Quality of Pulmonary Function Tests in Participants with Down Syndrome

IntroductionPeople with Down syndrome (DS) have high respiratory morbidity, evaluating their respiratory health with standardized, objective tests is desirable. Thus, the objective of this study was to evaluate the technical quality of Pulmonary Function Tests (PFTs) to determine which ones are most suitable for this population.MethodsParticipants included children, teenagers and adults with DS, 5 years of age or older (n = 302). The technical quality of the impulse oscillometry system (IOS), forced spirometry, lung-diffusing capacity for carbon monoxide (DL_CO), and 6-min walk test (6MWT) were analyzed by age group. Capnography and pulse oximetry were included in the study. Technical quality was determined on the basis of current international PFTs standards.ResultsFifty-one percent of participants were males. A total of 184 participants (71%) who completed the IOS fulfilled the quality criteria, while 210 (70%) completed the 6MWT. Performance on forced spirometry and DL_CO was poor. All pulse oximetries and 96% percent heart rates obtained had good quality, but exhaled carbon dioxide (PetCO₂) and respiratory rate (RR) showed deficient repeatability.ConclusionsIOS appears to be the most reliable instrument for evaluating lung mechanics in individuals with DS.     

神经精神性红斑狼疮的脑部MRI表现

目的 分析神经精神性红斑狼疮（NP-SLE）的脑部MRI表现,探讨MRI对NP-SLE的诊断价值.方法 收集2000年1月～2005年4月符合NP-SLE临床诊断标准病例13例,均为女性,年龄10～40岁,平均30岁,病程30天～25年.采用Simens Impact 1.0T MR成像仪,SE序列行轴位T1WI、T2WI、矢状位T2WI及增强扫描,分析其脑部MRI表现.结果 13例20次MRI检查均有异常,阳性率为100%,表现为点状、斑片状长T1长T2异常信号,主要分布在大脑皮层、层下白质及基底节区,病灶周围无水肿,占位效应不明显.2例增强扫描病灶呈不规则强化,7例有脑萎缩.结论 MRI对NP-SLE脑部病变有较高的价值,但作出NP-SLE诊断需结合临床和实验室检查.     

食管癌术后完整胸胃的排空功能

目的观察保留完整的胸胃在未附加幽门引流术的情况下,对半固体食物的排空过程,探讨完整胸胃的排空规律。方法20例胸段食管癌病人分2组,近期术后组(12例)和远期术后组(8例),另设对照组(健康成年人10例)。观察不同时期病人,在进食试餐后120min内不同时间点的胃排空率(GER)和0～30min及30～120min的胃排空速率(GEV),并进行组间比较。结果近期术后病人的GER与术前相比,餐后5～100min明显快于术前(P<0.05);120minGER无差别(P>0.05);近期术后病人餐后GEV:0～30min加快而30～120min延迟,两个时间段的GEV比较差别显著(P<0.001);远期术后与近期术后病人的GER各时间点比较无显著性差异(P>0.05)。结论食管癌近期术后大部分病人的胸胃对半固体食物排空呈双相,但120min总排空率与术前相比无差别;远期术后病人胸胃对半固体食物的排空与近期术后无差别,食管癌病人手术时不需要常规附加幽门引流术。     

Body composition estimation in children and adolescents by bioelectrical impedance analysis: A systematic review

Background

Bioelectrical impedance analysis (BIA) has commonly been used to assess the body composition of children and adolescents. BIA validation studies have found distinct correlation values with reference methods.

Pain assessment and management in the NICU: analysis of an educational intervention for health professionals

Objectiveto study the perception of a Neonatal Intensive Care team on pain assessment and management before and after an educational intervention created and implemented in the unit.Methodsintervention study developed as action research, in three phases. In Phase 1, a quantitative study was performed to identify how professionals perceive pain management in the unit. In Phase 2, an educational intervention was carried out, using the Operational Group (OG), which defined strategies to be adopted to seek improvements in pain assessment and management. In Phase 3, the initial questionnaire was reapplied to assess professionals’ perceptions about the subject after the intervention. All professionals directly working in newborn care were included.Resultsthe perception of professionals about pain management and assessment in the unit showed a statistically significant difference between the two phases of research, highlighting the increase in frequency of reference for evaluation and use of some method of pain relief procedures for most analyzed procedures. Participation in training (one of the strategies defined by the operational group) was reported by 86.4% of the professionals. They reported the use of scales for pain assessment, established by the protocol adopted in the service after the intervention, with a frequency of 94.4%. Changes in pain assessment and management were perceived by 79.6% of the participants.Conclusionthe professionals involved in the educational intervention observed changes in pain management in the unit and related them to the strategies defined and implemented by the OG.     

Streptococcus pneumoniae: prevalence in nasopharyngeal carriers of more than 50-years-old,in a Mexican rural community

Introduction

Streptococcus pneumoniae (Sp) is the main cause of community-acquired pneumonia in the elderly, hence the importance to establish the prevalence of nasopharyngeal colonization by different Sp serotypes in adults.