Flap of the sternocephalicus muscle in the repair of a partial defect in the trachea of a rabbit (Oryctolagus cuniculus)

Purpose: The current study aimed at evaluating the repair of a partial defect of the trachea with a muscle flap, an advanced technique that employs combined suture patterns. Methods: Sixteen healthy male New Zealand white rabbits were used as an experimental model. A partial defect in the trachea within the ventral region of the fourth to eighth tracheal ring was created. Subsequently, repair was initiated with a flap of the sternocephalicus muscle. The animals were divided into four groups for postoperative evaluation using clinical, tracheoscopic, and histopathological analyses. Each group was separated according to the time of euthanasia, programmed at interval of seven (G7), 15 (G15), 30 (G30), and 60 days (G60). Results: One animal from the G60 group died, whereas the other animals had good surgical recovery without serious changes in the breathing pattern. The major clinical signs observed were stridor and coughing. Tracheoscopy revealed secretions in the tracheal lumen, exuberant granulation, and stenosis. Histopathological analysis showed growth of the ciliary respiratory epithelium at the flap site 30 days after implantation. Conclusions: Partial repair showed satisfactory results owing to the anatomical location of the muscle, adequate vascular support, and structural and physiological maintenance without serious changes in the respiratory system.

Mecánica Tusígena / Cough Mechanics

El control neurológico de la tos o la neurofisiología de la tos, implica una serie de eventos complejos en el sistema nervioso que coordinan y desencadenan este reflejo protector pulmonar. Esta intrincada red de señales nerviosas y coordinación muscular se origina en los receptores de la tos, pasa por el centro de la tos en el bulbo raquídeo y finalmente activa los músculos necesarios para la adecuada eliminación del agente irritante. Este mecanismo involucra, la detección del estímulo por receptores especializados, transducción de señales que viajan a lo largo de fibras nerviosas aferentes hacia el sistema nervioso central, centro integrador a nivel del bulbo raquídeo, en el centro de la tos es donde se procesa las señales de los receptores y se coordina la respuesta. La integración de las señales y la respuesta radica en este centro de la tos y en la corteza cerebral quien regula y modula la tos. El control neuronal cortical de la tos implica la participación consciente y voluntaria de la corteza cerebral en la percepción, regulación y adaptación de la tos. La coordinación muscular requiere que la señal viaje por vías nerviosas eferentes motoras hacia los músculos involucrados, la contracción muscular se integra en una secuencia específica que desencadena las fases de la tos, inspiración máxima, compresión y expulsiva.

The neurological control of cough, or the neurophysiology of cough, involves a series of complex events in the nervous system that coordinate and trigger this lung protective reflex. This intricate network of nerve signals and muscle coordination originates from the cough receptors, passes through the cough center in the medulla oblongata, and finally activates the muscles necessary for proper elimination of the irritant. This mechanism involves the detection of the stimulus by specialized receptors, transduction of signals that travel along afferent nerve fibers towards the central nervous system, integrating center at the level of the medulla oblongata, in the cough center is where the signals are processed. receptors and the response is coordinated. The integration of signals and response resides in this cough center and in the cerebral cortex, which regulates and modulates coughing. Cortical neural control of cough involves the conscious and voluntary participation of the cerebral cortex in the perception, regulation, and adaptation of cough. Muscle coordination requires that the signal travel through efferent motor nerve pathways to the muscles involved; muscle contraction is integrated into a specific sequence that triggers the cough, maximum inspiration, compression, and expulsive phases.

Foreign Body Accidents in a Pediatric Emergency Department

Abstract Introduction Foreign body accidents (FBAs) are frequent in children and can be severe, being a common cause of morbidity and mortality and a public health problem. As these accidents are multifactorial, their cause can only be determined by analyzing the clinical details and characteristics of the object. Knowing the associated mechanisms and factors is essential to determine a risk profile and have a preventive, therapeutic, and diagnostic purpose. Objective The present study aimed to describe the incidence of FBAs in otorhinolaryngology according to their anatomical location, focusing on the aerodigestive system. Methods This is a retrospective study performed by reviewing the medical records of 668 cases seen in the emergency department of a tertiary pediatric hospital in São Paulo, state of São Paulo, Brazil, between 2014 and 2017. Results Foreign bodies (FBs) were found in the digestive system (238/668), in the nasal cavities (206/668), in the ears (182/668), in the oropharynx (34/668), and in the respiratory system (8/668). A total of 91.77% of the patients were treated in the emergency room. The main age group affected was < 5 years old, with no difference between genders. The most frequent complications affected the digestive system and the most serious occurred in cases involving the respiratory system. Conclusion Multidisciplinary teams should be ready in the emergency room to provide adequate care in FBAs. Early diagnosis, FB removal in the emergency room or the surgical center and follow-up are essential. Developing prevention campaigns including a risk profile for certain products and/or materials, helping to ensure safety for consumers, is necessary. For this, a national database with compulsory notification containing relevant information on FBAs in the pediatric population should be created.

Hipoplasia tímica en pacientes pediátricos con enfermedad respiratoria / Thymic hypoplasia in pediatric patients with respiratory illnesses

Objetivos : Determinar las características clínicas y epidemiológicas de niños con hipoplasia del timo y enfermedad respiratoria en Cuba. Material y Métodos : Estudio descriptivo retrospectivo en niños con edades comprendidas entre 1 y 6 años, de ambos sexos, atendidos en la consulta de Inmunología Pediátrica del Programa de Proyección Comunitaria del Municipio Arroyo Naranjo de La Habana o en la consulta de Inmunología Pediátrica del Hospital Materno Infantil Ángel Arturo Aballí Arellano del Municipio Arroyo Naranjo La Habana, entre los meses de septiembre 2019 y agosto 2022. Se incluyeron los niños con hipoplasia tímica y con antecedentes personales de enfermedad respiratoria infecciosa o no infecciosa diagnosticadas durante el período de estudio. Resultados : No se encontró relación entre la hipoplasia tímica y la edad o el sexo; se encontró mayor frecuencia de la hipoplasia tímica leve y moderada en niños con desarrollo de enfermedad respiratoria grave. Los factores con mayor frecuencia descritos en la enfermedad respiratoria complicada fueron la lactancia materna inefectiva, los antecedentes patológicos personales de atopia, el embarazo de riesgo, la prematuridad, el humo de tabaco en el ambiente y la asistencia a círculo infantil o a casa de cuidado infantil. Conclusiones : El desarrollo de hipoplasia tímica no mostró relación con la edad y el sexo. Se describieron varias condiciones con mayor frecuencia en niños con hipoplasia tímica y con enfermedad respiratoria complicada. La frecuencia de la hipoplasia tímica leve y moderada fue mayor en los pacientes con enfermedad respiratoria grave.

SUMMARY Objective : To determine the clinical and epidemiologic features of children with thymic hypoplasia and respiratory illnesses in Cuba. Methods : A retrospective study was conducted among children of 1-6 years of age of both sexes attended at a Pediatric Immunology Program of Hospital Materno Infantil Ángel Arturo Aballí Arellano in Habana, Cuba from September 2019 to August 2022. Children with thymic hypoplasia with and without a history of a respiratory illness either infectious or non-infectious were included. Results : No association between age and sex with thymic hypoplasia but an association was found with children with a severe respiratory illness. Factors associated with a severe respiratory illness were ineffective breastfeeding, history of an atopic condition, pregnancy of high risk, prematurity and exposure to tobacco smoke. Conclusions : Thymic hypoplasia was not associated with age or sex. An association with mild-moderate thymic hypoplasia was found with a severe respiratory illness.

Morphological Effects of Cigarette Smoking on Respiratory System and Related Functions Based on AQPs Expression

SUMMARY: A great deal of attention of air pollution on respiratory health is increasing, particularly in relation to haze days. It is that exposure to cigarette smoke augments the toxicity of common air contaminants, thereby increasing the complexity of respiratory diseases. Although there are various mechanisms involved to respiratory diseases caused or worsen by cigarette smoking, in which the role of AQPs in the lung with regard to fluid homeostasis still remains elusive. In this paper, we copied the rat models based on smoke generator, and investigated the morphological changes of mucosa and related functions depending on the balance of lining liquid of alveoli via AQPs expression. Compared with normal group, weak labelling of AQP1 and AQP5 protein abundance were clearly detected in the corresponding part of smoke exposure groups compared with normal group. Hence, it is suggested that the contribution of AQPs in the lung is diminished, thereby causing perturbed balancing between resorptive and secretory fluid homeostasis under cigarette smoking.

Cada vez se presta más atención a la contaminación del aire en la salud respiratoria, particularmente, en relación con los días de neblina. En consecuencia la exposición al humo del cigarrillo aumenta la toxicidad de los contaminantes comunes del aire, lo que además aumenta la complejidad de las enfermedades respiratorias. Aunque existen varios mecanismos involucrados en las enfermedades respiratorias causadas o empeoradas por el tabaquismo, en las que el papel de las AQP en el pulmón respecto a la homeostasis de líquidos sigue siendo difícil de alcanzar. En este artículo, copiamos los modelos de rata basados en el generador de humo e investigamos los cambios morfológicos de la mucosa y las funciones relacionadas según el equilibrio del líquido de revestimiento de los alvéolos a través de la expresión de AQP. En comparación con el grupo normal, se detectó claramente un etiquetado débil de la abundancia de proteínas AQP1 y AQP5 en la parte correspondiente de los grupos de exposición al humo en comparación con el grupo control. Por lo tanto, se sugiere que la contribución de las AQP en el pulmón está disminuida, provocando así un equilibrio perturbado entre la homeostasis del líquido secretor y de reabsorción bajo el hábito de fumar cigarrillos.

Associação entre doenças respiratórias e fumo passivo domiciliar em crianças de 6 a 10 anos atendidas pela atenção primária em Araguaína/TO / Association between respiratory diseases and passive smoking at home in children from the age of 6 to 10 years old assisted by the primary healthcare in Araguaína, Tocantins / Asociación entre enfermedades respiratorias y tabaco pasivo en hogares con niños entre 6 y 10 años atendidos por atención primaria en Araguaína-TO

Introdução: O tabagismo é definido como a dependência física e psicológica de tabaco, e o fumo passivo consiste na inalação da fumaça de derivados do tabaco por não fumantes. As crianças são especialmente vulneráveis à exposição à fumaça do tabaco. Objetivo: Identificar a associação entre fumo passivo domiciliar e morbidade respiratória em pré-escolares de seis a dez anos, por meio de coleta de dados na Atenção Primária à Saúde em Araguaína/TO. Métodos: Estudo de perfil descritivo, com corte transversal de caráter quantitativo, conduzido em três unidades básicas de saúde. Foi determinada uma amostra de 72 entrevistados, selecionados de forma aleatória em meio às unidades básicas. Os resultados foram colhidos de questionários respondidos por familiares ou responsáveis das crianças. Resultados: O teste de Odds Ratio (OR) obteve o resultado de 3,06, com intervalo de confiança de 95% ­ IC95% 1,16 ­ 8,11 e p<0,05, revelando assim a existência de correlação entre o desenvolvimento de doenças respiratórias e o fumo passivo domiciliar em crianças de seis a dez anos. A prevalência do tabagismo passivo domiciliar foi de 44,4%, expondo à fumaça do cigarro as crianças, que manifestam sintomas como tosse seca, chiado no peito, respiração rápida, dor e secreção no ouvido. Conclusões: Foi comprovada a associação entre tabagismo passivo domiciliar e morbidade respiratória entre crianças de seis a dez anos. Não se obteve a conexão entre o tabagismo passivo e o aumento do número de internações por causa respiratória.

Introduction: smoking is defined as the physical and psychological dependence of tobacco, passive smoke consists of inhaling the smoke and tobacco derivatives by non-smokers. Children are especially vulnerable to exposure to tobacco smoke. Objective: identify the association between passive smoking at home and respiratory tract morbidity in pre-school children from the age of 6 to 10 years old, utilizing data gathering in Primary Healthcare units from Araguaína ­ TO. Methods: cross-sectional descriptive research with quantitative character conducted within three Basic Healthcare Units. A sample comprised of 72 interviewed subjects was determined, selected in random fashion at the healthcare units. Results: The Odds Ratio test obtained the result of OR 3.06, with 95%CI 1.16­8.11 and p<0.05, thus evidencing the existence of a correlation between the development of respiratory diseases and the secondhand smoke in children aged 6 to 10 years. The prevalence of passive smoking at home was 44,4%, exposing, this way, the children to cigarette smoke, leading to the manifestation of symptoms such as dry cough, wheezing, fast breathing, pain, and auricular secretions. Conclusions: the association between passive smoking at home and respiratory tract morbidity in children from the age of 6 to 10 years old was proved. No connection between passive smoking and the increase of respiratory tract-related hospitalizations was obtained.

Introducción: El tabaquismo se define como la dependencia física y psicológica al tabaco, el humo de segunda mano consiste en la inhalación del humo del tabaco por parte de los no fumadores. Los niños son especialmente vulnerables a la exposición al humo del tabaco. Objetivo: Identificar la asociación entre el humo de segunda mano en el hogar y la morbilidad respiratoria en niños preescolares de 6 a 10 años, a través de la recolección de datos en la Atención Primaria de Salud en Araguaína-TO. Métodos: estudio descriptivo de perfil, de corte transversal cuantitativo, realizado en tres unidades básicas de salud. Se determinó una muestra de 72 entrevistados, seleccionados aleatoriamente entre las unidades básicas. Resultados: la prueba de Odds Ratio obtuvo el resultado de OR 3.06, con IC95% 1,16­8,11 y p<0,05, evidenciando así la existencia de una correlación entre el desarrollo de enfermedades respiratorias y el humo de segunda mano en niños de 6 a 10 años. La prevalencia de tabaquismo pasivo en el hogar fue del 44,4%, exponiendo así a los niños al humo del cigarrillo, manifestando síntomas como tos seca, sibilancias, respiración acelerada, dolor y secreción en el oído. Conclusiones: se comprobó la asociación entre el tabaquismo pasivo en el hogar y la morbilidad respiratoria en niños de 6 a 10 años. No hubo relación entre el tabaquismo pasivo y el aumento del número de hospitalizaciones por causas respiratorias.

The damaging effect of ozone in the respiratory system / 中国职业医学

The global issue of ozone pollution is becoming increasingly prominent. Previous epidemiological studies suggested that ozone might cause respiratory system damage and increase the risk of mortality from all causes, as well as respiratory diseases such as chronic obstructive pulmonary disease and pneumonia. It results in severe illness and economic burden. Ozone can also lead to lung inflammation, asthma, and chronic obstructive pulmonary disease, increasing susceptibility to pathogen infections and affecting lung development. Some studies have observed upregulated of serum amyloid-like protein A and neutrophil chemotactic keratinocyte chemoattractant in mice exposed to ozone, along with increased percentage of polymorphonuclear leukocytes, total protein, oxidative proteins, lactate, and phospholipids in bronchoalveolar lavage fluid. Ozone exposure could cause enlarged alveolar spaces, granulocyte infiltration, type 2 inflammation, mucus obstruction, and metaplasia of mucus cells in the lungs of mice. When mass concentration of ozone was 1.962 mg/m3, rats showed necrosis and detachment of bronchial ciliated cells, swelling of type 1 alveolar epithelial cells, disruption of endothelium in capillaries, and increased emptying of type 2 alveolar epithelial cells. At a mass concentration of 5.886 mg/m3, monkeys showed degeneration or complete loss of the inner layers of alveolar epithelium, partial pulmonary interstitial edema, and thickening of the blood-air barrier. Ozone could induce oxidative stress, leading to increased oxidative stress response in cells. Particular attention should be paid to personal protection for workers exposed to ozone, researches on the mechanisms related to ozone, as well as the development of corresponding treatments, preventive drugs, and medical devices.

The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population.@*METHODS@#We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort).@*RESULTS@#In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women.@*CONCLUSION@#The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.

Role of interleukin-6 signaling pathway in adverse health effects induced by air pollution / 环境与职业医学

Air pollution is one of the most important environmental issues in China and worldwide, as well as a critical public health problem affecting human health. With the implementation of emission reduction and other programs, the air quality in China has been improved dramatically in recent years, but is still worse than the WHO guideline recommended levels. Numerous epidemiological and toxicological studies have shown that short-term or long-term exposure to air pollution is strongly associated with respiratory diseases, cardiovascular diseases, diabetes, and so forth, in which interleukin-6 (IL-6), a well-known inflammatory factor, may play an important role. Studies have found that IL-6 can bind to interleukin-6 receptor (IL-6R) , which leads to the recruiting and activation of glycoprotein 130, and then the formed IL-6/IL-6R/gp130 complex triggers the janus kinase/signal transducer and activator of transcription, Src homology-2 domain-containing protein tyrosine phosphatase-2/mitogen-activated protein kinase, and phosphatidylinositol 3-kinase/protein kinase B signaling pathways. All of these signaling pathways are found to be involved in a variety of physiopathological processes. In the present review, information about the IL-6 signaling pathway and its role in air pollution-induced adverse health effects was systematically reviewed, hoping to provide insights for the future prevention and control policies.

Fisiología respiratoria: mecanismos de defensa del sistema respiratorio / Defense mechanisms of the respiratory system

El sistema respiratorio cumple múltiples funciones no respiratorias, entre ellas es fundamental su rol en la defensa del organismo frente a una gran variedad de agentes externos potencialmente nocivos. Para ello, cuenta con mecanismos de protección de la vía aérea, dado por sus estructuras anatómicas, reflejos y el transporte mucociliar, además de un complejo y amplio desarrollo del sistema inmune pulmonar. El objetivo de este articulo es revisar los conceptos y componentes más importantes de función defensiva del sistema respiratorio.

The respiratory system fulfills multiple non-respiratory functions, including its role in defending the body against a wide variety of potentially harmful external agents. For this, it has airway protection mechanisms, given by its anatomical structures, reflexes and mucociliary transport, as well as a complex and extensive development of the pulmonary immune system. The objective of this article is to review the most important concepts and components of the defensive function of the respiratory system.

Cigarros eletrônicos: uma abordagem acerca do conhecimento de jovens adultos e os riscos para o sistema respiratório / Electronic cigarettes: an approach about the knowledge of young adults and the risks to the respiratory system / Cigarrillos electrónicos: una aproximación sobre el conocimiento de los adultos jóvenes y los riesgos para el sistema respiratorio

A presente pesquisa teve o objetivo de avaliar o conhecimento dos jovens adultos sobre os cigarros eletrônicos e os seus efeitos no sistema respiratório. Tratou-se de uma pesquisa transversal, descritiva, com abordagem quantitativa, que foi desenvolvida através da plataforma Google Forms com aplicação de um questionário, contendo dados sociodemográficos e informações acerca do nível de conhecimento sobre os cigarros eletrônicos, divulgado nos grupos de Whatsapp e redes sociais, durante o período de julho a outubro de 2022. A amostra foi composta por adultos jovens, com idade entre 18 e 24 anos, com histórico de tabagismo ou não. Foram respeitadas as normas da Resolução 466/12 do Conselho Nacional de Saúde e a análise foi feita através da estatística descritiva simples. O estudo contou com a participação de 80 indivíduos, com participação homogênea entre os gêneros , sendo 40 do sexo feminino e 40 do masculino, com média de idade dos participantes de 21 anos ± 2,16, no qual, 35% (n=28) utilizam cigarros eletrônicos, 48% (n=38) afirmam ter alto nível de conhecimento sobre os mesmos, 41% (n=33) acreditavam que os dispositivos eletrônicos possuíam o mesmo risco que os cigarros convencionais, com isso, 76% (n=61) afirmam que os cigarros eletrônicos podem causar malefícios, mas não especificaram, além disso, observou-se que 25% (n=20) relatam sentir sensação de relaxamento, prazer ao consumir cigarro eletrônico. Dessa forma, pode-se observar que a amostra da pesquisa possui conhecimento sobre os cigarros eletrônicos, assim como os riscos, embora não saibam quais especificamente, bem como sua proporção no sistema respiratório.

This research aimed to evaluate the knowledge of young adults about electronic cigarettes and their effects on the respiratory system. This was a cross- sectional, descriptive research, with quantitative approach, which was developed through the Google Forms platform with application of a questionnaire, containing sociodemographic data and information about the level of knowledge about electronic cigarettes, disclosed in Whatsapp groups and social networks, during the period from July to October 2022. The sample was composed of young adults, aged between 18 and 24 years, with a history of smoking or not. The norms of Resolution 466/12 of the National Health Council were respected and the analysis was done through simple descriptive statistics. The study had the participation of 80 individuals, with homogeneous participation between genders, 40 females and 40 males, with a mean age of 21 years ± 2.16, in which, 35% (n=28) use electronic cigarettes, 48% (n=38) claim to have a high level of knowledge about them, 41% (n=33) believed that electronic devices have the same risk as conventional cigarettes, with this, 76% (n=61) stated that electronic cigarettes can cause harm, but did not specify, in addition, it was observed that 25% (n=20) report feeling a sense of relaxation, pleasure when consuming electronic cigarette. Thus, it can be observed that the research sample has knowledge about electronic cigarettes, as well as the risks, although they do not know which ones specifically, as well as their proportion on the respiratory system.

La presente investigación tuvo como objetivo evaluar el conocimiento de los jóvenes adultos sobre los cigarrillos electrónicos y sus efectos sobre el sistema respiratorio. Se trató de una investigación transversal, descriptiva, con abordaje cuantitativo, que se desarrolló a través de la plataforma Google Forms con aplicación de un cuestionario, conteniendo datos sociodemográficos e informaciones sobre el nivel de conocimiento sobre cigarrillos electrónicos, divulgados en grupos de Whatsapp y redes sociales, durante el período de julio a octubre de 2022. La muestra fue compuesta por jóvenes adultos, con edad entre 18 y 24 años, con historia de fumador o no. Fueron respetadas las normas de la Resolución 466/12 del Consejo Nacional de Salud y el análisis fue hecho a través de estadística descriptiva simple. El estudio contó con la participación de 80 individuos, con participación homogénea entre géneros, siendo 40 mujeres y 40 hombres, con edad media de los participantes de 21 años ± 2,16, en los cuales, 35% (n=28) utilizan cigarrillos electrónicos, 48% (n=38) afirman tener alto nivel de conocimiento sobre los mismos, 41% (n=33) creen que los dispositivos electrónicos tienen el mismo riesgo que los cigarrillos convencionales, con esto, 76% (n=61) afirman que los cigarrillos electrónicos pueden causar daño, pero no especificaron, además, se observó que 25% (n=20) dicen sentir sensación de relajación, placer al consumir cigarrillo electrónico. Por lo tanto, se puede observar que la muestra de la investigación tiene conocimiento sobre los cigarrillos electrónicos, así como los riesgos, aunque no saben cuáles específicamente, así como su proporción en el sistema respiratorio.

Patência nasal em crianças respiradoras orais / Nasal patency in mouth breathing children

RESUMO Vários estudos mostram a importância da avaliação quantitativa na patência nasal e do estado funcional das vias aéreas superiores para fornecer informações clínicas e diagnósticas em indivíduos respiradores orais, as quais são de grande interesse para a fonoaudiologia. O objetivo deste estudo foi avaliar o efeito da irrigação de solução salina nasal nas vias aéreas superiores através da aeração nasal e rinomanometria anterior ativa em crianças respiradoras orais. Estudo de série de oito casos, realizado em crianças com idades entre 7 e 10 anos, com diagnóstico clínico otorrinolaringológico de respiração oral. O estudo consistiu em três etapas: avaliação inicial; intervenção e avaliação final. Foram aplicados os questionários do Índice de Identificação dos Sinais e Sintomas da Respiração Oral e qualidade de vida específica para doenças em pacientes pediátricos com queixas sinonasais. Realizaram-se as avaliações da aeração nasal e o exame da rinomanometria anterior ativa. A intervenção foi realizada por meio da irrigação de solução salina nasal com 10 ml. Em seguida, os pacientes foram reavaliados pela avaliação da aeração nasal e rinomanometria, para comparar os resultados. Em relação à avaliação da aeração nasal e rinomanometria, das 16 medidas comparativas entre pré e pós-irrigação nasal, constataram-se mudanças significativas na aeração nasal e na resistência nasal. A irrigação nasal resultou em melhora nas medidas da aeração nasal, enquanto para o fluxo nasal da rinomanometria, as medidas permaneceram inalteradas entre pré e pós-irrigação nasal.

ABSTRACT Several studies have shown the importance of quantitative assessment in nasal patency and functional status of the upper airways to provide clinical and diagnostic information in oral breather individuals, which are of great interest to speech therapy. The aim of the study was to evaluate the effect of nasal saline solution irrigation on the upper airways through nasal aeration and active anterior rhinomanometry in oral breathing children. This was an eight case series study, carried out in children aged 7 to 10 years with an otorhinolaryngological clinical diagnosis of mouth breathing. The study consisted of three stages: (I) initial evaluation; (II) intervention; and (III) final evaluation. The questionnaires of the Index for the Identification of Oral Breathing Signs and Symptoms and disease-specific quality of life in pediatric patients with sinonasal complaints were applied, nasal aeration assessments and the anterior active rhinomanometry exam were carried out. The intervention was performed by irrigating nasal saline solution with 10ml. Afterwards, they were re-evaluated by nasal aeration evaluation and rhinomanometry to compare the results. Regarding nasal aeration and rhinomanometry evaluation, from the 16 comparative measurements between pre and post nasal irrigation, we obtained significant changes in nasal aeration and nasal resistance. Nasal irrigation resulted in improvement in nasal aeration measurements while nasal flow measurements from rhinomanometry remained unchanged considering pre and post nasal irrigation.

Infecciones respiratorias recurrentes en paciente escolar, asociadas a Síndrome de Mounier-Khün: reporte de caso / Recurrent respiratory infections associated with Mounier-Khün Syndrome in a school patient: clinical case report / Infecções respiratórias recorrentes associadas à Síndrome de Mounier-Khün num paciente escolar: relato do caso

El síndrome de Mounier Kühn es una patología infrecuente de la vía aérea, caracterizada por una dilatación anormal de tráquea y bronquios. Se debe sospechar ante la presencia de infecciones broncopulmonares recurrentes e irritación traqueobronquial. El diagnóstico se lleva a cabo a través de la medición del diámetro traqueal en tres segmentos de su anatomía, a través de tomografía torácica. Se presenta el caso de un paciente masculino escolar de 10 años de edad, con antecedentes de infecciones respiratorias recurrentes, hospitalizado por un cuadro neumónico; los hallazgos reportados en la tomografía de tórax corresponden a traqueobroncomegalia además de incremento del diámetro esofágico. El tratamiento de esta entidad es sintomático con medidas de sostén y fisioterapia pulmonar.

Mounier Kühn syndrome is a rare airway pathology characterized by abnormal dilatation of the trachea and bronchi. It should be suspected in the presence of recurrent bronchopulmonary infections and tracheobronchial irritation. The diagnosis is made by measuring the tracheal diameter in three segments of its anatomy, through thoracic tomography. We present the case of a 10 year-old male school boy with a history of recurrent respiratory infections, hospitalized for a pneumonic condition; the findings reported in the thoracic tomography correspond to a tracheobronchomegaly in addition to an increase of the esophageal diameter. The treatment of this entity is symptomatic with supportive measures and pulmonary physical therapy.

A síndrome de Mounier Kühn é uma patologia incomumdas vias aéreas, caracterizada por dilatação anormal da traqueia e brônquios. Devese suspeitar na presença de infecções broncopulmonares recorrentes e irritação traqueobrônquica. O diagnóstico é realizado através da medida do diâmetro traqueal em três segmentos de sua anatomia, através da tomografia de tórax. Apresentamos o caso de um paciente escolar de 10 anos de idade, do sexo masculino, com história de infecções respiratórias de repetição, internado por sintomas pneumônicos; os achados relatados na tomografia de tórax correspondem a uma traqueobroncomegalia, além de aumento do diâmetro esofágico. O tratamento dessa entidade é sintomático com medidas de suporte e fisioterapia pulmonar.

Accuracy of the nursing diagnosis of ineffective airway clearance in intensive care unit patients / Acurácia do diagnóstico de enfermagem desobstrução ineficaz de vias aéreas em pacientes de unidade de terapia intensiva / Precisión del diagnóstico de enfermería de limpieza ineficaz de las vías aéreas en pacientes de unidades de cuidados intensivos

ABSTRACT Objectives: to analyze the accuracy of the clinical indicators of ineffective airway clearance in adult intensive care unit patients. Methods: diagnostic accuracy study, performed in the intensive care unit of a university hospital in northeastern Brazil. The sample consisted of 104 patients hospitalized between June and October 2019. Results: the prevalence of ineffective airway clearance was 36.54%. The indicators with high specificity included absence of cough (0.8326), orthopnea (0.6817), adventitious breath sounds (0.8175), and diminished breath sounds (0.8326). The clinical indicators with high sensitivity and specificity were alteration in respiratory rate (0.9999) and alteration in respiratory pattern (0.9999). Conclusions: six clinical indicators provided an accurate identification of ineffective airway clearance. The clinical indicators alteration in respiratory rate and alteration in respiratory pattern were the most accurate for critical adult patients. The findings of this study contribute to accurate diagnostic inferences and to prevention of respiratory complications in these patients.

RESUMO Objetivos: analisar a acurácia dos indicadores clínicos de desobstrução ineficaz de vias aéreas em pacientes de unidade de terapia intensiva adulto. Métodos: estudo de acurácia diagnóstica em unidade de terapia intensiva de um hospital universitário do nordeste do Brasil. Amostra de 104 pacientes internados entre junho e outubro de 2019. Resultados: a prevalência de desobstrução ineficaz de vias aéreas foi de 36,54%. Os indicadores com alta especificidade foram ausência de tosse (0,8326), ortopneia (0,6817), sons respiratórios adventícios (0,8175) e sons respiratórios diminuídos (0,8326). Os indicadores clínicos com alta sensibilidade e especificidade foram alteração na frequência respiratória (0,9999) e alteração no padrão respiratório (0,9999). Conclusões: seis indicadores clínicos forneceram identificação precisa da desobstrução ineficaz de vias aéreas. Os indicadores clínicos alteração na frequência respiratória e alteração no padrão respiratório foram os mais precisos para pacientes críticos. Os achados contribuem para inferências diagnósticas precisas e para prevenção de complicações respiratórias nesses pacientes.

RESUMEN Objetivos: analizar la precisión de indicadores clínicos de limpieza ineficaz de las vías aéreas en pacientes de unidades de cuidados intensivos adulto. Métodos: estudio de precisión diagnóstica en unidad de cuidados intensivos de hospital universitario en noreste brasileño. Muestra de 104 pacientes hospitalizados entre junio y octubre de 2019. Resultados: prevalencia de limpieza ineficaz de las vías aéreas del 36,54%. Indicadores con alta especificidad; ausencia de tos (0,8326), ortopnea (0,6817), ruidos respiratorios adventicios (0,8175) y ruidos respiratorios disminuidos (0,8326). Indicadores clínicos con alta sensibilidad y especificidad; cambio en la frecuencia respiratoria (0,9999) y cambio en el patrón de respiración (0,9999). Conclusiones: seis indicadores clínicos proporcionaron identificación precisa de la limpieza ineficaz de las vías aéreas; cambio en la frecuencia respiratoria y cambio en el patrón de respiración fueron los más precisos para pacientes críticos. Nuestros hallazgos contribuyen a inferencias diagnósticas precisas y la prevención de complicaciones respiratorias en estos pacientes.

Predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS / Fatores preditivos de maior precisão diagnóstica com EBUS com sonda radial

ABSTRACT Objective: To assess predictive factors for improved diagnostic accuracy with the use of radial-probe EBUS (RP-EBUS). Methods: This was a retrospective review of consecutive patients undergoing RP-EBUS between February of 2012 and January of 2020. Parameters including the presence of a bronchus sign on CT scans, the position of the radial EBUS probe, lesion size, lesion location, and lesion type were analyzed in relation to two defined outcomes (final diagnosis or no diagnosis). Univariate analysis was used in order to explore the individual effects of each parameter on diagnostic accuracy. Multivariate logistic regression was performed to identify significant predictors of diagnostic accuracy. Results: RP-EBUS was used for diagnostic purposes in 101 patients. The lesion was < 3 cm in size in 59 patients (58.4%) and predominantly solid in 60.3%. There was a positive correlation between radial EBUS probe position and diagnostic accuracy (p = 0.036), with 80.9% of the patients showing a bronchus sign on CT scans. Furthermore, 89% of the patients showed a bronchus sign on CT scans and a correlation with diagnostic accuracy (p = 0.030), with 65.8% of the lesions being located in the left/right upper lobe (p = 0.046). When the radial EBUS probe was within the target lesion, the diagnostic yield was = 80.8%. When the probe was adjacent to the lesion, the diagnostic yield was = 19.2%. A bronchus sign on CT scans was the only parameter that independently influenced diagnostic accuracy (adjusted OR, 3.20; 95% CI, 1.081-9.770; p = 0.036). Conclusions: A bronchus sign on CT scans is a powerful predictor of successful diagnosis by RP-EBUS.

RESUMO Objetivo: Avaliar fatores preditivos de maior precisão diagnóstica com EBUS com sonda radial. Métodos: Revisão retrospectiva de pacientes consecutivos submetidos a EBUS radial entre fevereiro de 2012 e janeiro de 2020. Parâmetros como a presença do sinal brônquico na TC, a posição da sonda radial de EBUS, o tamanho da lesão, a localização da lesão e o tipo de lesão foram analisados em relação a dois desfechos definidos (diagnóstico final ou sem diagnóstico). A análise univariada foi usada para explorar os efeitos individuais de cada parâmetro na precisão do diagnóstico. A regressão logística multivariada foi realizada para identificar preditores significativos de precisão diagnóstica. Resultados: O EBUS radial foi usado para fins diagnósticos em 101 pacientes. A lesão era < 3 cm em 59 pacientes (58,4%) e predominantemente sólida em 60,3%. Houve correlação positiva entre a posição da sonda radial de EBUS e a precisão do diagnóstico (p = 0,036), sendo que 80,9% dos pacientes apresentaram o sinal brônquico na TC. Além disso, 89% dos pacientes apresentaram o sinal brônquico na TC e correlação com a precisão do diagnóstico (p = 0,030), sendo que 65,8% das lesões localizavam-se no lobo superior esquerdo/direito (p = 0,046). Com a sonda radial de EBUS dentro da lesão-alvo, o rendimento diagnóstico foi de 80,8%. Com a sonda adjacente à lesão, o rendimento diagnóstico foi de 19,2%. O sinal brônquico na TC foi o único parâmetro que influenciou de forma independente a precisão do diagnóstico (OR ajustada = 3,20; IC95%: 1,081-9,770; p = 0,036). Conclusões: O sinal brônquico na TC é um poderoso preditor de diagnóstico bem-sucedido por meio de EBUS radial.

Application progress of air-liquid interface exposure technology in respiratory system toxicity induced by diesel exhaust in vitro / 环境与职业医学

Diesel exhaust (DE) is an important pollution source widely existing in the living and production environment, which is closely related to the health of the public and occupational groups. The International Agency for Research on Cancer has classified DE as a Group 1 carcinogen. Considering the negative health impacts on the respiratory system due to DE exposure in vitro, it is crucial to apply reliable test systems allowing accurate assessment of the biological effects of DE. The exposure technology of respiratory system in vitro is considered as one of the feasible measures to implement the 3R (reduce, refine, and replace) principle in animal experiments. Compared with the traditional submerged culture in vitro models, the air-liquid interface (ALI) exposure technology has the advantages including fewer influencing factors, easier exposure condition control, and shorter exposure cycle. ALI has become an important tool to study molecular events associated with physiology and pathology of respiratory system, and action modes and interactions of different cell types. Also, ALI has been increasingly widely used because it can simulate the actual processes of human respiratory system cells and/or tissues to DE exposure. This review was intended to introduce the development and advantages of ALI exposure technology, and further summarized the application progress of ALI exposure technology in studying the respiratory toxicity induced by DE exposure in vitro, so as to provide new ideas and pathways for the use of ALI exposure technology in the study of biomarkers and mechanisms of respiratory toxicity associated with DE exposure, and provide basic data to screen and promote biomarkers for exposed populations.

Ensino do exame respiratório: o que é história e o que é necessidade? / Teaching the respiratory physical examination: what is history and what is needed?

A semiologia é uma das técnicas mais utilizadas na prática médica há séculos. Ensinada por meio de roteiros sistematizados, estudantes de inúmeras escolas da área de saúde por todo o mundo aprendem as manobras semiológicas como fundamento na avaliação dos pacientes. No entanto, apesar de extremamente difundida, discute-se pouco sobre sua acurácia como manobra diagnóstica. Tendo este ponto em vista, este artigo aborda a precisão das diversas manobras semiológicas do exame físico do aparelho respiratório e a descrição comparativa do seu ensino em diferentes escolas médicas no mundo. Como resultados, tem-se valores de acurácia discordantes, o que pode ser justificado pela qualidade dos estudos ou pelas variáveis analisadas que diferem entre os estudos e propostas de padronização. Em conclusão, a semiologia é a base da avaliação médica, independentemente dos avanços e disponibilidade dos exames de imagens, e cada manobra deve ser ensinada com seu devido valor científico. Conhecer a aplicabilidade e individualizar a prática das etapas do exame respiratório pode ser um caminho possível de adequação aos tempos atuais, sem impor perdas de informações relevantes para o desenvolvimento do raciocínio clínico (AU)

Medical semiology has been one of the most common techniques used in medical practice for centuries. Health science students around the globe learn these techniques through a systematized model as a fundamental skill for patient evaluation. However, though being widespread, little is known about semiology's true accuracy as a diagnostic maneuver. Knowing that, through a literature review, this paper evaluated the precision of the preconized procedures that are used as part of the exam of the respiratory system and the comparative description of its teaching in different medical schools around the world. As a result, disagreement between several papers was found, which can be justified by the poor quality of the studies and the different variables that were studied in each one. However, one thing is still clear: respiratory physical examination continues to be essential in medical practice, independently of the recent advances and availability of imaging exams. Teaching each step should consider available scientific evidence. The knowledge of the applicability and practical individualization of the respiratory examination can be a possible way for the current times without missing relevant information for developing clinical reasoning (AU)

Secuelas pos-COVID-19 a largo plazo. Un estudio de revisión / Long-term post-COVID-19 sequelae. A review study

RESUMEN En la actualidad, son más frecuentes las investigaciones en las que se reportan que los sobrevivientes de la infección por SARS-CoV-2 no recuperan su estado de salud previo al proceso viral. El estudio recogió información acerca de las diversas secuelas registradas en investigaciones originales indizadas en bases de datos como Scielo, Scopus y Pubmed. Se encontraron 11 artículos sobre pacientes que tuvieron COVID-19, que participaron en diversos estudios en la etapa posterior al proceso agudo de la enfermedad, incluso, algunos de ellos fueron evaluados después de seis meses de haber iniciado la sintomatología; sin embargo, seguían presentando síntomas después de la remisión de la enfermedad. En otros artículos se realizó la evaluación a los pacientes mediante exámenes de imagen como tomografía axial computarizada y resonancia magnética cardiaca. Los resultados indicaron secuelas en el sistema respiratorio como disnea, fatiga, lesiones compatibles con fibrosis pulmonar; mientras que, en el sistema cardiovascular se reportaron secuelas como taquicardia, palpitaciones, hipertensión arterial, miocarditis y derrame pericárdico. Asimismo, en el sistema nervioso se evidenciaron secuelas como cefalea, ageusia, anosmia, insomnio, amnesia y déficit de concentración; en el sistema musculoesquelético se registró artralgia, mialgia, dificultad para movilizarse, y, finalmente, en la salud mental, las afecciones registradas fueron ansiedad, trastorno de estrés postraumático, depresión, abulia, disforia y sentimientos de inferioridad.

At present, investigations are more frequent in which it is reported that survivors of the SARS-CoV-2 infection do not regain their state of health prior to the viral process. The study collected information about the various sequelae recorded in original research indexed in databases such as Scielo, Scopus, and Pubmed, 11 articles were found from patients who had COVID-19, who participated in various studies in the post-acute stage of the acute disease process. the disease, some of them were even evaluated after 6 months of having started the symptoms, however, they continued presenting symptoms after the remission of the disease. In other articles, patients were evaluated by imaging tests such as computed axial tomography and cardiac magnetic resonance imaging. The results indicated sequelae in the respiratory system such as dyspnea, fatigue, lesions compatible with pulmonary fibrosis; while, in the cardiovascular system, sequelae such as tachycardia, palpitations, arterial hypertension, myocarditis and pericardial effusion were reported. Likewise, sequelae such as headache, ageusia, anosmia, insomnia, amnesia and concentration deficit were evidenced in the nervous system; In the musculoskeletal system, arthralgia, myalgia, difficulty moving, and, finally, in mental health, the conditions recorded were anxiety, post-traumatic stress disorder, depression, apathy, dysphoria, and feelings of inferiority.

Evaluation of sports ability to improve patients with pulmonary disease / Avaliação da habilidade no esporte para a melhoria de pacientes com doença pulmonar / Evaluación de la habilidad en el deporte para la mejoría de pacientes con enfermedad pulmonar

ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common diseases in the lungs. Objective: To evaluate the clinical effect of respiratory rehabilitation training combined with Traditional Chinese and western medicine on the clinical treatment of motor function in patients with COPD. Methods: 156 patients with chronic obstructive pulmonary disease admitted to a hospital from December 2013 to June 2015 were selected as study subjects and randomly divided into groups for treatment. Results: comparing blood gas exchange rates of patients in the four groups, the experimental group, trained using integrated Chinese and Western medicine, was significantly better than the control groups A, B and C, in aspects such as PaCO2, PaO2, SaO2, pH, etc., the difference was statistically significant (p < 0.05). The improvement of lung function in the experimental group was significantly better than in the other three groups, with statistical significance (p < 0.05). Conclusions: Applying Chinese and Western Medicine combined with comprehensive respiratory rehabilitation training has a significant clinical effect. It effectively improved patients' related clinical indicators and should be widely promoted. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A doença pulmonar obstrutiva crônica (DPOC) é uma das doenças pulmonares mais comuns. Objetivo: Avaliar os efeitos clínicos de treino para reabilitação respiratória somado ao uso de medicina ocidental e medicina tradicional chinesa combinadas, no tratamento da função motora de pacientes com DPOC. Métodos: 156 pacientes com DPOC, hospitalizados entre dezembro de 2013 e junho de 2015, foram selecionados como objetos de estudo e aleatoriamente divididos em grupos de tratamento. Resultados: Quanto aos níveis de troca gasosa dos pacientes nos quatro grupos, o grupo experimental, treinado por meio de práticas de medicina ocidental e de medicina tradicional chinesa combinadas teve uma performance significativamente melhor que a dos grupos A, B, e C, em aspectos tais como PaCO2, PaO2, SaO2, pH, etc., com significância estatística (p<0,05). A melhoria da função pulmonar no grupo experimental também foi significativamente maior que nos outros grupos, mais uma vez com significância estatística (p<0,05). Conclusões: A aplicação da medicina chinesa e da medicina ocidental combinadas, somadas a um treino de reabilitação respiratória abrangente, teve um efeito clínico significativo, efetivamente melhorando indicadores clínicos relevantes. Tal aplicação deveria ser largamente promovida. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica (EPOC) es una de las enfermedades pulmonares más comunes. Objetivo: Evaluar los efectos clínicos de entrenamiento para rehabilitación respiratoria sumado al uso de medicina occidental y medicina tradicional china combinadas en el tratamiento de la función motora de pacientes con EPOC. Métodos: 156 pacientes con EPOC, hospitalizados entre diciembre de 2013 y junio de 2015, fueron seleccionados como objetos de estudio y aleatoriamente divididos en grupos de tratamiento. Resultados: En cuanto a los niveles de intercambio gaseoso de los pacientes de los cuatro grupos, el grupo experimental, entrenado mediante prácticas combinadas de medicina occidental y medicina tradicional china, obtuvo un rendimiento significativamente mejor que los grupos A, B y C, en aspectos como PaCO2, PaO2, SaO2, pH, etc., con significancia estadística (p<0,05). La mejora de la función pulmonar en el grupo experimental también fue significativamente mayor que en los otros grupos, una vez más con significancia estadística (p<0,05). Conclusiones: La aplicación de la medicina china y de la medicina occidental combinadas, sumadas a un entrenamiento de rehabilitación respiratorio abarcativo, tuvo un efecto clínico significativo, efectivamente mejorando indicadores clínicos relevantes. Tal aplicación debería ser largamente promovida. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Síndrome Pós-COVID-19 e cirurgia plástica: relato de caso de paciente com retorno de sintomas respiratórios em pós-operatório de mamoplastia redutora / Post-COVID-19 syndrome and plastic surgery: case report of a patient with return of respiratory symptoms in the postoperative period of reduction mammaplasty

Introdução: Com o surgimento do conceito de síndrome Pós-COVID-19, o RT PCR negativo, isoladamente, não deve representar a completa recuperação da doença. Nesse contexto, interroga-se: qual segurança de operar um paciente que já apresentou COVID-19? Relato de Caso: Paciente feminina, 36 anos, apresentou COVID-19, com sintomas leves, em dezembro de 2020. Já com resultado negativo de RT-PCR e assintomática, foi submetida a mamoplastia redutora, em janeiro de 2021, utilizando-se a técnica de pedículo inferior do tipo I de Liacyr Ribeiro, com ascensão do complexo areolopapilar (CAP) pela manobra de Letterman. No primeiro dia de pós-operatório, reabriu quadro gripal sintomático e o manteve durante todo o período pós-operatório. Apesar do tratamento satisfatório da necrose parcial de CAP direito, a paciente manteve sintomas respiratórios e sistêmicos sugestivos do retorno do quadro de COVID-19 em pós-operatório tardio. Discussão: Define-se síndrome Pós-COVID-19 como a persistência dos sintomas de COVID-19, por pelo menos 6 meses, após fase aguda da infecção. A fisiopatologia da síndrome não é completamente elucidada, todavia propõe-se relação com a síndrome de Ativação Mastocitária. No relato, ressaltamos a proximidade cronológica entre a infecção por SARS-CoV-2 e o retorno de sintomas respiratórios e sistêmicos sugestivos da síndrome Pós-COVID-19, assim como enfatizamos a necessidade de conhecer os possíveis sintomas e complicações desta síndrome, sobretudo no contexto de pós-operatório. Conclusão: É evidente a necessidade de análise pré-operatória minuciosa em pacientes com histórico clínico de infecção pelo COVID-19, uma vez que há maior risco de complicações pós-operatórias.

Introduction: As the concept of post-COVID-19 syndrome emerges, the negative result of an RT-PCR test is no longer enough to represent a patient's complete clinical recovery. In this context, a question arises: what are the risks of performing surgery on a patient whom COVID-19 has already infected? Case Report: Female patient, 36 years, infected by COVID-19 in December 2020, showing mild symptoms. Once asymptomatic and with a negative RT-PCR test, she was submitted to a breast reduction surgery, in January 2021, through the inferior pedicle technique by Liacyr Ribeiro and Nipple- Areolar Complex (NAC) ascension by Letterman maneuver. On the first postoperative day, the patient developed respiratory symptoms, which continued throughout the postoperative period. Despite the unsatisfactory treatment of partial necrosis of the right NAC, the patient maintained respiratory and systemic symptoms suggestive of the return of COVID-19 in the late postoperative period. Discussion: Post-COVID-19 syndrome is defined as the persistence of symptoms of COVID-19, for at least 6 months, after the acute phase of infection. The syndrome's pathophysiology is not completely elucidated; however, a relationship with the Mast Cell Activation Syndrome is proposed. In the report, we emphasize the chronological proximity between SARS-CoV-2 infection and the return of respiratory and systemic symptoms suggestive of post- COVID-19 syndrome and the need to know the possible symptoms and complications of this syndrome, especially in the context of postoperative. Conclusion: The need for a thorough preoperative analysis in patients with a clinical history of COVID-19 infection is evident since there is a greater risk of postoperative complications.