Relación entre alteraciones de la tomografía computarizada de tórax en pacientes hospitalizados por neumonia COVID-19 y la recuperacion funcional respiratoria a los 3 meses del alta / Relationship between alterations of CT tomography of the thorax in patients hospitalized for pneumonía COVID-19 and respiratory functional recovery 3 months after discharge

Introducción: La neumonía por coronavirus SARS-CoV-2 es una enfermedad nueva, por lo que las secuelas a largo plazo siguen siendo poco claras y los reportes del tema son aún escasos. El presente estudio buscó describir los hallazgos tomográficos al ingreso hospitalario y luego de 3 meses de neumonía asociada a COVID-19 y correlacionarlos con la alteración de las pruebas de función pulmonar a los 3 meses de la hospitalización. Pacientes y Métodos: Estudio de cohorte prospectivo que evaluó las secuelas funcionales pulmonares y la evolución del compromiso imagenológico a los tres meses de hospitalización por neumonía asociada a COVID-19. Todos los exámenes fueron revisados por un radiólogo experto. Se identificó el patrón tomográfico predominante y se estableció la extensión de las alteraciones mediante un puntaje, previamente validado. En las TC de seguimiento, se evaluó la extensión del compromiso imagenológico, el porcentaje de reducción del compromiso del espacio aéreo y presencia de otras alteraciones. Estos hallazgos se relacionaron con las pruebas de función pulmonar (PFP) a los 3 meses (espirometría, DLCO y test de caminata de 6 min: TC6M). Para estos análisis los pacientes se agruparon según la oxigenoterapia utilizada en la hospitalización: oxigenación estándar (O2), cánula nasal de alto flujo (CNAF) o ventilación mecánica invasiva (VMI). Resultados: Se evaluaron un total de 116 pacientes, de los cuales 75 eran hombres, edad promedio fue 60,6 ± 14,5 años. Los pacientes fueron seguidos en promedio 100 días. 70 pacientes pertenecieron al grupo O2 estándar, 25 CNAF y 21 VMI. La TC control a los 3 meses mostró que 78 pacientes presentaron recuperación tomográfica mayor a 50%. El promedio del puntaje de extensión del compromiso tomográfico fue significativamente mayor en el grupo con PFP alterada, comparado con el grupo con PFP normal (espirometría 6,8 vs. 4,6, p = 0,03; DLCO 5,7 vs. 4,1, p = 0,04, TC6M 7,0 vs. 4,2, p = 0,002). Conclusiones: En el seguimiento de los pacientes adultos hospitalizados por neumonía asociada a COVID-19, los pacientes con mayor extensión del compromiso imagenológico pulmonar fueron los que presentaron alteraciones funcionales pulmonares significativas.

Introduction: SARS-CoV-2 pneumonia is an emergent disease, then long term sequelae are still on investigation. This study evaluated the imaging features at the admission to the hospital and then 3 months after discharge of patients hospitalized with COVID-19 pneumonia and compared findings with functional respiratory recovery. Patients and Methods: Prospective cohort study of patients hospitalized with SARS-CoV-2 pneumonia in "Hospital Naval Almirante Nef", Viña del Mar Chile. Imaging evolution and respiratory function were analyzed after 3 months discharge. All the imagens were reviewed by an expert radiologist, who identified a predominant pattern and defined an extension score previously validated. These findings were compared with 3 months CT and respiratory function evaluated with spirometry, DLCO and 6 minutes walking test (6MWT). Also, patients were categorized in 3 different group, depending on oxygen support: conventional oxygen, high-flow nasal cannula (HFNC) and mechanical ventilation. Results: 116 patients were evaluated, 75 men with a mean age of 60.6 ± 14.5 years-old. The median follow-up was 100 days. 70 patients were on conventional oxygen group, 25 in high-flow nasal cannula and 21 in mechanical ventilation. 3-month CT control showed tomographic recovery > 50% in 78 patients. The mean score of extension was significant higher in the group with altered respiratory functional test, compared with the group with normal results (spirometry 6.8 vs. 4.6, p = 0.03; DLCO 5.7 vs. 4.1, p = 0.04; 6MWT 7.0 vs. 4.2, p = 0.002). Conclusion: 3 months after discharge of COVID-19 pneumonia, patients with higher tomographic score present significant abnormalities in respiratory functional test.

Diagnostic assessment of patients with Meniere's disease through caloric testing and the video-head-impulse test / Avaliação diagnóstica dos pacientes com doença de Ménière por meio da prova calórica e do video-head impulse test

Abstract Introduction Meniere's disease is a labyrinth disease that usually presents with episodes of spontaneous vertigo associated with sensorineural hearing loss, tinnitus and ipsi- and unilateral aural fullness in most cases. Vestibular function tests, video-head-impulse test and the caloric test, are not specific for diagnosis of the disease, but may show alterations that help to evaluate the functional impairment. Objective To describe the results obtained at the caloric test and video-head-impulse test in patients with definite Meniere's disease and compare them between symptomatic, asymptomatic ears and those of the control group. Methods Cross-sectional and observational study including patients with definite Meniere's disease diagnosed according to the Bárány Society criteria (2015) and healthy individuals (control group) undergoing caloric test and video-head-impulse test. All subjects were assessed by neurotological anamnesis and audiological evaluation (pure-tone, vocal and immittance audiometry) to characterize the sample. The findings obtained at the caloric test and video-head-impulse test were described and compared between the symptomatic and asymptomatic ears of patients with Meniere's disease and those of the control group. Results Thirty-two patients with definite Meniere's disease were evaluated, with a mean age of 45.7 years, mostly females (68.8%) and unilateral disease. The control group consisted of 20 healthy individuals, with a mean age of 44.7 years, mostly females (70.0%). The groups were homogeneous in relation to age and gender. The patients' main complaint was vertigo (71.9%), and most patients had more than six episodes in the last six months (71.9%). Moderate sensorineural hearing loss was present in 38.5% of patients. The prevalence of hyporeflexia at the caloric test was higher in symptomatic (56.4%) and asymptomatic (36%) ears of patients with Meniere's disease compared to the ears of control subjects (7.5%), p < 0.001 and p = 0.004, respectively. Video-head-impulse test alterations in the lateral semicircular canals were more frequent in the symptomatic ears of patients with Meniere's disease than in the ears of control subjects (p = 0.026). Conclusion Most patients with definite Meniere's disease showed hyporeflexia at the caloric test and video-head-impulse test with normal function in the symptomatic ear. Vestibular hyporeflexia at the caloric test was more frequent in the symptomatic and asymptomatic ears of patients with Meniere's disease than in the control group. The video-head-impulse test showed more alterations in the lateral semicircular canals.

Resumo Introdução Doença de Ménière é uma labirintopatia que geralmente se manifesta com episódios de vertigem espontânea, associada à perda auditiva neurossensorial, ao zumbido e à plenitude aural ipsi e unilateral, na maioria dos casos. Os testes da função vestibular, vídeo-teste do impulso cefálico e prova calórica não são específicos para a doença, porém podem apresentar alterações que ajudam a avaliar o comprometimento funcional. Objetivo Descrever os resultados obtidos à prova calórica e ao vídeo-teste do impulso cefálico nos pacientes com doença de Ménière definida e compará-los entre as orelhas sintomáticas, assintomáticas e com as orelhas dos indivíduos do grupo-controle. Método Estudo transversal e observacional que incluiu pacientes com doença de Ménière definida diagnosticados de acordo com os critérios da Sociedade Bárány (2015) e indivíduos saudáveis (grupo controle) submetidos à prova calórica e ao vídeo-teste do impulso cefálico. Todos os sujeitos foram avaliados por meio de anamnese otoneurológica e avaliação audiológica (audiometria tonal, vocal e imitanciometria) para caracterização da amostra. Os achados obtidos foram descritos e comparados entre as orelhas sintomáticas e assintomáticas dos pacientes com doença de Ménière e também com as do grupo-controle. Resultados Foram avaliados 32 pacientes com doença de Ménière definida. A média de idade dos pacientes foi de 45,7 anos, a maioria do sexo feminino (68,8%) e unilateral. O grupo-controle foi composto por 20 indivíduos saudáveis, com média de 44,7 anos e maioria feminina (70,0%). Os grupos mostraram-se homogêneos em relação à idade e ao sexo. A principal queixa dos pacientes foi a vertigem (71,9%). A maioria dos pacientes apresentou mais de seis crises nos últimos seis meses (71,9%). A perda auditiva neurossensorial moderada esteve presente em 38,5% dos pacientes. A prevalência da hiporreflexia à prova calórica foi maior nas orelhas sintomáticas (56,4%) e assintomáticas (36%) dos pacientes com doença de Ménière quando comparadas às orelhas dos indivíduos do grupo-controle (7,5%), valor de p< 0,001 e p= 0,004 respectivamente. As alterações de vídeo-teste do impulso cefálico de canal semicircular lateral foram mais frequentes nas orelhas sintomáticas dos pacientes com doença de Ménière do que nas orelhas dos indivíduos controles, (p= 0,026). Conclusão A maioria dos pacientes com doença de Ménière definida apresentou hiporreflexia à prova calórica e vídeo-teste do impulso cefálico com função normal na orelha sintomática. A hiporreflexia vestibular à prova calórica foi mais frequente nas orelhas sintomáticas e assintomáticas dos pacientes com doença de Ménière do que nas orelhas do grupo-controle. O vídeo-teste do impulso cefálico apresentou mais alterações no canal semicircular lateral.

Tasa de angiografías coronarias sin lesiones ("en blanco") de indicación electiva tras estudios funcionales / Rate of coronary angiography without lesions ("blank") of elective indication after functional studies

Antecedentes: aunque la cineangiocoronariografía (CACG) sigue siendo el "patrón oro" diagnóstico en la enfermedad coronaria, la optimización de sus indicaciones electivas obliga a revisar sistemáticamente los resultados de los estudios funcionales de detección de isquemia. Objetivo: analizar la tasa de angiografías sin obstrucciones coronarias epicárdicas ("en blanco") de indicación electiva tras estudios funcionales. Material y método: se realizó un estudio observacional analítico y transversal, analizando las CACG electivas realizadas en 2011-2014 en el servicio de hemodinamia público del país. Se registraron variables clínicas, indicación y resultados de la interpretación angiográfica en los pacientes que fueron estudiados previamente mediante pruebas no invasivas para detección de isquemia. La ausencia de estenosis coronaria significativa fue definida como la presencia de estenosis luminal <50%. Se excluyeron las indicaciones electivas por preoperatorio de valvulopatías, disfunción sistólica severa y arritmias ventriculares, y los pacientes con antecedentes de intervencionismo coronario percutáneo o cirugía de bypass coronario. Resultados: se incluyeron los resultados de las CACG electivas en 219 pacientes con pruebas funcionales previas. La tasa de CACG "en blanco" fue de 35,62%. Las variables asociadas con la presencia de lesiones coronarias angiográficas fueron: el sexo masculino (OR=2,22, IC 95%: 1,26-3,92), la edad ³65 años (OR=2,09, IC 95%: 1,19-3,69), la diabetes (OR=2,94, IC 95%: 1,52-45,65) y un resultado funcional de moderado/alto riesgo (OR=22,99, IC 95%: 2,90-181,80). En contraposición, un resultado funcional normal/de bajo riesgo se asoció con la ausencia de lesiones angiográficas (OR=0,04, IC 95%: 0,005-0,34). La población de pacientes estudiados previamente mediante ecocardiografía de estrés fue poco representativa (5,02%). Conclusiones: en un centro universitario público de referencia la tasa de angiografías coronarias electivas "en blanco" es acorde con lo reportado en los grandes estudios multicéntricos.

Background: although coronary angiography is still the "gold standard" diagnostic of coronary artery disease, a systematic review of its elective indications after noninvasive (functional) tests is needed. Objective: to analyze through functional tests the rate of nonobstructive ("blank") elective coronary angiography (CA) in patients previously studied through noninvasive (functional) tests. Methods: we performed an observational analytic and cross-sectional study analyzing elective CA performed in 2011-2014 in a nationwide public hemodynamic service. Clinical data indications and results of angiographic interpretation were recorded in the subjects previously studied through noninvasive (functional) tests. Elective indications corresponding to preoperative evaluation of valvular disease, severe systolic dysfunction, ventricular arrhytmias, previous history of angioplasty or coronary artery bypass surgery were excluded. We defined the absence of significant coronary stenosis as those lesions determining a luminal stenosis <50%. Results: we analyzed the results of 219 functional tests. The rate of CA without significant coronary stenosis was 35,62%. Male gender (OR=2,22, IC 95%: 1,26-3,92), age >65 years (OR=2,09, IC 95%:1,19-3,69), diabetes (OR=2,94, IC 95%: 1.52-45,65) and a moderate/high risk functional test outcome (OR=22,99, IC 95%: 2,90-181,80) were positively associated with angiographic lesions. In contrast, a normal/low risk functional outcome was associated with the absence of coronary stenosis (OR=0,04, IC 95%: 0,005-0,34). The sample of patients studied through stress-ECHO was not representative (5,02%). Conclusions: in a nationwide public university center, the rate of "blank" elective coronary angiography after functional tests is similar to large international multicenter studies.

Evaluation of Liver Functional Test (LFT) and Kidney Functional Test (KFT) in Dengue Patients

Background: Dengue is an acute infection caused by an arbovirus in the Flavivirus genus, and the mosquito Aedes aegypti is the vector. Case fatality ratio in India is reported to be 3 to 5 percent. One of the least studies complications occurring in dengue is acute kidney injury (AKI) and liver abnormalities are few of the least studied complications of dengue. Hence, we planned the present study to assess the LFT and KFT in Dengue patients. Methods: The present study included assessment of 100 patients out of which 50 patients were found to be sero positive for dengue while rest 50 were found to be sero negative.  Assessment of levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), the degree of hepatic involvement was done in all the patients included in the present study. AKIN definition for classification of AKI (Acute kidney injury) Stages was used for the present study. All the results were analyzed by SPSS software. Results: Total proteins level among dengue sero positive and negative subjects was found to be 7.01 and 7.89 g/dl. Significant results were obtained while comparing the total proteins levels among dengue positive and negative subjects. While comparing the albumin and globulin levels between dengue positive and negative subjects, significant results were obtained. Significant results were obtained while comparing the AST and ALT levels between both the study groups. 14.5 And 63.5 percent of the patients were AKI and AKIN- 1 AKI. Conclusions: Hepatic and renal involvement occurs in patients suffering from dengue fever.

Correlation between Carroll Upper Extremities Functional Test and Fine Motor Domain of Gesell Developmental Scale in Children with Cerebral Palsy / 中国康复理论与实践

Objective To investigate if Carroll Upper Extremities Functional Test (UEFT) is a better rating scale for evaluating fine mo-tor function in children with cerebral palsy. Methods From January, 2011 to January, 2014, 104 children with cerebral palsy were divided in-to non-hemiplegic palsy group (n=76) and hemiplegic palsy group (n=28), they were assessed by two certified valuers in one week. Their fine motor function was evaluated with UEFT and the Gesell Developmental Scale. The scores of UEFT were compared respectively with the developmental age (DA) and developmental quotient (DQ) in fine motor domain of Gesell Developmental Scale. At the same time, the UEFT score of the affected limb was compared with of the unaffected limb in children with hemiplegic palsy. Results In the non-hemiplegic palsy group, the UEFT score strongly correlated with DA (r=0.752, P0.05). The UEFT score of unaffected limb was significantly higher than that of the affected limb (Z=-4.708, P<0.001). Conclusion Both of UEFT and the Ge-sell Developmental Scale could be used clinically in assessment of fine motor function in children with cerebral palsy. The UEFT was better in evaluating children with hemiplegic palsy.

Advance in morphological measurement and functional test for atrophic age-related macular degeneration / 眼科新进展

Age-related macular degeneration (AMD) is the main cause of blindness in the people older than 50 years old,and atrophic age-related macular degeneration accounts for 85％-90％ patients of AMD.Following the application of multi-spectral imaging,fundus autofluorescence,optical coherence tomography,microperimetry,multifocal electroretinogram and other new methods in ophthalmic clinical,the morphological and functional changes of atrophic AMD lesions have been more in-depth and comprehen sive,so this article will give a review on the relevant progress of examination techniques in recent years.

Advance in morphological measurement and functional test for atrophic age-related macular degeneration / 眼科新进展

Age-related macular degeneration (AMD) is the main cause of blindness in the people older than 50 years old,and atrophic age-related macular degeneration accounts for 85％-90％ patients of AMD.Following the application of multi-spectral imaging,fundus autofluorescence,optical coherence tomography,microperimetry,multifocal electroretinogram and other new methods in ophthalmic clinical,the morphological and functional changes of atrophic AMD lesions have been more in-depth and comprehen sive,so this article will give a review on the relevant progress of examination techniques in recent years.

Exercise capacity and pulmonary function in individuals with leprosy / Capacidade funcional de exercício e função pulmonar em indivíduos com hanseníase

Introduction In Brazil 23% of leprosy patients have some type of physical disability after discharge. The impact on the respiratory system and correlation with functional exercise capacity is still unknown. Objective To correlate the functional exercise capacity and pulmonary function in individuals with leprosy sequelae. Materials and methods We evaluated 20 subjects and 25 controls by sensory evaluation, muscle strength, graduate the grade of physical disability followed by pulmonary function tests with spirometry and manovacuometry, besides the functional exercise capacity through the six minute walking distance (6MWD). Results The majority (75%) of the subjects showed physical disability grade 1. The mean of the maximal inspiratory pressure were below than normal -71 ± 31 cmH20 and maximal expiratory pressure +89 ± 22 cmH20. Spirometric values presented measures within normal value. The functional exercise capacity found a reduced value with a distance of 404 ± 92m. Positive and statistically significant correlation between the inspiratory pressures with 6MWD (r = 0.49, p = 0.025) and, similarly, expiratory pressure (r = 0.53, p = 0.004). The same evidence is found in maximal respiratory pressures of individuals in grade 1 with significant correlations (r = 0.52, p = 0.036) and (r = 0.51, p = 0.042). Conclusion Individuals with leprosy sequelae had impaired respiratory muscle strength and functional exercise capacity. Maximal respiratory pressures are presented as an independent factor in the change in performance in the functional exercise capacity. .

Introdução No Brasil 23% dos pacientes com hanseníase apresentam algum tipo de incapacidade física após a alta. O impacto sobre o sistema respiratório e correlações com a capacidade funcional de exercício ainda é desconhecido. Objetivo Correlacionar a capacidade funcional de exercício com a função pulmonar de indivíduos com sequelas de hanseníase. Materiais e métodos Foram avaliados 20 indivíduos e 25 controles através de avaliação sensorial, força muscular dos membros e face, graduado o grau de incapacidade física e, seguido de testes de função pulmonar com espirometria e manovacuometria, além da capacidade funcional de exercício através do teste de caminhada em seis minutos (TC6). Resultados A maioria (75%) dos indivíduos apresentou grau de incapacidade física 1. A média das pressões respiratórias máximas encontrou-se abaixo da normalidade com PImáx – 71 ± 31 cmH20 e PEmáx + 89 ± 22 cmH20. Os valores espirométricos apresentaram medidas dentro dos valores de normalidade. A capacidade funcional de exercício encontrou-se reduzida apresentando média de distância percorrida de 404 ± 92 m. Correlação positiva e estatisticamente significativa entre a PImáx com a distância percorrida no TC6 (r = 0,49 e p = 0,025) e, da mesma forma, a PEmáx (r = 0,53 e p = 0,004). Foram encontrados. A mesma evidência é encontrada nas pressões respiratórias máximas dos indivíduos de grau 1, com correlações significativas PImáx (r = 0,52 e p = 0,036) e PEmáx (r = 0,51 e p = 0,042). Conclusão Indivíduos com sequelas de hanseníase apresentaram comprometimento da força muscular respiratória e da capacidade funcional de exercício. As ...

Relação entre torque extensor e relação I: Q com salto unipodal triplo horizontal em jogadores profissionais de futebol / Relationship between extensor torque and H: Q ratio with triple hop distance in professional soccer players

OBJETIVOS: 1) Determinar e comparar o torque extensor, relação I:Q e distância do salto triplo entre os membros; 2) identificar a relação entre o torque extensor e relação I:Q com o desempenho no salto triplo em jogadores profissionais de futebol. MATERIAIS E MÉTODOS: Foram selecionados 21 indivíduos, homens, idade média de 23,2 anos (± 3,6), saudáveis, sem histórico de lesões, praticantes profissionais de futebol. Os atletas foram avaliados em um dinamômetro isocinético nas velocidades de 60, 180 e 300°/s, das quais foram obtidos os picos de torque e calculada a relação I:Q nas três velocidades. Foi realizada também a avaliação funcional por meio do salto unipodal triplo horizontal, e desse foi obtida a distância saltada em metros. RESULTADOS: Não houve diferença entre membros (dominante e não dominante) para os testes (p = 0,23). Além disso, foi observada baixa correlação entre o torque extensor e teste funcional nas três velocidades (membro dominante: 60°/s_r = 0,38; 180°/s_r = 0,43*; 300°/s_r = 0,26. Membro não dominante: 60°/s_r = 0,36; 180°/s_r = 0,30; 300°/s_r = 0,48*) (*p < 0,05), assim como na relação I:Q e teste funcional (membro dominante: 60_r = 0,01; 180_r = 0,11; 300_r = - 0,02. Membro não dominante: 60_r = - 0,20; 180_r = - 0,15; 300_r = - 0,18). CONCLUSÃO: Devido à baixa correlação, não é possível substituir a avaliação isocinética pelo salto unipodal triplo horizontal (teste funcional) na avaliação da condição muscular.

OBJECTIVE: The aims of this study were: 1) to determine and compare the extensor torque, H:Q ratio and triple hop distance in functional test between lower extremities; 2) to identify the relationship between extensor torque and H:Q ratio with the performance in triple hop distance in professional soccer players. MATERIALS AND METHODS: Twenty-one healthy male professional soccer players, average 23.2 (± 3.6) years old, without history of injury were selected. The athletes were assessed in an isokinetic dynamometer at three angular velocities: 60, 180 and 300°/s, and from this assessment the peak of torque and calculated H:Q ratio at the three velocities were obtained. The triple hop distance was also used to calculate the hopped distance in meters. RESULTS: No significant difference was found between the lower extremities (dominant and non-dominant) (p = 0.23). Also, a weak relationship between extensor torque and functional test at the three velocities was observed (Dominant: 60°/s_r = 0.38; 180°/s_r = 0.43*; 300°/s_r = 0.26. Non dominant: 60°/s_r = 0.36; 180°/s_r = 0.30; 300°/s_r = 0.48*) (*p < 0.05). Similar results were found for H:Q ratio (Dominant: 60_r = 0.01; 180_r = 0.11; 300_r = - 0.02. Non-dominant: 60_r = - 0.20; 180_r = - 0.15; 300_r = - 0.18). CONCLUSION: Due to a weak relationship, the isokinetic test cannot be replaced by the triple hop distance (functional test) for muscular function assessment.

Modulação autonômica cardíaca nas posições supina e bípede em crianças não obesas, obesas e obesas mórbidas / Cardiac autonomic modulation in the supine and standing positions in nonobese, obese and morbidly obese children

Objetivo Avaliar a modulação autonômica cardíaca em crianças não obesas, obesas e obesas mórbidas, por meio do estresse cardiocirculatório promovido pela mudança da postura supina para bípede. Métodos Trata-se de estudo transversal envolvendo trinta crianças, com idade entre 9 e 11 anos, divididas em três grupos: a) não-obesas (n=10), b) obesas (n=10), c) obesas mórbidas (n=10), selecionados conforme os respectivos índices de massa corpórea na tabela do National Center for Health Statistics. Todas elas foram submetidas a avaliação antropométrica e clínica, seguida de aplicação de manobra postural ativa, constituída por mudança postural supino para bípede. Foram monitorados os dados das variáveis cardiovasculares, como pressão arterial e frequência cardíaca, assim como foi analisada a variabilidade da frequência cardíaca. Resultados Todos os grupos apresentaram significativo aumento da contribuição simpática e redução da atividade parassimpática, quando se comparou a variabilidade da frequência cardíaca na posição supina com a bípede. Houve significativa diferença na comparação dos deltas de frequência cardíaca (0 a 10s da manobra postural ativa) entre os grupos não obeso (+24,1bpm) e obeso (+21,7bpm). Conclusão A obesidade não interferiu significativamente nos mecanismos autonômicos cardiovasculares, quando se comparou a variabilidade da frequência cardíaca nas posições supina e bípede em crianças não obesas, obesas e obesas mórbidas

Objective This study assessed the cardiac autonomic modulation in nonobese, obese and morbidly obese children by cardiocirculatory stress induced by standing up from the supine position. Methods This cross-sectional study included 30 children aged 9 to 11 years, divided into three groups: a) nonobese (n=10), b) obese (n=10), c) morbidly obese (n=10), based on their body mass indices, classified according to the National Center for Health Statistics table. All of them underwent anthropometric and clinical assessment, followed by active postural change from the supine heart rate were monitored and the heart rate variability was analyzed. Results All groups presented a significant increase in sympathetic contribution and decrease in parasympathetic activity when the heart rate in the supine and standing positions were compared. The delta heart rate differed significantly (0 to 10s of active postural change) between the nonobese (+24.1bpm) and obese groups (+21.7bpm). Conclusion Obesity did not affect the cardiovascular autonomic mechanisms significantly when the heart rate variability from the supine to the standing position was compared in nonobese, obese and morbidly obese children

Valores funcionales respiratorios pre y post- operatorios en pacientes sometidos a resección pulmonar / Preoperating and postoperating respiratory functional values in patients submissive of lung volume reduction surgery

Se realizó un estudio observacional, analítico, prospectivo, en el período 2006-2008, en el Hospital Neumológico Benéfico Jurídico, con el objetivo de comparar los valores predictivos espirométricos de los enfermos candidatos a resección pulmonar con los obtenidos después de la intervención quirúrgica. La muestra quedó formada por 28 pacientes, residentes en Ciudad de La Habana. Para comparar el valor predictivo del volumen espiratorio forzado en el primer segundo con el valor real, seis meses después de la resección pulmonar se calculó el cociente delta relativo que expresó en porcentaje el grado de coincidencia entre estas dos variables. Una vez recogida la información se sometió a un análisis exploratorio de datos, con pruebas de significación asociadas. Los resultados mostraron que la espirometría clínica tiene un espacio indiscutible en la evaluación de la función pulmonar preoperatoria de los candidatos a resección pulmonar. Los valores predictivos y reales después de la resección pulmonar del volumen espiratorio forzado en el primer segundo fueron semejantes. La lobectomía superior izquierda fue el tipo de intervención quirúrgica con mayor similitud entre estos valores, por el contrario la neumectomía izquierda resultó ser la técnica con mayores diferencias entre los mismos(AU)

We carried out an observacional, analytical, prospective study in the period 2006-2008, at Neumologico Hospital Benéfico Jurídico, with the objective to compare the spirometry predicted values of the patients candidates to pulmonary surgery with the obtained ones after the operation. The sample was formed by 28 patients, residents in Havana City. In order to compare the predictive value of the forced expiratory volume in the first second with the real value six months after the pulmonary surgery, we calculated the quotient relative delta that expressed in percentage the degree of coincidence between these two variables. The information was put under an exploratory analysis of data, with associate tests of meaning. The results showed that the spirometry has an unquestionable space in the evaluation of the preoperating pulmonary function of the candidates to pulmonary surgery. The predictive and real values after the pulmonary surgery of the forced expiratory volume in the first second were similar. The left upper lobectomy was the type of operation with greater similarity between these values, on the contrary the left neumectomy turned out to be the technique with greater differences between such(AU)

The Effect of Amino Acid on Renal Functional Reserve in Senile Persons / 中国医师杂志

Objective To detect the renal reserve in senility and deduce the clinic significance.Methods The glomerular filtration rate and filtration fraction were measured in 43 healthy citizens before and after infusion 18-amino acid to investigate the renal functional reserve.Results Before infusion the amino acid,the range of GFR basal value of senile persons was(58～101)ml/min 1.73m 2 mean value was(76?8.5)ml/min 1.73m 2.And after the amino acid infusion,the GFR value was (65～128)ml/min 1.73m 2,mean value was (103?8.1)ml/min 1.73m 2,there was obviously elevation (P