Flujo espiratorio máximo: caracterización en un estudio en población adulta chilena; resultados basales de la cohorte del Maule (MAUCO) / Peak expiratory flow rate: characterization study in Chilean adult population; baseline results of the Maule cohort (MAUCO)

Resumen Introducción: Las enfermedades respiratorias crónicas tienen alta prevalencia en países en desarrollo, en poblaciones rurales y deprivadas. El flujo espiratorio máximo (FEM) obtenido mediante espiración forzada tiene uso clínico y de investigación. Describimos valores de medición del FEM en la medición basal de un estudio de cohorte en curso (Cohorte del Maule-MAUCO). Material y Método: Diseño transversal en 3.465 adultos (40-74 años) con registros de FEM (ATS). (Flujómetro Mini-Wright), usando valores de Gregg y Nunn. Valores < 80% del predicho se consideraron disminuidos. Se obtuvo sexo, edad, nivel educacional, actividad física y tabaquismo; se calculó índice de masa corporal (IMC) usando mediciones antropométricas. Resultados: La muestra tuvo 63,9% de mujeres; edad media de 55 (± 9) años, escolaridad de 9 (± 4) años; sobrepeso y obesidad fueron 43,1% y 41,5%: 81,5% fueron inactivos y 29,4% fumadores actuales. El valor medio de FEM fue 330 (± 80) L/min (mujeres) y 460 (± 119) L/min (hombres): el FEM disminuido alcanzó el 50,6% ([48,9-52,3]) con diferencias según edad, educación, IMC y actividad física. Conclusiones: Se observó alta prevalencia de FEM disminuido con variaciones según sexo, edad, escolaridad, IMC e inactividad física. Como otros estudios latinoamericanos, los valores bajos también fueron altamente prevalentes, sugiriendo sobreestimación de valores predichos al usar valores de Gregg & Nunn. Estos resultados sugieren la conveniencia de estudiar factores ambientales locales.

Introduction: Chronic respiratory (CRD) diseases show high prevalence in developing countries, rural and deprived populations. Peak expiratory flow rate (PEFR) is a functional measurement obtained through forced expiratory used for clinical and research purposes. We described PEFR in a rural setting in an ongoing cohort study (Maule Cohort-MAUCO). Material and Method: Cross-sectional design in 3,465 adults (40-74 years) with PEFR ATS standard records (Mini-Wright flowmeter) using Gregg and Nunn values. PEFR ≤ 80% predicted were considered decreased. Sex, age, educational level, physical activity and tobacco smoking were obtained. Body mass index (BMI) was calculated based on anthropometrical measurements. Main Results: Sample had 63.9% of women; mean age of 55 (± 9) years, schooling of 9 (± 4) years. Overweight and obesity were 43.1% and 41.5%. Physical inactivity was 81.5% and 29.4% were current smokers. PEFR mean value was 330 (± 80) L/min (women) and 460 (± 119) L/min (men): Decreased PEFR was 50.6% ([48.9-52.3]) with significant differences by age, schooling, BMI and physical activity. Conclusions: High prevalence of decreased PEFR was observed: PEFR showed variations according to sex, age, schooling, BMI and physical activity. As other Latin-American studies show, low values were also highly prevalent, suggesting that Gregg & Nunn overestimated PEFR values. These results suggests the convenience of studying local environmental factors.

Ultrasound measurement of visceral and subcutaneous fat in morbidly obese patients before and after laparoscopic adjustable gastric banding: comparison with computerized tomography and with anthropometric measurements.

BACKGROUND: There are now a variety of methods to assess body fat distribution, anthropometric (waist circumference and waist/hip W/H ratio), computed tomography (CT), and ultrasound (US) measurements, with CT considered as the reference method. Bariatric surgery leads to a significant and usually durable weight loss in morbidly obese patients; when assessing its results, it is of interest to measure changes of total fat tissue and of body fat distribution. METHODS: In this study, we compared anthropometric, US, and CT measurements of body fat distribution under basal conditions and 1 year after laparoscopic adjustable gastric banding (LAGB); 120 morbidly obese patients were considered at baseline, and 40 patients were re-evaluated 1 year after LAGB. RESULTS: Thickness of visceral and subcutaneous fat measured through CT and US methods was superimposable both under basal conditions and 1 year after LAGB, and the highest correlation was found between CT and US data on visceral fat, followed by CT and US data on subcutaneous fat; a fair correlation was also found between CT and US data on visceral fat and waist circumference. CONCLUSION: We suggest that evaluation of body fat distribution is accomplished by US instead of CT measurement, because of its lower cost and low exposure risk. Waist circumference stands as a reasonable surrogate of both methods, while W/H ratio is poorly correlated with other measures of body fat distribution.

[Is echography an adequate method for assessing the thickness of intra-abdominal fat? A comparison with computed tomography]. / L'ecografia è una metodica adeguata per la valutazione dello spessore del grasso intraaddominale? Confronto con la Tomografia Computerizzata.

PURPOSE: The methods to measure intraabdominal fat amount and to distinguish visceral from subcutaneous fat are useful and needed because visceral obese people are at risk of developing cardiovascular disorders. We investigated US capabilities in measuring intraabdominal fat thickness and distribution distinguishing visceral from subcutaneous fat. The results were compared with those obtained with CT, the gold standard, and with the waist-hip ratio (W/H). MATERIAL AND METHODS: Thirty obese women admitted to the Internal Medicine I Department, Ospedale S. Raffaele (Milan, Italy) were examined. The patients, aged 18-60 years and with BMI ranging 29.0-47.3, were submitted to consecutive double blind measurements with US and CT. The following anthropometric values were compared for every patient: W/H, US visceral/subcutaneous thickness, CT visceral/subcutaneous thickness, CT visceral area, CT subcutaneous adipose area and CT visceral/subcutaneous adipose area. RESULTS: The classification of visceral obesity by W/H (> .85) was confirmed by CT visceral/subcutaneous adipose area (> .491). The W/H correlated significantly with CT visceral/subcutaneous adipose thickness and CT visceral/subcutaneous adipose area (r = .52, p < .004; r = .51, p < .004), but not with US visceral/subcutaneous adipose thickness (r = .42, p < .06). Significant correlations were found between Ct visceral/subcutaneous adipose area and with both US and CT visceral/subcutaneous adipose thickness (r = .59, p < .006; = .71, p < .0001). A high correlation was found between US visceral/subcutaneous adipose thickness and CT visceral/subcutaneous adipose thickness (r = .96, p < .0001). CONCLUSION: Analyzing the results of the different methods, we conclude that US can always be used to study abdominal fat amount and distribution in obese women because this method exhibits significant correlations with CT, the gold standard. The W/H is not sufficient to distinguish visceral from subcutaneous intraabdominal fat.

The hypotonic effect of intranasal and intravenous glucagon in gastrointestinal radiology.

In the present study, following a double-blind, double placebo protocol vs. placebo, we compared the hypotonic effect of intranasal and intravenous glucagon during a double-contrast barium meal examination of the stomach. We found a statistically significant difference between placebo and intranasal or intravenous glucagon in inducing gastric hypomotility, with no significant differences between IN and IV glucagon. The intranasal administration of glucagon has the advantage of being noninvasive and well tolerated by the patients, and might be a valuable aid in upper gastrointestinal examination as well as in CT scan or magnetic resonance imaging of the abdomen.

Habitual snoring with and without obstructive sleep apnoea: the importance of cephalometric variables.

BACKGROUND: The obstructive sleep apnoea syndrome is characterised by an increased apnoea-hypopnoea index and a reduction in the minimal arterial oxygen saturation (SaO2) values during sleep. The extent to which these variables can be predicted by cephalometric and otorhinolaryngological variables was tested. METHODS: One hundred consecutive habitual snorers (84% male), with a mean (SD) age of 50.1 (10.1) years, were studied. The 45 patients with less severe sleep apnoea, with an apnoea-hypopnoea index of 10 or less (group A), were compared with the 55 with an index above 10 (group B). RESULTS: Body mass index, some cephalometric variables, and some otorhinolaryngological variables differed significantly between group A and group B, in particular the soft tissue measures PNS-P (posterior nasal spine to palate), MP-H (mandibular plane to hyoid bone), degree of oropharynx stenosis, and tongue size. In a multiple regression correlation analysis MP-H, SNB (angle from sella to nasion to subspinale point), SNA (angle from sella to nasion to supramentale point), PAS (posterior airway space), tongue size, and body mass index contributed significantly to the equation explaining the severity of sleep apnoea. Nevertheless, these variables together explained only 33% of the variance of the apnoea-hypopnoea index in the total sample; they were more important for patients with moderate to severe stages of the disease. CONCLUSION: The lack of association between cephalometric variables and mild sleep apnoea suggests that the differences in these variables (soft tissue measures) may be the consequence rather than the cause of habitual snoring and the obstructive sleep apnoea syndrome.

[Treatment of diaphyseal pseudoarthrosis with transosseous osteosynthesis by the Ilizarov method. Radiographic signs of reparative osteogenesis]. / Il trattamento delle pseudoartrosi diafisarie con osteosintesi transossea di Ilizarov. Segni radiografici di osteogenesi riparativa.

The main phases of ossification are shown-based on the results achieved by re-examining the X-ray pictures of 14 patients affected by tubular bones pseudoarthrosis treated with Ilizarov's closed compression-distraction osteosynthesis. The roentgen signs in particular are examined which are considered as expressive of positive evolution of the pseudoarthrosis. An outline of X-ray evolution of nonunions is also proposed, referring to the peculiar biological characters of ossification under compression-distraction stimulation.

[Radiological examination of corpora cavernosa in the lesions of the penis (author's transl)]. / Lo studio radiologico dei corpi cavernosi nelle malattie del pene.

Corpus cavernosography is described and some technical processes to improve the morphological response and to reduce local accidents are discussed. Considering several lesions of the penis, the usefulness of cavernosography is emphasized in order to programme a timely and adequate therapy. A series of cases is reported.