Spirometry And Volumetric Capnography In Lung Function Assessment Of Obese And Normal-weight Individuals Without Asthma

To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. Methods: Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. Results: At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV1/FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p <0.05). Volumetric capnography showed that obese individuals had a higher volume of produced carbon dioxide and alveolar tidal volume (p <0.05). Additionally, the associations between dead space volume and tidal volume, as well as phase-3 slope normalized by tidal volume, were lower in healthy subjects (p <0.05). These data suggest that obesity does not alter ventilation homogeneity, but flow homogeneity. After subdividing the groups by age, a greater difference in lung function was observed in obese and healthy individuals aged >11 years (p <0.05). Conclusion: Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV1/FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes. © 2017 Sociedade Brasileira de Pediatria

Mammillary body injury in neonatal encephalopathy: a multicentre, retrospective study

Background The mammillary bodies (MBs) have repeatedly been shown to be critical for memory, yet little is known about their involvement in numerous neurological conditions linked to memory impairments, including neonatal encephalopathy. Methods We implemented a multicentre retrospective study, assessing magnetic resonance scans of 219 infants with neonatal encephalopathy who had undergone hypothermia treatment in neonatal intensive care units located in the Netherlands and Italy. Results Abnormal MB signal was observed in similar to 40% of infants scanned; in half of these cases, the brain appeared otherwise normal. MB involvement was not related to the severity of encephalopathy or the pattern/severity of hypoxic-ischaemic brain injury. Follow-up scans were available for 18 cases with abnormal MB signal; in eight of these cases, the MBs appeared severely atrophic. Conclusions This study highlights the importance of assessing the status of the MBs in neonatal encephalopathy; this may require changes to scanning protocols to ensure that the slices are sufficiently thin to capture the MBs. Furthermore, long-term follow-up of infants with abnormal MB signal is needed to determine the effects on cognition, which may enable the use of early intervention strategies. Further research is needed to assess the role of therapeutic hypothermia in MB involvement in neonatal encephalopathy. ImpactThe MBs are particularly sensitive to hypoxia in neonates. Current hypothermia treatment provides incomplete protection against MB injury. MB involvement is likely overlooked as it can often occur when the rest of the brain appears normal. Given the importance of the MBs for memory, it is necessary that this region is properly assessed in neonatal encephalopathy. This may require improvements in scanning protocols.Developmen

Associação Entre Variáveis Clínicas Relacionadas à Asma Em Escolares Nascidos Com Muito Baixo Peso Com E Sem Displasia Broncopulmonar

To assess the prevalence, spirometry findings and risk factors for asthma in schoolchildren who were very low birth weight infants with and without bronchopulmonary dysplasia. Methods Observational and cross-sectional study. The parents and/or tutors answered the International Study of Asthma and Allergies in Childhood questionnaire. The schoolchildren were submitted to the skin prick test and spirometry assessment. Results 54 schoolchildren who were very low birth weight infants were assessed and 43 met the criteria for spirometry. Age at the assessment (bronchopulmonary dysplasia=9.5±0.85; without bronchopulmonary dysplasia=10.1±0.86 years) and birth weight (bronchopulmonary dysplasia=916.7±251.2; without bronchopulmonary dysplasia=1171.3±190.5g) were lower in the group with bronchopulmonary dysplasia (p<0.05). The prevalence of asthma among very low birth weight infants was 17/54 (31.5%), being 6/18 (33.3%) in the group with bronchopulmonary dysplasia. There was an association between wool blanket use in the first year of life (p=0.026) with the presence of asthma at school age. The skin prick test was positive in 13/17 (76.5%) and 23/37 (62.2%) of patients with and without asthma, respectively. The schoolchildren with asthma had lower z-score values of forced expiratory flow between 25% and 75% of forced vital capacity (n=16;−1.04±1.19) when compared to the group of patients without asthma (n=27;−0.380.93) (p=0.049). There was no difference between the spirometry variables in the groups regarding the presence or absence of bronchopulmonary dysplasia. Conclusions Very low birth weight infants with and without bronchopulmonary dysplasia showed a high prevalence of asthma (33.3% and 30.6%, respectively). Pulmonary flow in the small airways was lower in children with asthma. © 2016 Sociedade de Pediatria de São Paulo34327128

Effect Of Exercise Test On Pulmonary Function Of Obese Adolescents

Objective to investigate the pulmonary response to exercise of non-morbidly obese adolescents, considering the gender. Methods a prospective cross-sectional study was conducted with 92 adolescents (47 obese and 45 eutrophic), divided in four groups according to obesity and gender. Anthropometric parameters, pulmonary function (spirometry and oxygen saturation [SatO2]), heart rate (HR), blood pressure (BP), respiratory rate (RR), and respiratory muscle strength were measured. Pulmonary function parameters were measured before, during, and after the exercise test. Results BP and HR were higher in obese individuals during the exercise test (p = 0.0001). SatO2 values decreased during exercise in obese adolescents (p = 0.0001). Obese males had higher levels of maximum inspiratory and expiratory pressures (p = 0.0002) when compared to obese and eutrophic females. Obese males showed lower values of maximum voluntary ventilation, forced vital capacity, and forced expiratory volume in the first second when compared to eutrophic males, before and after exercise (p = 0.0005). Obese females had greater inspiratory capacity compared to eutrophic females (p = 0.0001). Expiratory reserve volume was lower in obese subjects when compared to controls (p ≤ 0,05). Conclusion obese adolescents presented changes in pulmonary function at rest and these changes remained present during exercise. The spirometric and cardiorespiratory values were different in the four study groups. The present data demonstrated that, in spite of differences in lung growth, the model of fat distribution alters pulmonary function differently in obese female and male adolescents. © 2013 Sociedade Brasileira de Pediatria.903242249Littleton, S.W., Impact of obesity on respiratory function (2012) Respirology, 17, pp. 43-49Kumanyika, S.K., Obarzanek, E., Stettler, N., Bell, R., Field, A.E., Fortmann, S.P., Population-based prevention of obesity: The need for comprehensive promotion of healthful eating, physical activity, and energy balance: A scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science) (2008) Circulation, 118, pp. 428-464Camilo, D.F., Ribeiro, J.D., Toro, A.D., Baracat, E.C., Barros Filho, A.A., Obesity and asthma: Association or coincidence? 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ATS/ERS Statement on respiratory muscle testing (2002) J Respir Crit Care Med, 166, pp. 518-624Miller, M.R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., Standardisation of spirometry (2005) Eur Respir J, 26, pp. 319-338Sole, D., Gomes, I.C., Vanna, A.T., Guelpa, A., Mallozi, M.C., Naspitz, C.K., Pulse oximetry in the evaluation of bronchoprovocation with methacoline and exercise testing in asthmatic children (1998) Rev Bras Alergia Imunopatol, 21, pp. 46-51Corte De Araujo, A.C., Roschel, H., Picanço, A.R., Do Prado, D.M., Villares, S.M., De Sá Pinto, A.L., Similar health benefits of endurance and high-intensity interval training in obese children (2012) PLoS One, 7, p. 42747Collins, L.C., Hoberty, P.D., Walker, J.F., Fletcher, E.C., Peiris, A.N., The effect of body fat distribution on pulmonary function tests (1995) Chest, 107, pp. 1298-1302Del Río-Navarro, B., Cisneros-Rivero, M., Berber-Eslava, A., Espínola-Reyna, G., Sienra-Monge, J., Exercise induced bronchospasm in asthmatic and non-asthmatic obese children (2000) Allergol Immunopathol (Madr), 28, pp. 5-11Paralikar, S.J., Kathrotia, R.G., Pathak, N.R., Jani, M.B., Assessment of pulmonary functions in obese adolescent boys (2012) Lung India, 29, pp. 236-240Van De Griendt, E.J., Van Der Baan-Slootweg, O.H., Van Essen-Zandvliet, E.E., Van Der Palen, J., Tamminga-Smeulders, C.L., Benninga, M.A., Gain in lung function after weight reduction in severely obese children (2012) Arch Dis Child, 97, pp. 1039-1042Hakala, K., Mustajoki, P., Aittomäki, J., Sovijärvi, A.R., Effect of weight loss and body position on pulmonary function and gas exchange abnormalities in morbid obesity (1995) Int J Obes Relat Metab Disord, 19, pp. 343-346Biring, M.S., Lewis, M.I., Liu, J.T., Mohsenifar, Z., Pulmonary physiologic changes of morbid obesity (1999) Am J Med Sci, 318, pp. 293-297Ceylan, E., Cömlekçi, A., Akkoçlu, A., Ceylan, C., Itil, O., Ergör, G., The effects of body fat distribution on pulmonary function tests in the overweight and obese (2009) South Med J, 102, pp. 30-35Santana, A.N., Souza, R., Martins, A.P., Macedo, F., Rascovski, A., Salge, J.M., The effect of massive weight loss on pulmonary function of morbid obese patients (2006) Respir Med, 100, pp. 1100-1104Marinov, B., Kostianev, S., Turnovska, T., Ventilatory efficiency and rate of perceived exertion in obese and non-obese children performing standardized exercise (2002) Clin Physiol Funct Imaging, 22, pp. 254-260Salome, C.M., King, G.G., Berend, N., Physiology of obesity and effects on lung function (2010) J Appl Physiol, 108, pp. 206-211Dreher, M., Kabitz, H.J., Impact of obesity on exercise performance and pulmonary rehabilitation (2012) Respirology, 17, pp. 899-907Polgar, G., Promadhat, V., (1971) Pulmonary Function Testing in Children: Techniques and Standards, , WB Saunders Company Philadelphia, PAQuanjer, P.H., Stanojevic, S., Cole, T.J., Baur, X., Hall, G.L., Culver, B.H., Multi-ethnic reference values for spirometry for the 3-95-yr age range: The global lung function 2012 equations (2012) Eur Respir J, 40, pp. 1324-134

Características agronômicas de cultivares de mamona em função do local de cultivo e da época de semeadura no Rio Grande do Sul Characteristics of castor bean cultivars according to the environmental crop and sowing season in Rio Grande do Sul State, Brazil

A mamona (Ricinus communis L.) é uma planta oleaginosa anual e, ocasionalmente, bienal em regiões tropicais, com ciclo médio de 150 dias para a maioria das cultivares anuais e de 120 a 130 dias para cultivares anuais precoces. O objetivo deste trabalho foi avaliar características agronômicas de cultivares das mamonas 'Al Guarany 2002', 'IAC 80', 'IAC 226' e 'BRS 188 Paraguaçu'em função do ambiente de cultivo e da época de semeadura. As cultivares foram semeadas entre o primeiro e o quinto dia dos meses de novembro e dezembro, na Embrapa Clima Temperado, em Pelotas, Rio Grande do Sul. Cada época teve 12 unidades experimentais em três blocos casualizados. A emergência, a altura de planta e de inserção do primeiro cacho, o período de florescimento e colheita e o ataque de pragas e doenças foram avaliados e analisados com o programa WinStat Versão 2.0. O comportamento entre as cultivares diferiu entre locais de cultivo e época de semeadura. A inserção do cacho foi mais alta, e as florações e colheitas foram mais tardias em plantas da segunda época de semeadura. Danos por pragas e doenças e os descritores morfológicos da planta de mamona apresentaram diferenças entre os locais de cultivo.<br>Castor bean (Ricinus communis L.) is an oleaginous plant with annual cycle and occasionally biennial cycle in tropical areas, with mean cycle of 150 days for the majority of annual cultivars and 120 to 130 days for annual early cultivars. The objective of this study was to evaluate the agronomic characteristics of castor cultivars according to environmental crop and sowing season. The experiment was conduced at Embrapa Clima Temperado - Pelotas/RS, in two places. The castor cultivars used in this research were 'Al Guarany 2002', 'IAC 80', 'IAC 226' and 'BRS 188 Paraguaçu', which were sown in two sowing times: the first was in early November (between 1st and 5st) and the second was in early December (between 1st and 5st). Each sowing season was constituted of 12 experimental units, distributed in three random blocks. It was evaluated the emergency, plant height and first spike insertion , flowering and harvest time, pest and disease attacks. The WinStat program Version 2.0 was used for data statistical analysis. There was a significant difference among cultivar behaviors between the environmental crops and sowing seasons. The second sowing season provided a larger plant and first spike insertion was higher. It also promoted retardation in the flowering and harvesting time. The differences among cultivars, between the two environmental crops, were clearer in the pest and disease attacks, but also in morphologic characteristics of castor plant

The International Consortium on Lithium Genetics (ConLiGen): An initiative by the NIMH and IGSLI to study the genetic basis of response to lithium treatment

For more than half a decade, lithium has been successfully used to treat bipolar disorder. Worldwide, it is considered the first-line mood stabilizer. Apart from its proven antimanic and prophylactic effects, considerable evidence also suggests an antisuicidal effect in affective disorders. Lithium is also effectively used to augment antidepressant drugs in the treatment of refractory major depressive episodes and prevent relapses in recurrent unipolar depression. In contrast to many psychiatric drugs, lithium has outlasted various pharmacotherapeutic 'fashions', and remains an indispensable element in contemporary psychopharmacology. Nevertheless, data from pharmacogenetic studies of lithium are comparatively sparse, and these studies are generally characterized by small sample sizes and varying definitions of response. Here, we present an international effort to elucidate the genetic underpinnings of lithium response in bipolar disorder. Following an initiative by the International Group for the Study of Lithium-Treated Patients (www.IGSLI.org) and the Unit on the Genetic Basis of Mood and Anxiety Disorders at the National Institute of Mental Health,lithium researchers from around the world have formed the Consortium on Lithium Genetics (www.ConLiGen.org) to establish the largest sample to date for genome-wide studies of lithium response in bipolar disorder, currently comprising more than 1,200 patients characterized for response to lithium treatment. A stringent phenotype definition of response is one of the hallmarks of this collaboration. ConLiGen invites all lithium researchers to join its efforts