RESUMEN
INTRODUCTION: The goal of the present study is to assess the relationship between functional respiratory parameters measured by the forced oscillation technique (FOT) in COPD patients and (1) dyspnea; (2) inspiratory capacity (IC), along with the variations occurring subsequent to bronchodilation. METHODS: This cross-sectional study analyzed 40 stable COPD patients. Dyspnea was assessed by means of the San Diego Shortness of Breath Questionnaire. Forced oscillations were measured before and after bronchodilation by means of routine pulmonary function tests (PFTs). RESULTS: The reactance parameters measured by the FOT correlated with dyspnea (AX5: r=0.46; P=0.003) similarly to IC (r=-0.46; P=0.003). Changes in AX5 following bronchodilation led to a predicted 12% and 200mL improvement in IC, AX5 (area under the ROC curve=0.85, P<0.001). CONCLUSIONS: Forced oscillation technique (FOT) appears to be an interesting complement to routine PFTs in COPD assessment. Reactance parameters are correlated with dyspnea and their response to bronchodilators is a predictor of significantly improved inspiratory capacity (IC). All in all, FOT may be considered as a functional test with regard to pulmonary hyperinflation, a critical determinant of dyspnea.
Asunto(s)
Broncodilatadores , Enfermedad Pulmonar Obstructiva Crónica , Resistencia de las Vías Respiratorias , Broncodilatadores/farmacología , Broncodilatadores/uso terapéutico , Estudios Transversales , Disnea/diagnóstico , Disnea/etiología , Volumen Espiratorio Forzado/fisiología , Humanos , Oscilometría/métodos , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Pruebas de Función Respiratoria/métodos , EspirometríaRESUMEN
BACKGROUND: Herniation of the liver through the anterior abdominal wall is an extremely rare phenomenon. Most cases occur within an incisional hernia (mostly upper abdomen surgery or cardiac surgery). Only two reports mentioned liver herniation without previous abdominal incision. Case Presentation. We report the case of a 70-year-old woman presenting an epigastric swelling. Radiological findings showed a liver herniation in a primary ventral hernia. This case is the first to have been described requiring semiurgent hernia repair associated with partial liver resection. CONCLUSION: This case is, to the best of our knowledge, the first case of primary ventral hernia with liver content necessitating wedge resection of the left liver lobe.
RESUMEN
The intensification of agricultural practices has been identified as the main cause of population decline in farmland birds since the 1960s in both Europe and North America. Although the links between species richness or abundance and various components of agricultural intensification are well established, the mechanisms underlying these trends have rarely been addressed along a gradient of intensification or have been quantified at only one spatial scale. Here we quantified the influence of landscape structure on the nest box occupancy and breeding success of Tree Swallows (Tachycineta bicolor) at seven spatial scales (1, 2, 3, 4, 5, 10, and 20 km radii) over a 10 200-km2 gradient of agricultural intensification in southern Québec, Canada. A network of 400 nest boxes distributed among 40 farms was visited every two days over three breeding seasons, 2004-2006. Nest box occupancy decreased with the proportion of intensive cultures (maize, cereals, and soybeans) in the landscape, especially when manure heaps and tanks were abundant, and was also determined by local variables (i.e., nest box clearance, interspecific competition) and by previous-year fledging success. Clutch size decreased as the breeding season progressed and with the proportion of intensive cultures in the landscape, with no consistent variation across spatial scales. Hatching success was not related to any landscape variables but increased with clutch size. Both the number of fledglings and fledging probability increased with the proportion of extensive cultures (hayfields, pastures, and fallows). These effects increased with spatial scale and reached a plateau at the 5 km radius: the maximum distance from the nest reached by foraging Tree Swallows. Our results can likely be attributed to lower food availability in intensive cultures compared to extensive ones. This study suggests that several components of breeding that impact on population structure and dynamics of insectivorous birds will be negatively affected by agricultural intensification.