Adaptation of the Pediatric Smell WheelTM to evaluate olfactory function in Brazilian children

Abstract Objective: Olfaction influences nutrition, safety, and the cognitive development of children. Presently there are few olfactory tests for children, and normative reference values are generally lacking. In this study, we validate the Pediatric Smell WheelTM (PSW) to evaluate olfactory function in Brazilian children. Methods: We modified and validated the PSW, a test developed in the United States, for administration in Brazil, and established normative data for Brazilian children. The validation process consisted of five phases. First, we identified odorants familiar to Brazilian children. Second, we established the test-retest reliability of the Brazilian PSW test that employed these odorants. Third, we compared the test scores of healthy children to those microsmic from adenoid hypertrophy. Fourth, we examined the test's ability to detect improvement in olfactory function before and after adenoidectomy. Finally, we determined a normative 10th percentile cut point for defining microsmia in a sample of 169 healthy Brazilian children between 5 and 12 years of age. Results: Eleven odors were identified for inclusion in the test. The test-retest reliability was modest (r = 0.54, p < 0.001), although likely attenuated based on the inclusion of only data from children with normal function. The test clearly differentiated the olfactory function of children with adenoid hypertrophy from that of healthy children and demonstrated the return of function after adenoidectomy. An overall score <7 was found useful in defining hyposmia, although additional age-related cut-points were also defined. Conclusion: A Brazilian version of the PSW was developed and validated and found to be efficacious in detecting smell dysfunction in children ranging in age from 5 to 12 years. Level of evidence: 1b (Diagnosis).

Padronização da anestesia em suínos para procedimentos cirúrgicos cardiovasculares experimentais / Standardization of anesthesia in swine for experimental cardiovascular surgeries / Estandarización de la anestesia en cerdos para procedimientos quirúrgicos cardiovasculares experimentales

JUSTIFICATIVA E OBJETIVO: Embora sejam os cães os animais mais utilizados em Cirurgia Experimental, nota-se crescente utilização de ovinos, bovinos e suínos como modelos para experimentação científica. Assim, faz-se necessário maior aprendizado de seu tratamento e padronizações básicas para os procedimentos cirúrgicos mais complexos em suínos. O objetivo foi avaliar a sedação e analgesia, obtidas pela injeção intramuscular de midazolam e cetamina e anestesia local com lidocaína a 2 por cento sem vasoconstritor, na realização de traqueostomia, dissecção de artéria e veia femorais. MÉTODO: A freqüência cardíaca e o reflexo córneo-palpebral foram avaliados logo no início da sedação, durante os procedimentos cirúrgicos descritos e após seu término. Foram utilizados oito suínos fornecidos por fazendas locais sem tratamento prévio da raça Large White, com peso de 35 a 42 quilos que receberam injeção intramuscular de 22 mg.kg-1 de cetamina e 0,3 mg.kg-1 de midazolam. RESULTADOS: A abordagem anestésica nesses animais, de difíceis intubação e acesso aos vasos profundos, provou ser segura para sedação e analgesia através do método utilizado: acesso intramuscular. CONCLUSÃO: Obteve-se adequado plano de anestesia para o procedimento proposto.

BACKGROUND AND OBJECTIVES: Although dogs are the animals used more often in Experimental Surgeries, the use of sheep, bovine, and swine as models for scientific experiments has been growing. Thus, further learning on the treatment and basic standardization of more complex surgeries in swine are necessary. The objective of this study was to evaluate sedation and analgesia, obtained by the intramuscular administration of midazolam and ketamine, and local anesthetics with 2 percent lidocaine without vasoconstrictor, in tracheostomy and dissection of femoral artery and vein. METHODS: The heart rate and corneal-palpebral reflex were evaluated at the beginning of sedation, during the surgical procedures, and at the end of those procedures. Eight Large White swine, without prior treatment, weighing 35 to 42 kg were provided by local farms. They received intramuscular injections of 22 mg.kg-1 of ketamine and 0.3 mg.kg-1 of midazolam. RESULTS: The anesthetic approach on those animals, who present both difficult intubation and access to deep vessels, proved to be safe for sedation and analgesia by the method chosen: intramuscular administration. CONCLUSIONS: An adequate plane of anesthesia for the proposed procedure was achieved.

JUSTIFICATIVA Y OBJETIVOS: Aunque los perros sean los animales más a menudo usados en Cirugía Experimental, se nota un aumento en la utilización de los ovinos, bovinos y porcinos como modelo para experimentación científica. De esa forma, se hace necesario aprender más con su tratamiento y estandarizaciones básicas para los procedimientos quirúrgicos más complejos en porcinos. El objetivo fue evaluar la sedación y la analgesia obtenidas por la inyección intramuscular de midazolán y la cetamina y anestesia local con lidocaína a un 2 por ciento sin vasoconstrictor, en la realización de traqueostomía, disección de arteria y vena femorales. MÉTODO: La frecuencia cardíaca y el reflejo córneo-palpebral fueron evaluados inmediatamente al inicio de la sedación, durante los procedimientos quirúrgicos descritos y después en su conclusión. Se utilizaron ocho porcinos que fueron suministrados por haciendas de la región sin tratamiento previo de la raza Large White, con peso de 35 a 42 kilos que recibieron inyección intramuscular de 22 mg.kg-1 de cetamina y 0.3 mg.kg-1 de midazolán. RESULTADOS: El abordaje anestésico en esos animales, de difícil intubación y acceso a los vasos profundos, demostró ser seguro para la sedación y analgesia a través del método utilizado: el acceso intramuscular. CONCLUSIÓN: Se obtuvo un adecuado plan de anestesia para el procedimiento propuesto.