Assuntos
Infecções Oportunistas Relacionadas com a AIDS/virologia , Infecções por HIV/complicações , Pneumopatias/virologia , Neoplasias Pulmonares/virologia , Doença Pulmonar Obstrutiva Crônica/virologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , Terapia Antirretroviral de Alta Atividade , Criança , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Humanos , Incidência , Pneumopatias/epidemiologia , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/virologia , Neoplasias Pulmonares/epidemiologia , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/virologia , Pneumonia por Pneumocystis/epidemiologia , Pneumonia por Pneumocystis/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/virologia , Estados Unidos/epidemiologiaRESUMO
The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV (P(2)C(2) HIV) Study is a multicenter study examining pulmonary and cardiac outcomes in offspring of HIV-infected mothers. This portion of the P(2)C(2) study tests the hypothesis that infants exposed to, but uninfected by, maternal HIV have normal maximal expiratory flow at functional residual capacity (V'max,(FRC)). We obtained 500 measurements of V'max,(FRC) by rapid thoracic compression in 285 children ages 6-30 mo in five U.S. centers. The data were compared with those from a healthy cohort of children described elsewhere. V'max,(FRC) rose with height in a linear relationship. The slope of the regression line in the exposed infants did not differ statistically from the slope in the comparison group, but the intercept was about 20% lower (p < 0.001). Height and weight were comparable in the two cohorts, and the differences between intercepts persisted after adjusting for birth weight and gestational age. However, maternal HIV infection cannot be assumed to be the cause as the cohorts may have differed in other variables, such as socioeconomic status and frequency of maternal smoking and drug use. Also, measurements varied substantially within and between our five centers, probably in part because of different racial and ethnic distributions. In summary, maternal HIV infection probably has only a modest effect, if any, on maximal expiratory flow at functional residual capacity in uninfected infants.
Assuntos
Fluxo Expiratório Forçado , Infecções por HIV/congênito , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas , Fatores Etários , Análise de Variância , Estudos de Casos e Controles , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , Gravidez , Probabilidade , Valores de Referência , Testes de Função Respiratória , Sensibilidade e Especificidade , Fatores SexuaisRESUMO
PURPOSE: To determine the usefulness of technetium 99m diethyltriaminepentacetic acid (DTPA) radioaerosol inhalation-clearance scintigraphy for early detection of pulmonary complications of human immunodeficiency virus (HIV) disease in children. MATERIALS AND METHODS: A total of 301 studies were performed in 132 HIV-positive children (group 1; mean age, 46.6 months). In children born to HIV-positive mothers (group 2), 273 studies were performed in 160 children who eventually were proved to be HIV negative (mean age, 10.3 months), and 80 studies were performed in 47 HIV-positive children (mean age, 15.6 months). Radioaerosol studies were performed by using commercially available radioaerosol nebulizers. Pulmonary clearance half-time was measured by using conventional gamma camera computer systems. Radioaerosol results were correlated with indexes of pulmonary health and function. RESULTS: The HIV-negative, group 2 children had a mean radioaerosol clearance half-time (58.1 minutes; 162 studies in 108 children) similar to that reported in healthy adults. Group 1 children with pulmonary involvement exhibited a faster mean clearance half-time (28.6 minutes) than did children without evidence of pulmonary involvement from either group 1 or group 2 (P < .05). A faster pulmonary clearance rate did not simply reflect the presence of chest disease that also was detectable on radiographs (P = .3). CONCLUSION: Quantitative DTPA radioaerosol clearance studies may provide useful information about pulmonary involvement in selected children with HIV disease.
Assuntos
Infecções por HIV/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Compostos Radiofarmacêuticos , Pentetato de Tecnécio Tc 99m , Administração por Inalação , Adulto , Aerossóis , Criança , Pré-Escolar , Estudos de Coortes , Sistemas Computacionais , Feminino , Seguimentos , Câmaras gama , Infecções por HIV/transmissão , Soronegatividade para HIV , Soropositividade para HIV/diagnóstico por imagem , Meia-Vida , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Análise dos Mínimos Quadrados , Pulmão/diagnóstico por imagem , Nebulizadores e Vaporizadores , Modelos de Riscos Proporcionais , Estudos Prospectivos , Cintilografia , Compostos Radiofarmacêuticos/administração & dosagem , Pentetato de Tecnécio Tc 99m/administração & dosagemAssuntos
Pneumopatias Obstrutivas/fisiopatologia , Fenômenos Fisiológicos da Nutrição , Fenômenos Fisiológicos Respiratórios , Fenômenos Fisiológicos da Nutrição Animal , Animais , Tecido Conjuntivo/fisiologia , Modelos Animais de Doenças , Matriz Extracelular/fisiologia , Feminino , Privação de Alimentos , Humanos , Pulmão/crescimento & desenvolvimento , Pulmão/patologia , Músculos/fisiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/fisiopatologia , Deficiência de Vitamina B 6/complicações , Deficiência de Vitamina B 6/fisiopatologiaRESUMO
Single breath diffusing capacities for carbon monoxide (DLco) were measured in 12 normal supine subjects before and after ingestion of 15 to 30 ml of 95 percent ethanol (ETOH) to determine if alcohol could acutely change the DLco. Both DLco and specific DLco (DLco/alveolar volume) were significantly decreased 90 minutes after the ingestion of alcohol. This change may be due to a direct effect of alcohol on the alveolar capillary interface by possibly interfering with a carbon monoxide carrier molecule. Another plausible explanation for the reduced diffusing capacity after ingestion of alcohol may be redistribution of blood from the lung to the periphery secondary to the hemodynamic effects of alcohol.
