[Functional endoscopic evaluation of swallowing in infants with deglutition disorders]. / Evaluación funcional endoscópica de la deglución en lactantes con alteración en la mecánica de la deglución.

BACKGROUND: Functional endoscopic evaluation of swallowing (FEES) is a recognized method for Deglutition Disorders (DD) in adults, with anecdotal experience in children, obtaining not conclusive results. OBJECTIVE: To compare the accuracy of test FEES in infants with high suspicion of altered DD seen in a third level hospital with the gold standard Videofluoroscopic (VF). PATIENTS, MATERIAL AND METHODS: The results and findings by FEES and VF of 66 children with clinical diagnosis of DD were compared. STATISTICAL ANALYSIS: An estimate of the sensitivity and specificity of FEES was performed. As well as calculating positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios. RESULTS: 60 patients enrolled, 4 and FEES showed high sensitivity to identify the presence of aspiration and penetration (9 98%) and high specificity for the arrest of spillage and waste (94% and 95%). Gastroesophageal reflux to make the diagnosis of DD with FEES had a sensitivity of 80% and specificity of 84%. Spill and penetration had the highest agreement with respect to the gold standard of 0.81. CONCLUSIONS: FEES in infants diagnosed with DD had a sensitivity of 80.8% and specificity 85.3%. 0696 concordance regarding to the VFD in the diagnosis of DD, and to identify suction stroke had a kappa of 0815.

ANTECEDENTES: La Evaluación Funcional Endoscópica de la deglución (EFED) es un método reconocido para evaluar alteración en la mecánica de la deglución (AMD), con experiencia anecdótica en niños, y con resultados no concluyentes. OBJETIVO: Comparar la exactitud de la EFED en lactantes con alta sospecha de alteración en la mecánica de la deglución atendidos en un hospital de tercer nivel, con el estándar de oro, la Vídeo Fluoroscopia de Deglución (VFD). Tipo de estudio: transversal, analítico, observacional, ambilectivo. Diseño: Prueba diagnóstica. PACIENTES, MATERIAL Y METODOS: Se compararon los resultados y hallazgos por EFED y VFD de 66 niños con diagnóstico clínico de AMD. ANALISIS ESTADISTICO: Se realizó la estimación de sensibilidad y especificidad de la EFED, así como cálculo de valor predictivo positivo (VPP), valor predictivo negativo (VPN) y razones de verosimilitud. RESULTADOS: De los 60 pacientes incluidos, el EFED presentó una alta sensibilidad para la presencia de aspiración y penetración (94 y 98%), y una alta especificidad para la detención de derrame y residuo (94% y 95%). El reflujo gastroesofágico para hacer el diagnóstico de AMD con el EFED tuvo una sensibilidad del 80% y especificidad del 84%. Derrame y penetración tuvieron la más alta concordancia con respecto al estándar de oro de 0.81. CONCLUSIONES: La EFED tuvo una sensibilidad del 80,8% y especificidad 85,3% en lactantes con diagnóstico de AMD. Una concordancia del 0,696 con respecto a la VFD en el diagnóstico de la AMD, y para identificar derrame y aspiración tuvo una kappa de 0,815.

Efficacy of human recombinant DNase in pediatric patients with cystic fibrosis.

BACKGROUND: Most respiratory complications in cystic fibrosis (CF) arise from abnormally viscid mucus, and rhDNase has shown to be effective in enhancing mucous clearance. We explored the responses to rhDNase in a Mexican population of CF patients. METHODS: Patients with CF received aerosolized rhDNase (2.5 mg daily) during 3 months, followed by daily aerosolized placebo during 3 months. RESULTS: A total of 21 CF patients entered the study (11.1 +/- 0.5 years of age, mean +/- SEM, 10 girls): 15 patients (71%) had basal forced vital capacity (FVC) higher than the 70% predicted value, and the remainder of the patients had an FVC of between 30 and 70%. As a group, rhDNase progressively increased the forced expiratory flow at 1 sec (FEV1) as well as the FVC, reaching statistical significance (p <0.005) at the end of the third month of treatment. Sputum production and difficulty to expectorate or to breathe also improved during the rhDNase treatment period (p <0.05 to p <0.001). All these changes progressively decreased to basal values after 3 months with aerosolized placebo. Adverse reactions were almost null, with a sole patient reporting dysphonia. CONCLUSIONS: Aerosolized rhDNase was effective in progressively improving respiratory function and symptoms in most CF patients.

Growth, carcass traits, and plasma amino acid concentrations of gilts fed low-protein diets supplemented with amino acids including histidine, isoleucine, and valine.

Three experiments were conducted to determine the fifth-limiting amino acid for growing pigs in an 11% CP, corn-soybean meal diet. In each experiment, 36 gilts (initial weight 19.5, 21.9, and 21.0 kg, respectively) were penned individually and fed one of six diets in a randomized block design for 35 d. Diets containing 16, 12, and 11% CP were fed in each experiment. All 12 and 11% CP diets were supplemented with lysine, tryptophan, threonine, and methionine to provide the same total concentrations as those in the 16% CP diet. In Exp. 1, the 11% CP diet was supplemented with isoleucine, valine, or isoleucine + valine to concentrations equal to those in the 16% CP diet. In Exp. 2, the 11% CP diet was supplemented with histidine, histidine + valine, or histidine + isoleucine + valine. In Exp. 3, the 11% CP diet was supplemented with valine, histidine + valine, or isoleucine + valine. Gilts were allowed free access to feed and water. In all experiments, ADG and feed efficiency (G/F) were reduced (P < or = 0.07) as dietary protein was reduced. Supplementation of isoleucine alone further reduced (P < 0.05) ADG, ADFI, G/F, and fat-free lean gain. In contrast, supplementation of valine alone resulted in numerical increases in ADG and ADFI in two experiments, although the differences were not significant (P > 0.05). Supplementation with histidine and valine together resulted in growth performance equal to or greater than that of pigs fed the 12% CP diet, but less than that of pigs fed the 16% CP diet. Supplementation of isoleucine and valine together resulted in better growth performance (P < 0.05) than supplementation of either amino acid alone. In two experiments (Exp. 1 and 3), supplementation of the 11% CP diet with isoleucine and valine together resulted in ADG that were not significantly different (P > 0.05) from those of pigs fed the 16% CP diet. Supplementation of all three amino acids (Exp. 2) did not improve performance over supplementations with histidine and valine. Plasma urea concentrations were reduced (P < 0.05) as dietary protein was lowered from 16 to 12%. Additions of crystalline amino acids did not affect plasma urea levels. Plasma amino acid concentrations reflected the dietary additions of crystalline amino acids, but did not assist in the identification of the sequence of limiting amino acids. These data suggest that valine is the fifth-limiting amino acid and that either histidine or isoleucine is the sixth-limiting amino acid in an 11% CP diet.

Nitrogen metabolism and growth performance of gilts fed standard corn-soybean meal diets or low-crude protein, amino acid-supplemented diets.

Two experiments were conducted to determine the CP concentration below which N retention and growth performance are reduced when low-protein, amino acid-supplemented, corn-soybean meal diets are fed. In a N balance trial (Exp. 1), 12 gilts (initial weight 41 kg) were fitted with urinary catheters and fed six different diets during three 7-d periods in an incomplete block design. The diets were: 1) 18% CP; 2) 14% CP + AA, 3) 16% CP; 4) 12% CP + AA; 5) 14% CP; and 6) 10% CP + AA. Amino acids (lysine, threonine, tryptophan, and methionine) were supplemented such that the concentrations in the low-protein diets were equal to those in their standard (4% CP higher) counterparts. Nitrogen retention (g/d) decreased (P < 0.01) as CP decreased, in both standard (27.10, 24.53, and 20.99) and low-protein (21.51, 19.18, and 15.83) diets, but was lower (P < 0.01) in low-protein diets. There were no differences among treatments (P > 0.05) in biological value (68.2% standard vs 71.0% low-protein). In a growth performance trial (Exp. 2), 36 gilts (initial weight 19.5 kg) were penned individually and fed one of six diets for 35 d in a randomized complete block design. Dietary treatments were a 16% CP standard diet and low-protein diets formulated to contain 15, 14, 13, 12, and 11% CP supplemented with crystalline lysine, tryptophan, threonine, and methionine to equal the total concentrations in the standard diet. Protein concentration affected (P < or = 0.05) ADG, ADFI, feed efficiency, fat-free lean gain, longissimus muscle area, plasma urea, and plasma concentrations of most essential AA. For most of these traits, the major difference was poor performance of pigs fed the 11% CP diet. Thus, in Exp. 1, at AA concentrations from deficient to excess, low-protein, amino acid-supplemented diets failed to produce the same N retention as the equivalent corn-soybean meal diets. However in Exp. 2, the same performance was obtained with 16, 15, 14, 13, and 12% CP. Based on these data, we suggest that N balance is more sensitive than growth to amino acid adequacy andthat other AA (e.g., isoleucine and valine) may limit growth performance when the protein concentration is reduced by more than four percentage units.

[Effects of the dietary incorporation of carotenoid pigments on gonad development and oocyte maturity in females of rainbow trout (Oncorhynchus mykiss, Walbaum, 1972)]. / Efectos de la incorporación en la dieta de pigmentos carotenoides, sobre el desarrollo gonadal y la madurez de los ovocitos en hembras de trucha arco iris (Onchorhynchus mykiss, Walbaum, 1972).

Four groups of rainbow trout (Onchorhynchus mykiss) each with 60 females with an average body weight of 467 g were submitted to an aleatory assay in order to compare the efficiency of four diets containing different concentrations of carotenoid pigments, and to determine if pigment concentration and source had an influence on female gonad development and oocyte maturity. The first diet was the non-pigmented control (C). The second diet contained 100 mg kg(-1) of Carophyll Pink (CR). The third and fourth diets contained 200 (RC200) and 250 (RC250) mg kg(-1) of saponified red chili oleoresin, respectively. The results indicated significant differences (p < or = 0.05) between C and RC250, with respect to the gonado-somatic index (IGS), average gonad weight (PG) and average diameter of oocyte (DO), with CR250 showing higher IGS, PG and DO values. Treatments CR and CR200 presented similar values. At the end of the experimental period, only 10% of oocytes were mature in the RC250 diet.

Sistema de Adquisición de Señales SEMG para la Detección de Fatiga Muscular / SEMG Signal Acquisition System for Muscle Fatigue Detection

Resumen Este trabajo presenta el desarrollo de un sistema de adquisición y procesamiento de señales mioeléctricas superficiales o SEMG. El sistema propuesto adquiere las señales SEMG de la superficie de la piel utilizando electrodos superficiales de AgCl. El sistema tiene una etapa de amplificación y de filtrado por hardware para eficientar el tiempo de proceso. Se desarrolló un software para procesar por transformada de Fourier la señal SEMG amplificada y filtrada. A diferencia de otros sistemas de adquisición de señales biológicas que son desarrollados para terapia o rehabilitación, este sistema está pensado para ser usado para el control de brazos robóticos, por ello el software desarrollado mide la fatiga utilizando parámetros como el corrimiento de la frecuencia media instantánea y la densidad espectral de potencia de la señal SEMG.

Abstract This paper presents the development of a system for acquiring and processing of surface myoelectric signals or SEMG. The proposed system acquires signals SEMG skin surface using AgCl surface electrodes. The system has an amplification step and hardware filtering to streamline the processing time. Developed software for processing the Fourier transform SEMG amplified and filtered signal. Unlike other systems for acquisition of biological signals, which are developed for therapy or rehabilitation, this system is intended to be used for the control of robotic arms, so the software performs the measurement of fatigue using parameters like bleed average frequency and instantaneous power spectral density of the signal SEMG.

Sexual behavior of castrated boars treated with prostaglandin F(2alpha).

The objectives were to test the hypothesis that exogenous prostaglandin F(2alpha) (PGF(2alpha)) temporarily restores sexual behavior of castrated boars, and to evaluate effects of PGF(2alpha) on serum hormone concentrations. At 35 d after castration, nine lean-type adult boars were randomly assigned to three treatments in a 3x3 latin square (with three replicates). Treatments were three doses of PGF(2alpha) doses (0, 10, and 20mg) and three periods of treatment, with 5 d between each period. Serum testosterone (T) concentrations were non-detectable at the start of the experiment. Serum concentrations of estradiol (E2), LH, prolactin (PRL), and cortisol were unaffected (P>0.05) by PGF(2alpha) treatment. The interval from treatment to ejaculation in boars treated with 10mg (758s) or 20mg (660s) PGF(2alpha) did not differ, but were different (P < 0.05) from control boars (>1 800s). Ejaculation duration and false mounts differed (P < 0.05) between control boars and boars treated with 10 or 20mg PGF(2alpha). In conclusion, PGF(2alpha) treatment did not change serum concentrations of T, E2, LH, PRL, or cortisol, but restored sexual behavior. This restoration may have been due to an effect of PGF(2alpha) directly in specific areas of the brain, or indirectly via release of other hormones that stimulated areas in the brain that affected sexual behavior.

Critical issues in the assessment of headache.

In an earlier paper, Thompson (1982) made the point that "an adequate assessment and understanding of the relevant independent and dependent variables related to subjects' headache complaints will yield information pointing to the most logical choice for a treatment intervention" (p. 230). It is essential that researchers and clinicians adopt an idiographic approach if we are to fully realize the potential of biofeedback, behavior therapy, and other nonpharmacological approaches as primary or ancillary interventions in the management of head pain. Large group comparisons, composed of heterogeneous subject populations treated with standardized techniques, have failed to elucidate the optimal intervention for individualized headache complaints. Yates (1980) noted with reference to biofeedback. "The reason for the failure of biofeedback training to show any consistent superiority over other relaxation training techniques stems from its use as a blunderbuss rather than as a rapier or precision instrument" (p. 499). We would maintain that a similar situation has pervaded the headache literature with a "blunderbuss" approach characterizing assessment and client-treatment-matching strategies. The remediation of the current controversy regarding treatment efficacy in the area of head pain is dependent upon the careful and critical use of assessment strategies in future research and clinical activity.

Pulmonary hemorrhage in systemic lupus erythematosus.

In order to assess the clinical characteristics and survival rate of pulmonary hemorrhage (PH) in systemic lupus erythematosus (SLE), we studied SLE patients who developed this complication. We found 34 patients within a total lupus cohort of 630 patients. All the patients had severe respiratory failure. We identified three different treatment regimens: (a) oral prednisone (1 mg/kg); (b) conventional methylprednisolone (3 g total dose) and (c) massive methylprednisolone (> 4 g). The overall survival rate was 38.2% and it was correlated with the massive regimen and early treatment (within the first 48 h after the onset of the acute event).

[Prune belly syndrome associated with cystic adenomatoid malformation of the lung and pulmonary sequestration]. / Síndrome de "prune belly" asociado a malformación adenomatoide quística pulmonar y secuestro pulmonar.

The "prune belly" syndrome classically described in males, has also been described in female patients with a variable incidence. Associations with multiple respiratory tract malformations have been reported which together with urinary tract anomalies and renal failure are often the cause of early mortality. We report the case of a female patient with prune belly in association with cystic adenomatoid malformation of the lung and pulmonary sequestration with a favorable clinical evolution following medical and surgical treatment.

[Severe respiratory failure secondary to vascular ring. Report of 2 cases]. / Insuficiencia respiratoria grave secundaria a anillo vascular. Informe de dos casos.

Vascular compression of the airways is an infrequent situation that can be masked by inespecific respiratory symptoms. We present two cases with severe respiratory distress, that needed assisted mechanical ventilation in patients with overdistended lungs which improved when the endotracheal cannula was shifted near the carina. The chest radiograph showed hyperinflation of the lungs; an identation was demonstrated in the esophagogram and the endoscopy demostrated extrinsic esophagical compression. The angiogram documented double aortic arch in the first case and aberrant subclavia artery in the second. Vascular section and liberation of trachea and esophagus were performed with good outcome. The decrease of thoracic overdistention when the cannula was placed in the lower part of the trachea gave the clue to the diagnosis of vascular ring. A high index of suspicion is necessary for an early diagnosis.