Cambios en la tolerancia al ejercicio, disnea y calidad de vida a las 8 vs. 12 semanas de rehabilitación pulmonar en pacientes con EPOC / Changes in tolerance to exercise, dyspnoea and quality of life at 8 vs. 12 weeks of pulmonary rehabilitation in patients with COPD

Introducción En pacientes con enfermedad pulmonar obstructiva crónica (EPOC), la rehabilitación pulmonar reporta mejorías en la tolerancia al ejercicio, la calidad de vida y la disminución de síntomas; sin embargo, pocos estudios comparan programas de rehabilitación pulmonar de menor y mayor duración. El objetivo fue describir los beneficios de la RP en cuanto a tolerancia al ejercicio, percepción de disnea y de calidad de vida, en pacientes con EPOC que asisten a un programa de rehabilitación pulmonar durante 8 semanas comparados con los que asisten durante 12 semanas en una institución de tercer nivel de la ciudad de Cali-Colombia. Métodos Estudio cuasiexperimental vinculando pacientes con EPOC, 15 pacientes en el programa de rehabilitación pulmonar de 8 semanas y 15 pacientes en el programa de rehabilitación pulmonar de 12 semanas. Se valoró al inicio y final del programa el índice de masa corporal, distancia recorrida en el test de caminata de los 6 minutos (TC6M), la calidad de vida CRQ-SAS. Resultados El índice de masa corporal no presentó cambios estadísticamente significativos en los grupos, la tolerancia al ejercicio presentó mejoría estadísticamente significativa en la rehabilitación pulmonar de 12 semanas (p<0,05), el cuestionario CRQ-SAS evidenció una mejoría en todos los dominios, pero no hubo diferencias entre ambos grupos. Conclusiones Pacientes con EPOC presentaron mejorías estadísticamente significativas después del programa de rehabilitación pulmonar en variables como la disnea y la calidad de vida; sin embargo, solo el grupo de rehabilitación pulmonar de 12 semanas presentó mejorías estadísticamente significativas en la distancia recorrida del TC6M comparado con el grupo de rehabilitación pulmonar de 8 semanas (AU)

Introduction In patients with chronic obstructive pulmonary disease (COPD), pulmonary rehabilitation reports improvements in exercise tolerance, quality of life and decrease in symptoms; however, few studies compare shorter and longer pulmonary rehabilitation programmes. The objective was to describe the benefits of PR in terms of exercise tolerance, perception of dyspnoea and quality of life, in patients with COPD attending a pulmonary rehabilitation programme for 8 weeks compared to those attending for 12 weeks in a third level institution in the city of Cali, Colombia. Methods Quasi-experimental study linking patients with COPD, 15 patients in the 8-week pulmonary rehabilitation programme and 15 patients in the 12-week pulmonary rehabilitation programme. Body mass index (BMI), distance covered in the 6-minute walk test (TC6M), quality of life CRQ-SAS questionnaire were assessed at the beginning and end of the programme. Results BMI did not show statistically significant changes in the groups, exercise tolerance showed statistically significant improvement in 12-week pulmonary rehabilitation programme (p<.05), the CRQ-SAS questionnaire evidences improvement in all domains, but there were no differences between both groups. Conclusions COPD patients, statistically significant improvement after the pulmonary rehabilitation programme in variables such as dyspnoea and quality of life; however, only the 12-week pulmonary rehabilitation programme group presented statistically significant improvements in the distance travelled of the TC6M compared to the 8-week pulmonary rehabilitation programme group (AU)

Modulation of hepatocyte growth factor plasma levels in relation to the dose of exogenous heparin administered: an experimental study in rats.

INTRODUCTION: Partial liver transplantation has been consolidated to be a valid treatment option. We sought to understand the factors that modulate and may be harnessed to accelerate hepatocyte regeneration. We sought to determine the impact of heparin on m-hepatocyte growth factor (HGF) plasma concentrations. MATERIALS AND METHODS: Sixteen rats were assigned to four groups of four animals each: group A, without heparin; group B, 600 IU/kg; group C, 1000 IU/kg, group D, 1400 IU/kg. Blood samples (0.5 mL) were obtained from each rat at baseline and at 30, 60, 120, and 240 minutes. After the samples were centrifuged to separate supernates from the cell phase they were stored at -20 degrees C in the m-HGF reagent and subsequently tested using enzyme-linked immunosorbent assay. Results were analyzed using SPSS 11.5 statistical software. RESULTS: Among the 16 rats, one died at 110 minutes, just prior to the last extraction. The remaining rats were sacrificed. Mean weight was: 466 +/- 64.24 g with no intergroup differences (P = .149). The comparative results (using Student t test) were: baseline A(1-4) versus A(1-4) 30 minutes: P < .05; baseline A(1-4) versus A(1-4) 60 minutes: P < .05; baseline A(1-4) versus A(1-4) 120 minutes: P = .10 (NS); baseline A(1-4) versus A(1-4) 240 minutes: P = .15 (NS). No significant differences were found among group B: baseline C(1-4) versus C(1-4) 30 minutes and 60 minutes: NS; baseline C(1-4) versus C(1-4) 120 minutes: P < .001; baseline C(1-4) versus C(1-4) 240 minutes: P < .10 (NS). Finally, the results in group D were: baseline D(1-4) versus D(1-4) 30 minutes: NS; baseline D(1-4) versus D(1-4) 60 minutes and 120 minutes: P < .05; baseline D(1-4) versus D(1-4) 240 minutes: P < .0005. When we compared group A to C and D, we detected differences (albeit not when compared to B) with P values = .01. Peak values were obtained at 120 and 240 minutes (225.21 pg/mL and 221.78 pg/mL) among groups C and D. CONCLUSION: Heparin has a positive effect to increase serum HGF concentrations among rats. The effect was dependent on the administered dose and the time elapsed.

Spontaneous carotid and vertebral artery dissection in children.

Carotid and vertebral artery dissection is a rarely reported cause of stroke in childhood and adolescence, especially if there is not a direct trauma to the neck. Four patients, under 15 years of age, presented with an internal carotid artery dissection, and one patient presented with a vertebral artery dissection. They were all making a physical effort when the event occurred. The five patients had ischemic symptoms, and in two the events were preceded by transient ischemic attacks. Headache was associated in four patients. The diagnosis was made by magnetic resonance imaging and angiography, which included transfemoral angiography in two patients. All improved before leaving the hospital, and four patients did not suffer recurrent episodes. The diagnostic accuracy of artery dissection has improved because of noninvasive neuroimaging testing, but it should still be suspected in any pediatric ischemic stroke, especially if there is headache or cervical pain associated.