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Background/Objective: Men do not use external condoms for several reasons, which can result in public health problems. One of these is related to Condom-Associated Erectile Problems. This study aimed to examine the sexual arousal response of heterosexual men when using an external condom made of synthetic resin type AT-10. Method: A total of 82 Colombian young men (Mage = 23.17 years, SD = 3.04, age range = 18-30) participated in this experimental study. Two random groups (experimental and control; n = 41 each) were compared. The experimental group used condoms, whereas the control group did not. Fit and feel condom perceptions, initial erectile scores, age, and substance use were controlled for. Erection was measured while viewing a sexual video by using penile plethysmography and subjective arousal. Results: The results, obtained from comparing the experimental group (using pre-erection condoms) with the control group (not using condoms), revealed no significant difference in both subjective and physiological sexual arousal. This suggests that pre-erection condoms do not have an effect on the erectile response. Discussion: More research is needed in this area to provide treatment and clinical interventions or sexual and reproductive education to mitigate the occurrence of sexual dysfunction, unplanned pregnancies, or sexually transmitted infections. Also, research addresses public health issues related to the prevention and/or intervention of sexual risk behaviors and sexual dysfunctions, highlighting their significance in sexual education and clinical practice.
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Objective: Provide new validity evidence of the Spanish version of the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) by associating its scores with measures of sexual arousal. Method: In a sample of 48 men, using a quasi-experimental design, sexual functioning, propensity for sexual inhibition/excitation, subjective sexual arousal, and genital response (penile plethysmography recorded with Biopac MP150 equipment) were evaluated. Results: Arousal and erection scores correlated with sexual inhibition due to the threat of performance failure (r = .29; p < .05) and genital response (r = .31; p < .05), respectively. Participants with diï¬culties in sexual functioning indicated greater sexual inhibition due to the threat of performance failure (p = .04) and lower intensity in their genital response (p = .05). Conclusions: The validity of the measures obtained with the Spanish version of the MGH-SFQ is supported, showing the erection item to be useful for the detection of possible erectile disorders.
Objetivo: Aportar nuevas evidencias de validez a la versión española del Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ), asociando sus puntuaciones a medidas de la excitación sexual. Método: En una muestra de 48 hombres, mediante un diseño cuasiexperimental, se evaluó el funcionamiento sexual, la propensión para la excitación/inhibición sexual, la excitación sexual subjetiva y la respuesta genital (pletismografía peniana registrada con un equipo Biopac MP150). Resultados: Las puntuaciones en excitación y erección del MGH-SFQ correlacionaron signiï¬cativamente con la inhibición sexual por miedo al fallo en el rendimiento sexual (r = .29; p < .05) y con la respuesta genital (r = .31; p < .05), respectivamente. Los participantes con diï¬cultades en el funcionamiento sexual, en comparación con los que mostraron un adecuado funcionamiento, indicaron mayor inhibición sexual por miedo al fallo en el rendimiento sexual (p = .04) y menor intensidad en su respuesta genital (p = .05). Conclusiones: Se avala la validez de las medidas obtenidas con la versión española del MGH-SFQ, mostrándose el ítem de erección útil para la detección de posibles trastornos eréctiles.
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Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due to transitory immunological disorders, inadequate wound healing, reduced gut function, longer dependency on mechanical ventilation, and longer hospital stays compared with eutrophic children who are critically ill. Nutrition care studies have proposed that early interventions targeting nutrition assessment can prevent or minimize the complications of undernutrition. Stress promotes an acute inflammatory response mediated by cytokines, resulting in increased basal metabolism and nitrogen excretion and leading to muscle loss and changes in body composition. Therefore, the inclusion of body composition assessment is important in the evaluation of these patients because, in addition to the nutrition aspect, body composition seems to predict clinical prognosis. Several techniques can be used to assess body composition, such as arm measurements, calf circumference, grip strength, bioelectrical impedance analysis, and imaging examinations, including computed tomography and dual-energy x-ray absorptiometry. This review of available evidence suggests that arm measurements seem to be well-established in assessing body composition in children who are critically ill, and that bioelectrical impedance analysis with phase angle, handgrip strength, calf circumference and ultrasound seem to be promising in this evaluation. However, further robust studies based on scientific evidence are necessary.
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Enfermedad Crítica , Desnutrición , Humanos , Niño , Enfermedad Crítica/terapia , Fuerza de la Mano , Absorciometría de Fotón , Composición Corporal , Desnutrición/diagnósticoRESUMEN
BACKGROUND: Changes in body weight are associated with the regulation of DNA methylation (DNAm). In this study, we investigated the associations between maternal gestational weight gain-related DNAm and foetal and neonatal body composition. METHODS: Brazilian pregnant women from the Araraquara Cohort Study were followed up during pregnancy, delivery, and after hospital discharge. Women with normal pre-pregnancy BMI were allocated into two groups: adequate gestational weight gain (AGWG, n = 45) and excessive gestational weight gain (EGWG, n = 30). Foetal and neonatal body composition was evaluated via ultrasound and plethysmography, respectively. DNAm was assessed in maternal blood using Illumina Infinium MethylationEPIC BeadChip arrays. Linear regression models were used to explore the associations between DNAm and foetal and neonatal body composition. RESULTS: Maternal weight, GWG, neonatal weight, and fat mass were higher in the EGWG group. Analysis of DNAm identified 46 differentially methylated positions and 11 differentially methylated regions (DMRs) between the EGWG and AGWG groups. Nine human phenotypes were enriched for these 11 DMRs located in 13 genes (EMILIN1, HOXA5, CPT1B, CLDN9, ZFP57, BRCA1, POU5F1, ANKRD33, HLA-B, RANBP17, ZMYND11, DIP2C, TMEM232), highlighting the terms insulin resistance, and hyperglycaemia. Maternal DNAm was associated with foetal total thigh and arm tissues and subcutaneous thigh and arm fat, as well as with neonatal fat mass percentage and fat mass. CONCLUSION: The methylation pattern in the EGWG group indicated a risk for developing chronic diseases and involvement of maternal DNAm in foetal lean and fat mass and in neonatal fat mass.
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OBJECTIVES: The aim of this study is to develop predictive body fat mass models, one for newborns and one for infants, using air displacement plethysmography as a reference method. METHODS: The study was carried out with 125 newborns (1-5 d of age) and 71 infants (≥3-6 mo). The stepwise method was used to estimate the final model from the predictors of sex, weight, length, triceps skinfold, waist circumference, mean arm circumference, and gestational age. The quality of the models was evaluated by the determination coefficient, variance inflation factor, and residual analysis. The paired t test and Bland-Altman plot were used to assess the agreement between observed and estimated values. RESULTS: The final model for newborns was - 0.76638 + 0.2512 * weight (kg) + 0.0620 * PCT (mm) + 0.0754 * gender (R² = 70%) and the final model for infants: -2.22748 + 0.4928 * weight (kg) + 0.0737 * TSF (mm) + 0.2647 * gender (R² = 84%). CONCLUSIONS: This work determined equations to estimate the BFM of term newborns and infants. The models can be used in clinical practice, especially in health units without access to technologies for measuring body composition, adding important information for nutritional monitoring.
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Tejido Adiposo , Composición Corporal , Humanos , Recién Nacido , Lactante , Anciano , Peso Corporal , Antropometría/métodos , Edad Gestacional , Pletismografía/métodosRESUMEN
PURPOSE: We investigated respiratory muscle strength, diaphragm mobility, lung function, functional capacity, quality of life, body composition, breathing pattern, and chest wall (VT,CW) and compartmental volumes of Mucopolysaccharidosis (MPS) patients and compared these variables with matched healthy individuals. METHODS: A cross-sectional study with data analyzed separately according to age group. A total of 68 individuals (34 MPS and 34 matched-healthy subjects) were included. Six-minute walking test assessed functional capacity and ultrasound assessed diaphragm mobility during quiet spontaneous breathing (QB). Optoelectronic plethysmography assessed VT,CW and breathing pattern during QB in two different positions: seated and supine (45° trunk inclination). RESULTS: Body composition, lung function, respiratory muscle strength, and functional capacity were reduced in MPS (all p < 0.01). Diaphragm mobility was only reduced in adolescents (p = 0.01) and correlated with body composition and breathing pattern. Upper chest wall compartmental volumes were significantly lower in MPS, while abdominal volume only differed significantly in adolescents. Percentage contribution (%) of upper ribcage compartments to tidal volume was reduced in MPS children, whereas %AB was significantly increased compared with healthy subjects. CONCLUSION: Lung function, respiratory muscle strength, functional capacity, diaphragm mobility, and quality of life are reduced in MPS compared with matched healthy subjects. VT,CW was mainly reduced due to pulmonary and abdominal ribcage impairment. Implications for RehabilitationReduction in respiratory muscle strength, functional capacity, diaphragm excursion and low lung volumes were found in individuals with Mucopolysaccharidoses (MPS).Chest wall volumes and the upper chest wall compartmental volumes during quiet spontaneous breathing are reduced in MPS.Assessment and monitoring of the respiratory system for individuals with MPS should be performed periodically through standardized assessments to enable identification of changes and early intervention by rehabilitation protocols.This study may provide the necessary basis for carrying out respiratoty rehabilitation protocols that can improving chest wall mechanics with breathing exercise in this group.
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Pared Torácica , Niño , Humanos , Adolescente , Pared Torácica/diagnóstico por imagen , Diafragma/diagnóstico por imagen , Calidad de Vida , Estudios Transversales , Respiración , Músculos RespiratoriosRESUMEN
Background.Lung volumes can be measured by body plethysmography (BP), by inert gas dilution during a single-breath or multiple breaths and by radiographic methods based on chest roentgenogram or CT scanning. Our objective was to analyze the concordance between several methods including a new pressure-derived method (PDM) in a variety of pulmonary conditions.Methods. We recruited four groups of adult volunteers at the chronic obstructive pulmonary disease and tobacco clinic of a respiratory referral hospital: patients with lung bullae, with obstructive lung diseases, with restrictive lung diseases and healthy controls; all subjects underwent lung volume measurements according to ATS/ERS standards in random order with each method and then CT scanning. Differences among groups were estimated by Kruskal-Wallis tests. Concordance correlation coefficients (CCC) and Bland-Altman plots were performed.Results. Sixty-two patients were studied including 15 with lung bullae, 14 with obstructive lung diseases, 12 with restrictive lung disease and 21 healthy subjects. Highest concordance was obtained between BP and CT scanning (CCC 0.95, mean difference -0.35 l) and the lowest, with TLC-DLCOsb(CCC 0.65, difference -1.05 l). TLC measured by BP had a moderate concordance with the PDM (CCC = 0.91, mean difference -0.19 l). The PDM on the other hand had the lowest intra-test repeatability (2.7%) of all tested methods.Conclusions. Lung volumes measured by BP and CT had high concordance in the scenario of varied pulmonary conditions including lung bullae, restrictive and obstructive diseases. The new PDM device, had low intra-test variability, and was easy to perform, with a reasonable concordance with BP.
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Vesícula , Enfermedad Pulmonar Obstructiva Crónica , Adulto , Humanos , Pulmón , Mediciones del Volumen Pulmonar/métodosRESUMEN
The evaluation of body composition (BC) is relevant in the evaluation of children's health-disease states. Different methods and devices are used to estimate BC. The availability of methods and the clinical condition of the patient usually defines the ideal approach to be used. In this cross-sectional study, we evaluate the accuracy of different methods to estimate BC in Mexican children and adolescents, using the 4-C model as the reference. In a sample of 288 Mexican children and adolescents, 4-C body composition assessment, skinfold-thickness (SF), dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), and deuterium dilution (D2O) were performed, along with MRI in a subsample (52 participants). The analysis of validity was performed by correlation analysis, linear regression, and the Bland-Altman method. All methods analyzed showed strong correlations for FM with 4-C values and between each other; however, DXA and MRI overestimated FM, whereas skinfolds and ADP under-estimated FM. Conclusion: The clinical assessment of BC by means of SF, ADP, DXA, MRI and D2O correlated well with the 4-C model and between them, providing evidence of their clinical validity and utility. The results from different methods are not interchangeable. Preference between methods may depend on their availability and the specific clinical setting.
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Composición Corporal , Pletismografía , Absorciometría de Fotón/métodos , Adolescente , Niño , Estudios Transversales , Óxido de Deuterio , Humanos , Imagen por Resonancia Magnética , Pletismografía/métodosRESUMEN
OBJECTIVE: To review the technical aspects of body composition assessment by dual-energy X-ray absorptiometry (DXA) and other methods based on the most recent scientific evidence. MATERIALS AND METHODS: This Official Position is a result of efforts by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism (Associação Brasileira de Avaliação Óssea e Osteometabolismo, ABRASSO) and health care professionals with expertise in body composition assessment who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications. In this first part of the Official Position, the authors discuss the different methods and parameters used for body composition assessment, general principles of DXA, and aspects of the acquisition and analysis of DXA scans. CONCLUSION: Considering aspects of accuracy, precision, cost, duration, and ability to evaluate all three compartments, DXA is considered the gold-standard method for body composition assessment, particularly for the evaluation of fat mass. In order to ensure reliable, adequate, and reproducible DXA reports, great attention is required regarding quality control procedures, preparation, removal of external artifacts, imaging acquisition, and data analysis and interpretation.
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Composición Corporal , Absorciometría de Fotón/métodos , Brasil , Impedancia Eléctrica , Humanos , Reproducibilidad de los ResultadosRESUMEN
ABSTRACT OBJETIVE To assess the association of gestational age (GA) and intrauterine growth with body composition at 11 years of age. METHOD Analysis of data from the 2004 Pelotas birth cohort, whose outcomes were fat mass (FM, kg), fat mass index (FMI, kg/m2), fat-free mass (FFM, kg), fat-free mass index (FFMI, kg/m2) - measured by air displacement plethysmography - and body mass index for age (BMI/age, Z-score). The exposures of interest were the gestational index (GA) of infants born at less than 33 weeks, from 34 to 36 and from 37 to 41, and intrauterine growth categorized as small (SGA), adequate (AGA) and large (LGA) for gestational age. Analysis of variance was used to compare means and linear regression was used to assess the strength of association. The analyses were adjusted according to variables collected at birth, such as monthly family income, maternal characteristics - education, age, pre-gestational body mass index (BMI), weight gain during pregnancy, smoking during pregnancy, type of delivery, and parity - and adolescent characteristics - skin color and birth weight. For analysis, FM and FMI underwent logarithmic transformation due to data asymmetry. RESULTS A total of 3,401 adolescents were analyzed, including boys and girls born at less than 33 weeks, with lower FM and FFM means than those born at term. However, in the adjusted analyses, there was no association between GA and any of the outcomes in either sex. LGA boys had a 10.5% higher FMI (p = 0.026) and +0.3 BMI/age Z-score (p = 0.019) as compared to AGA boys, and LGA girls had +0.3 kg/m 2 of FFMI (p = 0.039) than AGA girls. CONCLUSION GA was not associated with body composition at 11 years of age. However, LGA boys had higher BMI and BMI/age Z-score, and LGA girls had higher FFMI than AGA girls.
RESUMO OBJETIVO Avaliar a associação da idade gestacional (IG) e crescimento intrauterino com a composição corporal aos 11 anos de idade. MÉTODO Análise de dados da coorte de nascimentos de Pelotas de 2004, cujos desfechos foram massa gorda (MG, kg), índice de massa gorda (IMG, kg/m2), massa livre de gordura (MLG, kg), índice de massa livre de gordura (IMLG, kg/m2) - medidos por pletismografia por deslocamento de ar -, e índice de massa corporal para idade (IMC/Idade, escore-Z). Sendo as exposições de interesse o índice gestacional (IG) de nascidos com menos de 33 semanas, de 34 a 36 e de 37 a 41, e crescimento intrauterino categorizado em pequeno para a idade gestacional (PIG), adequado (AIG) e grande (GIG). Para comparar médias, utilizou-se análise de variância e, para avaliar a força de associação, regressão linear. As análises foram ajustadas de acordo com variáveis coletadas ao nascer, como renda familiar mensal, características maternas - escolaridade, idade, índice de massa corporal (IMC) pré-gestacional, ganho de peso na gestação, tabagismo na gestação, tipo de parto e paridade - e características dos adolescentes - cor da pele e peso ao nascer. Para análise, o MG e o IMG sofreram transformação logarítmica devido a assimetria dos dados. RESULTADOS Foram analisados 3.401 adolescentes, entre meninos e meninas nascidos com menos de 33 semanas, com médias de MG e MLG menores que as dos nascidos(as) a termo. Porém, nas análises ajustadas, não houve associação entre IG e qualquer um dos desfechos em ambos os sexos. Meninos GIG apresentaram IMG 10,5% maior (p = 0,026) e +0,3 escore-Z de IMC/Idade (p = 0,019) em relação aos AIG, e meninas GIG apresentaram +0,3 kg/m2 de IMLG (p = 0,039) do que as AIG. CONCLUSÃO A IG não se associou à composição corporal aos 11 anos. Entretanto, meninos GIG apresentaram maiores IMG e escore-Z de IMC/Idade e meninas GIG, maior IMLG, quando comparados aos AIG.
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Humanos , Masculino , Femenino , Recién Nacido , Pletismografía , Composición Corporal , Desarrollo Infantil , Estudios de Cohortes , Edad GestacionalRESUMEN
Background: Photoplethysmography is widely used in human medicine, with few studies on its use in veterinary medicine. Its sensor detects fluctuations in blood volume at the site, providing direct readings of cardiac pulse and peripheral oxygen saturation, as well as estimating cardiac output, respiratory rate and blood pressure. This study aimed to evaluate the use of photoplethysmography and compare it to vascular Doppler ultrasound as an indirect method of measuring systolic blood pressure in bitches undergoing elective ovariohysterectomy, using the invasive assessment of systolic blood pressure as a reference. Materials, Methods and Results: After clinical and laboratory evaluation, 34 healthy bitches were selected to undergo elective ovariohysterectomy. After food and water fasting, patients received pethidine hydrochloride intramuscularly as pre-anesthetic medication, followed by anesthetic induction with fentanyl citrate and propofol intravenously. General anesthesia was maintained by inhalation with isoflurane diluted in 100% oxygen. Intraoperative analgesia consisted of continuous infusion of fentanyl citrate intravenously. The animals were randomly divided into 2 groups, the thoracic limb group (TLG) and the pelvic limb group (PLG). In each patient, non-invasive blood pressure measurement was obtained simultaneously with Doppler (DOP) and photoplethysmography (PPG). The sensors of both devices were placed on the end of the same limb. The PPG sensor was positioned in the interdigital region. In patients belonging to the TLG, the Doppler sensor was placed in the ventral region of the thoracic limb, under the ulnar artery. In PLG patients, the Doppler sensor was placed in the dorsal region of the pelvic limb, over the dorsal artery of the foot. The sphygmomanometer was positioned close to the sensors. For systolic blood pressure (SBP) measurement, the cuff was inflated until the Doppler sound signal and the plethysmographic wave were lost. The cuff was then deflated until the Doppler pulse sound resumed and the photoplethysmography showed at least 2 continuous waves on a regular basis. The corresponding pressure value observed on the manometer consisted of the SBP. The same 2 evaluators performed all SBP measurements: 1 responsible for the DOP method and the other for the PPG method; both were blind to the other's findings, thus minimizing potential bias in the results. All animals underwent cannulation of the auricular artery for invasive measurement of systolic blood pressure, using a multiparameter monitor. All blood pressure measurements were performed at 5-min intervals, as well as obtaining additional parameters (heart and respiratory rate, esophageal temperature, partial tissue oxygen saturation, carbon dioxide concentration) and electrocardiographic monitoring. All parameters were documented for further statistical analysis. A strong correlation (r² = 0.95) was obtained between the DOP and PPG methods regardless of the limb on which the sensors were placed. There was a low correlation between the invasive method of measuring systolic blood pressure and the other methods. There was better agreement between the DOP and PPG methods (r2 = -0.0061; P = 0.85) when systolic blood pressure was measured in the TLG. Discussion: In the PLG, the values obtained with the DOP and PPG methods were significantly higher than those obtained with the invasive method, while the values obtained in the TLG differed slightly. It was found that the best measurement site by non-invasive methods was the thoracic limb. It was concluded that the non-invasive methods showed a low correlation with the invasive method; however, both methods had similar characteristics and photoplethysmography can be used to replace the vascular Doppler method.
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Animales , Femenino , Perros , Determinación de la Presión Sanguínea/veterinaria , Ecocardiografía Doppler/métodos , Fotopletismografía/veterinaria , Ovariectomía/veterinaria , Histerectomía/veterinaria , Anestesia General/veterinariaRESUMEN
BACKGROUND: In patients with ischemia and no obstructive coronary artery disease (INOCA), coronary microvascular dysfunction is associated with higher rate of major adverse cardiovascular events. OBJECTIVE: To demonstrate if microvascular dysfunction present in coronary microcirculation of patients with INOCA may be detected noninvasively in their peripheral circulation. METHODS: 25 patients with INOCA and 25 apparently healthy individuals (controls) were subjected to nailfold videocapillaroscopy (NVC) and venous occlusion plethysmography (VOP) to evaluate peripheral microvascular function and blood collection for biomarkers analysis, including soluble vascular cell adhesion molecule-1 (sVCAM-1), endothelin-1 (ET-1) and C-reactive protein (CRP). RESULTS: Red blood cell velocity (RBCV) before and after ischemia (RBCVmax) were significantly lower in patients with INOCA (pâ=â0.0001). Time to reach maximal red blood cell velocity (TRBCVmax) was significantly longer in INOCA group (pâ=â0.0004). Concerning VOP, maximal blood flow (pâ=â0.004) and its relative increment were significantly lower in patients with INOCA (pâ=â0.0004). RBCVmax showed significant correlations with sVCAM-1 (râ=â-0.38, pâ<â0.05), ET-1 (râ=â-0.73, pâ<â0.05) and CRP (râ=â-0.33, pâ<â0.05). Relative increment of maximal post-ischemic blood flow was significantly correlated with sVCAM-1 (râ=â-0.42, pâ<â0.05) and ET-1 (râ=â-0.48, pâ<â0.05). CONCLUSIONS: The impairment of microvascular function present in coronary microcirculation of patients with INOCA can be also detected in peripheral microcirculation.
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Enfermedad de la Arteria Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Circulación Coronaria , Vasos Coronarios , Hemodinámica , Humanos , Isquemia , Microcirculación , Angioscopía MicroscópicaRESUMEN
Introducción: La enfermedad pulmonar obstructiva crónica es un problema sanitario mundial por su elevada prevalencia, morbilidad y cuantioso costo económico. Objetivo: Caracterizar mediante la pletismografía a los pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica que presentaron una discrepancia clínica espirométrica. Métodos: Se realizó un estudio descriptivo y transversal en 33 pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica que acudieron a consulta externa del Hospital Neumológico Benéfico Jurídico y el Centro de Investigaciones Clínicas. Se les realizaron volúmenes pulmonares por pletismografía corporal y espirometría en el período comprendido de noviembre 2016 a marzo 2018. Resultados: El sexo masculino (69,7 por ciento) resultó el más frecuente y el grupo de edad predominante fue mayor de 65 años (60,6 por ciento). El 41,2 por ciento de los pacientes presentaron grado de obstrucción moderadamente severo. La capacidad pulmonar total y el volumen residual fueron normales (72,7 por ciento y 42,5 por ciento) respectivamente. El 43,8 por ciento de los pacientes presentaron hiperinsuflación leve. El grado 3 de disnea fue el que predominó en los pacientes. El 12,1 por ciento de los pacientes presentaron aumento del volumen residual dado por atrapamiento aéreo grave con la disminución del volumen espiratorio forzado en el primer segundo. Conclusiones: El comportamiento de los volúmenes pulmonares por pletismografía corporal en la enfermedad pulmonar obstructiva crónica con disociación clínico-espirométrica, evidenció la disminución del volumen espiratorio forzado en el primer segundo y el aumento del volumen residual relacionándose con el grado de disnea(AU)
Introduction: Chronic obstructive pulmonary disease is a global health problem due to its high prevalence, morbidity and high economic cost. Objective: By using plethysmography, to describe patients with diagnosis of chronic obstructive pulmonary disease that had spirometric clinical discrepancy. Methods: A descriptive and cross-sectional study was carried out in 33 patients with diagnosis of chronic obstructive pulmonary disease who attended the outpatient clinic at Benéfico Jurídico Pneumologic Hospital and the Clinical Research Centre. Lung volumes were performed by body plethysmography and spirometry from November 2016 to March 2018. Results: The male sex (69.7 percent) was the most frequent and the predominant age group was older than 65 years (60.6 percent). 41.2 percent of the patients had moderately severe degree of obstruction. Total lung capacity and residual volume were normal, 72.7 percent and 42.5 percent, respectively. 43.8 percent of the patients had mild hyperinflation. Grade 3 dyspnea was the one that predominated in the patients. 12.1 percent of the patients showed increased residual volume due to severe air trapping with decreased forced expiratory volume in the first second. Conclusions: The behavior of lung volumes by body plethysmography in chronic obstructive pulmonary disease with clinical-spirometric dissociation, evidenced decrease in forced expiratory volume in the first second and increased in residual volume related to the degree of dyspnea(AU)
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Humanos , Pletismografía Total/métodos , Espirometría/métodos , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Epidemiología Descriptiva , Estudios TransversalesRESUMEN
BACKGROUND: We aimed to investigate the association between preterm birth and body composition at 6, 18, and 30 years of age using data from three population-based birth cohort studies. METHODS: Gestational age (GA), defined by the date of the last menstrual period (categorized in ≤33, 34-36, and ≥ 37 weeks), was gathered in the first 24-h after delivery for all live births occurring in the city of Pelotas, Brazil, in 2004, 1993 and 1982. Body composition was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent FM (%FM), FM index (FMI, kg/m2), fat-free mass (FFM, kg); percent FFM (%FFM), FFM index (FFMI, kg/m2), body mass index (BMI, kg/m2 at 18 years in the 1993 cohort and 30 years in the 1982 cohort), and BMI Z-score (at 6 years in the 2004 cohort). We further explored the association of birth weight for GA with body composition indicators and BMI. Crude and adjusted linear regressions provided beta coefficients with 95% confidence intervals (95%CI). RESULTS: A total of 3036, 3027, and 3369 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, preterm boys (born at 34-36 weeks) presented lower adjusted mean of FM (ß = - 0.80 kg, - 1.45;-0.16, p = 0.046), %FM (ß = - 2.39%, - 3.90;-0.88, p = 0.008), FMI (ß = - 0.70 kg/m2, - 1.13;-0.27, p = 0.004) as well as lower FFM (ß = - 0.4 kg, - 0.77; - 0.12, p = 0.010) and FFMI (ß = - 0.3 kg/m2, - 0.46;-0.10, p < 0.001), and BMI Z-score (ß = - 0.69,; - 0.99;-0.40, p < 0.001); but higher %FFM (ß = 2.4%, 0.87;-3.90, p = 0.008), when compared to boys born at term (≥37). At 30 years, FM (15.7 kg, 0.25;31.1, p = 0.102) was higher among males born at ≤33 weeks. No association was observed for females from the three cohorts and for 18-year-old males. The association of birth weight for GA with body composition and BMI was not significant in any cohort. At 6 years, SGA boys had lower FFMI than boys AGA. CONCLUSIONS: Our results suggest that preterm birth is associated with decreased body fat and fat-free mass in childhood but higher fat mass in adulthood. Nevertheless, results were only significant for males. SGA boys also showed lower FFMI.
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Nacimiento Prematuro , Tejido Adiposo , Adolescente , Adulto , Composición Corporal , Índice de Masa Corporal , Brasil/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Pletismografía , Embarazo , Nacimiento Prematuro/epidemiologíaRESUMEN
Total traumatic injury often requires surgical intervention such as neurotization using the phrenic nerve with the aim to recover the elbow function. However, its repercussions on the respiratory kinematics are unknown. Objective: To evaluate the ribcage volume in tricompartments division, kinematics of Duty Cycle, and shortening velocity of the respiratory muscles after nerve phrenic transfer. Methods: Five participants (4 male), aged 18 to 40 years old (32±2), diagnosed with total brachial plexus injury and with nerve phrenic transfer. The optoelectronic plethysmography (OEP) was the instrument to evaluate volume in quiet breathing (QB), inspiratory capacity (IC) and vital capacity (VC) of the rib cage in its tricompartments division (pulmonary rib cage, abdominal rib cage and abdomen rib cage) and in each hemithorax, as well as the shortening velocity of the respiratory muscles, and respiratory rate. Assessments occurred 30 days prior and 30 days after surgery. Results: There was a decrease in the total compartmental distribution in QB with statistical difference only in the abdominal compartment (p <0.05). Four patients showed a reduction in the shortening speed of the left diaphragm muscle. It was not possible to perform a group analysis of respiratory kinematics and volumes in CV, IC due to the variation found in each patient analyzed. Conclusion: There was a reduction in volume in the rib cage as well as a change in the speed of shortening of the respiratory muscles after the transfer of the phrenic nerve one month after surgery.
A lesão traumática total freqüentemente requer intervenção cirúrgica, como neurotização usando o nervo frênico, com o objetivo de recuperar a função do cotovelo. No entanto, suas repercussões na cinemática respiratória são desconhecidas. Objetivo: Avaliar o volume da caixa torácica na divisão dos tricompartimentos, a cinemática do Duty Cycle e a velocidade de encurtamento dos músculos respiratórios após a transferência do nervo frênico. Métodos: Cinco participantes (4 do sexo masculino), com idade entre 18 e 40 anos (32 ± 2), com diagnóstico de lesão total do plexo braquial e transferência do nervo frênico. A pletismografia optoeletrônica (OEP) foi o instrumento para avaliar o volume na respiração silenciosa (QB), a capacidade inspiratória (IC) e a capacidade vital (VC) da caixa torácica em sua divisão tricompartimental (caixa torácica pulmonar, caixa torácica abdominal e caixa torácica do abdômen ) e em cada hemitórax, bem como a velocidade de encurtamento dos músculos respiratórios e a frequência respiratória. As avaliações ocorreram 30 dias antes e 30 dias após a cirurgia. Resultados: Houve diminuição da distribuição compartimental total no QB com diferença estatística apenas no compartimento abdominal (p <0,05). Quatro pacientes apresentaram redução da velocidade de encurtamento do músculo diafragma esquerdo. Não foi possível realizar uma análise de grupo da cinemática respiratória e dos volumes em CV, IC devido à variação encontrada em cada paciente analisado. Conclusão: Houve redução do volume da caixa torácica e também alteração da velocidade de encurtamento dos músculos respiratórios após a transferência do nervo frênico um mês após a cirurgia.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Nervio Frénico/cirugía , Músculos Respiratorios/fisiopatología , Plexo Braquial/lesiones , Transferencia de Nervios/métodos , Pletismografía/instrumentación , Pruebas de Función Respiratoria/métodos , Resultado del TratamientoRESUMEN
Abstract This article aims to evaluate the anthropometric equations developed by selected studies in order to estimate the body composition of neonates. The systematic review consisted in the research of published articles in the following databases: PubMed, Brazilian Virtual Health Library, Embase and ScienceDirect by utilizing the following descriptors: "fat mass, fat free mass, anthropometry, air displacement plethysmography, validation, neonate". For doing so, the PRISMA protocol has been utilized. The bibliographical research resulted in 181 articles. However, only eight were selected for the present review because repetition in different databases and having been performed in adults, during pregnancy, in athletes, in preterm and children. There was discrepancy in terms of study method, mainly over the variables of the anthropometric equations, age and ethnicity of the neonates. All studies used the plethysmography method as a reference apart from one study. Only four studies had their equations validated. The studies that developed anthropometric models for estimating the body composition of neonates are scarce, and the use of these equations needs to be conducted carefully in order to avoid errors in nutritional diagnosis.
Resumo Este artigo tem por objetivo avaliar as equações antropométricas desenvolvidas pelos estudos selecionados para estimar a composição corporal de neonatos. A revisão sistemática consistiu na busca de artigos publicados nas bases de dados PubMed, Biblioteca Virtual de Saúde, Embase e ScienceDirect utilizando os seguintes descritores: "fat mass, fat free mass, anthropometry, air displacement plethysmography, validation, neonate". Para isso foi utilizado o protocolo PRISMA. A busca bibliográfica resultou em 181 artigos. Entretanto, apenas oito foram selecionados para compor a presente revisão por estarem presentes em outras bases de dados, por terem sido realizados com adultos, atletas, prematuros e crianças. Houve discrepância em relação aos métodos dos estudos, sobretudo no que diz respeito as variáveis que compuseram as equações antropométricas. Com exceção de um artigo, todos utilizaram a pletismografia como método de referência. Apenas quatro estudos tiveram suas equações validadas. Além de serem escassos os estudos que desenvolveram equações antropométricos para estimar a composição corporal de neonatos, o uso desses modelos deve ser realizado com cautela para evitar erros no diagnóstico nutricional dos neonatos.
Asunto(s)
Humanos , Recién Nacido , Niño , Adulto , Pletismografía , Composición Corporal , Grosor de los Pliegues Cutáneos , Brasil , Etnicidad , AntropometríaRESUMEN
BACKGROUND: Advanced stages of Duchenne muscular dystrophy (DMD) result in muscle weakness and the inability to generate an effective cough. Several factors influence the effectiveness of cough in patients with DMD. The aim of this study was to assess whether differences in positioning affect cough peak flow (CPF) and muscular electromyographic activation in subjects with DMD compared with paired healthy subjects. METHODS: Optoelectronic plethysmography and surface electromyography were used to assess chest wall volumes, chest wall inspiratory capacity, CPF, breathing pattern, and electromyographic activity of sternocleidomastoid, scalene, rectus abdominis, and external oblique muscles during inspiratory and expiratory cough phases in the supine position, supine position with headrest raised at 45°, and sitting with back support at 80° in 12 subjects with DMD and 12 healthy subjects. RESULTS: Subjects with DMD had lower CPF (P < .01) in comparison to control subjects in all positions; the DMD group also exhibited lower CPF (P = .045) in the supine position versus 80°. Moreover, the relative volume contributions of the rib cage and abdominal compartments to tidal volume modified significantly with posture. The electromyographic activity during inspiratory and expiratory cough phases was lower in subjects with DMD compared to healthy subjects for all evaluated muscles (P < .05), but no significant differences were observed with posture change. CONCLUSIONS: In subjects with DMD, posture influenced CPF and the relative contribution of the rib cage and abdominal compartments to tidal volume. However, muscular electromyographic activation was not influenced by posture in subjects with DMD and healthy subjects.
Asunto(s)
Tos/etiología , Distrofia Muscular de Duchenne , Humanos , Ápice del Flujo Espiratorio , Pletismografía , Músculos Respiratorios , Volumen de Ventilación PulmonarRESUMEN
BACKGROUND: We sought to evaluate the acute effects of different inspiratory loads using nasal and oral interfaces on the volumes of the chest wall and its compartments, breathing pattern, and respiratory muscle activation in children with mouth-breathing syndrome. METHODS: Children with mouth-breathing syndrome were randomized into 2 groups, one with an inspiratory load intensity 20% of maximum inspiratory pressure (n = 14), and the other with an inspiratory load intensity 40% of maximum inspiratory pressure (n = 15). The chest wall volumes and electromyography of sternocleidomastoid, rectus abdominis, scalene, and internal intercostal muscles were used to analyze respiration against the 2 load intensities and using 2 interfaces (ie, nasal and oral). RESULTS: A total of 72 children with mouth-breathing syndrome were recruited, and 29 were evaluated in this study. The use of inspiratory load promoted improvement in the components of the breathing pattern: breathing frequency (P = .039), inspiratory time (P = .03), and total respiratory time (P = .043); and increases in tidal volume (P < .001), end-inspiratory volume (P < .001), and electrical activity of scalene muscles and sternocleidomastoid muscles (P < .001) when compared to quiet breathing. The load imposed via a nasal interface versus an oral interface provided an increase in tidal volume (P = .030), end-inspiratory volume (P = .02), and electrical activity of scalene muscles (P < .001) and sternocleidomastoid muscles (P = .02). CONCLUSIONS: The use of acute inspiratory loads improved the breathing pattern and increased lung volume and electrical activity of inspiratory muscles. This work brings new perspective to the investigation of using nasal interfaces during the application of inspiratory loads. The nasal interface was more effective compared to the oral interface commonly used in clinical practice.
Asunto(s)
Pared Torácica , Fenómenos Biomecánicos , Niño , Electromiografía , Humanos , Boca , Respiración , Músculos RespiratoriosRESUMEN
SUMMARY OBJECTIVE The current study aimed to examine the body composition of adult male ultra-trail runners (UTR) according to their level of participation (regional UTR-R, vs. national UTR-N). METHODS The sample was composed of 44 adult male UTR (aged 36.5±7.2 years; UTR-R: n=25; UTR-N: n=19). Body composition was assessed by air displacement plethysmography, bioelectrical impedance, and dual-energy X-ray absorptiometry. In addition, the Food Frequency Questionnaire (FFQ) was applied. A comparison between the groups was performed using independent samples t-test. RESULTS Significant differences between groups contrasting in the competitive level were found for chronological age (in years; UTR-R: 38.8±8.2 vs. UTR-N: 33.5±4.1); body density (in L.kg-1; UTR-R: 1.062±0.015 vs. UTR-N: 1.074±0.009); and fat mass (in kg; UTR-R: 12.7±6.8 vs. UTR-N: 7.6±2.7). CONCLUSION UTR-N were younger, presented higher values for body density, and had less fat mass, although no significant differences were found for fat-free mass. The current study evidenced the profile of long-distance runners and the need for weight management programs to regulate body composition.
RESUMO OBJETIVO O presente estudo objetivou examinar a composição corporal dos corredores de ultra-trail (UTR) e, adicionalmente, comparar dois grupos de acordo com o nível de participação (Regional vs. Nacional, respectivamente UTR-R e UTR-N). MÉTODOS A amostra foi composta por 44 corredores adultos masculinos (36,5±7,2 anos de idade; UTR-R: n=25; UTR-N: n=19). A composição corporal foi avaliada recorrendo à pletismografia de ar deslocado, bioimpedância elétrica e absorciometria de raios X de dupla energia. Adicionalmente, foi utilizado o Questionário de Frequência Alimentar. A comparação entre grupos foi realizada com base na prova t-student para amostras independentes. RESULTADOS Foram encontradas diferenças significativas por nível de competição para as seguintes variáveis dependentes: idade cronológica (em anos; UTR-R: 38,8±8,2 vs. UTR-N: 33,5±4,1); densidade corporal (em kg/L; UTR-R: 1,062±0,015 L/kg vs. UTR-N: 1,074±0,009); massa gorda (em kg; UTR-R: 12,7±6,8 kg vs. UTR-N: 7,6±2,7). CONCLUSÃO Os UTR-N tendem a ser mais jovens e apresentam valores superiores de densidade corporal e, consequentemente, valores menores de massa gorda, sendo a massa isenta de gordura semelhante entre os grupos. O presente estudo determinou o perfil dos corredores adultos masculinos de longa distância (ultra-trail), realçando a importância de uma cuidadosa regulação da massa corporal.
Asunto(s)
Humanos , Masculino , Adulto , Carrera/fisiología , Composición Corporal/fisiología , Pletismografía/métodos , Valores de Referencia , Factores de Tiempo , Absorciometría de Fotón , Antropometría , Encuestas y Cuestionarios , Impedancia Eléctrica , Rendimiento Atlético/fisiología , AtletasRESUMEN
OBJECTIVE: We evaluated the effects of posture, sex, and age on breathing pattern and chest wall motion during quiet breathing in healthy participants. METHODS: Eighty-three participants aged 42.72 (SD=21.74) years presenting normal pulmonary function were evaluated by optoelectronic plethysmography in the seated, inclined (with 45° of trunk inclination), and supine positions. This method allowed to assess the chest wall in a three dimensional way considering the chest wall as three compartments: pulmonary rib cage, abdominal rib cage and abdomen. RESULTS: Posture influenced all variables of breathing pattern and chest wall motion, except respiratory rate and duty cycle. Chest wall tidal volume and minute ventilation were reduced (p<0.05) in both sexes from seated to inclined and from seated to supine positions, mainly in males. Moreover, moving from seated to supine position significantly increased the percentage contribution of the abdomen to the tidal volume in both sexes (p<0.0001). Regarding sex, women showed higher contribution of thoracic compartment compared to men (p=0.008). Aging provided reductions on rib cage contributions to tidal volume that were compensated by increases of abdomen contributions (p<0.0001). In addition, increases in end-inspiratory and end-expiratory volumes over the years were observed. CONCLUSION: The degree of contribution of chest wall compartments is dependent on posture, sex, and age. Therefore, verticalization increases expansion of pulmonary rib cage as well as horizontalization increases abdominal displacement. Women presented higher thoracic contribution to tidal volume than men. Aging reduces rib cage contributions to tidal volume that were compensated by increases of abdomen contributions.