+3,3 y 0,3+0,5, respectivamente (p<0,001). La AI+FTR redujo la FR media (p=0,003) y aumentó la SpO2 (p=0,006), el volumen espiratorio forzado en el primer segundo (p=0,021) y los valores nutricionales (p=0,002). En el momento de la hospitalización, la TEF mejoró de inmediato la FC (p=0,028), FR (p=0,001) y la SpO2 (p=0,015), a pesar de un reducción significativa de la ventilación voluntaria máxima (p=0,028); tras la remisión de la infección, la TEF no alteró significativamente los parámetros(AU)

ConclusiónLa AI+FTR mejoró el estado clínico de los pacientes con fibrosis quística. La TEF mejoró las variables cardiorrespiratorias de los pacientes con riesgo de infección(AU)

IntroductionIntravenous antibiotics in combination with intensive respiratory physiotherapy were evaluated for acute lung exacerbations in chronic infections of Pseudomonas aeruginosa in cystic fibrosis patients. Forced expiratory technique (FET) was assessed during hospital stay and discharge. The aim of this study was 1) to evaluate the immediate effects of FET and of 2) Intravenous antibiotics in combination with daily respiratory physiotherapy (IA+RPT) on parameters of lung function, body anthropometry and clinical scores of cystic fibrosis patients with acute lung exacerbation with chronic infection by Pseudomonas aeruginosa, during hospital stay and at hospital discharge after clearing the infection.Patients and methodEighteen patients between 7–28 years old were included in a prospective non-controlled clinical study. Body anthropometry values, Cystic Fibrosis Clinical Score (CFCS) exacerbation, Cystic Fibrosis Foundation Score (CFFS), and severity scores (SS) were evaluated before and after admission. Oxygen saturation (SpO2), heart (HR) and respiratory rate (RR) were evaluated before and after FET.ResultsCFCS (32.4+7.2) and CFFS (6.4+1.7) had decreased at hospital discharge for 18.9+3.3 and 0.3+0.5, respectively (p<0.001). IA+ RPT reduced RR means (p=0.003) and increased SpO2 (p=0.006), forced expiration volume at 1min (FEV1) (p=0.021) and nutritional values (p=0.002). During admission, FET immediately improved HR (p=0.028), RR (p=0.001) and SpO2 (p=0.015), despite significant maximum voluntary ventilation reduction (p=0.028); after the infection was treated the FET did not significantly alter parameters.ConclusionIA+RPT improved clinical conditions of cystic fibrosis patients. FET improved cardiorespiratory variables of patients at risk for infection(AUing