Homero Puppo - Academia.edu (original) (raw)
Papers by Homero Puppo
Medicine & Science in Sports & Exercise, 2002
Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mell... more Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method.
European Journal of Physical and Rehabilitation Medicine
Rev Chil Enferm Respir, Mar 1, 1998
Frontiers in Physiology
Purpose: To evaluate the concordance between the value of the actual maximum voluntary ventilatio... more Purpose: To evaluate the concordance between the value of the actual maximum voluntary ventilation (MVV) and the estimated value by multiplying the forced expiratory volume in the first second (FEV 1) and a different value established in the literature. Methods: A retrospective study was conducted with healthy subjects and patients with stable chronic obstructive pulmonary disease (COPD). Five prediction formulas MVV were used for the comparison with the MVV values. Agreement between MVV measured and MVV obtained from five prediction equations were studied. FEV 1 values were used to estimate MVV. Correlation and agreement analysis of the values was performed in two groups using the Pearson test and the Bland-Altman method; these groups were one group with 207 healthy subjects and the second group with 83 patients diagnosed with COPD, respectively. Results: We recruited 207 healthy subjects (105 women, age 47 ± 17 years) and 83 COPD patients (age 66 ± 6 years; 29 GOLD II, 30 GOLD III, and 24 GOLD IV) for the study. All prediction equations presented a significant correlation with the MVV value (from 0.38 to 0.86, p < 0.05) except for the GOLD II subgroup, which had a poor agreement with measured MVV. In healthy subjects, the mean difference of the value of bias (and limits of agreement) varied between-3.9% (-32.8 to 24.9%), and 27% (-1.4 to 55.3%). In COPD patients, the mean difference of value of bias (and limits of agreement) varied between-4.4% (-49.4 to 40.6%), and 26.3% (-18.3 to 70.9%). The results were similar in the subgroup analysis.
Clocks & Sleep
Obstructive sleep apnoea (OSA) constitutes a public health problem, with various systemic consequ... more Obstructive sleep apnoea (OSA) constitutes a public health problem, with various systemic consequences that can increase cardiovascular morbidity and mortality as well as increase healthcare expenditure. This review discusses the rationale and effects of using general physical exercise, oropharyngeal exercises, and respiratory muscle training as an adjunctive treatment for patients with sleep apnoea. The recommended treatment for OSA is the use of continuous positive airway pressure, which is a therapy that prevents apnoea events by keeping the airways open. In the last decade, coadjuvant treatments that aim to support weight loss (including diet and physical exercise) and oropharyngeal exercises have been proposed to lower the apnoea/hypopnoea index among patients with OSA. Based on the available evidence, health professionals could decide to incorporate these therapeutic strategies to manage patients with sleep apnoea.
Clocks & Sleep
Background: Effective treatments for obstructive sleep apnoea (OSA) include positive pressure, we... more Background: Effective treatments for obstructive sleep apnoea (OSA) include positive pressure, weight loss, oral appliances, surgery, and exercise. Although the involvement of the respiratory muscles in OSA is evident, the effect of training them to improve clinical outcomes is not clear. We aimed to determine the effects of respiratory muscle training in patients with OSA. Methods: A systematic review was conducted in seven databases. Studies that applied respiratory muscle training in OSA patients were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. Results: Of the 405 reports returned by the initial search, eight articles reporting on 210 patients were included in the data synthesis. Seven included inspiratory muscle training (IMT), and one included expiratory muscle training (EMT). Regarding IMT, we found significant improvement in Epworth sleepiness scale in −4.45 points (95%CI −7.64 to −1.27 points, p = 0.006),...
Neumol. pediátr. (En línea), 2016
Background: Coughing is the most important mechanism for evacuating mucus secretions from the air... more Background: Coughing is the most important mechanism for evacuating mucus secretions from the airways. Its efSicacy directly depends on the Peak Cough Flow (PCF), which corresponds to the maximum air-Slow generated during a cough. PCF is used to assess cough in patients with respiratory muscle weakness, mainly in neuromuscular diseases. This measurement is performed using a peak Slow meter. However, the literature describes two forms of evaluation: one using a facemask or using a cylindrical mouthpiece and a nose clip. Objective: The aim of this study was to analyze the differences in PCF values obtained when using a mouthpiece or a facemask in healthy subjects. Methods: We recruited 42 healthy volunteers, of which 34 (16 men) were able to Sinish the study. The PCF was measured using both interfaces (PCFmouth and PCFmask) applied in a random order. At least three valid maneuvers were performed by each one of the subjects to obtain reproducible values. Results: The population charact...
Neumología Pediátrica, Jul 10, 2019
C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r ... more C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r i c a. c l INTRODUCCIÓN La prueba de provocación bronquial con metacolina es una prueba inespecífica y directa, que evalúa el grado de reactividad de la vía aérea. Constituye la prueba de provocación bronquial más indicada en la práctica clínica habitual. El aumento de la reactividad bronquial es una característica distintiva del asma, pero también está presente en otras condiciones como displasia broncopulmonar, bronquiectasias, rinitis alérgica, fibrosis quística, infecciones virales y también en niños sanos. Además, la reactividad bronquial en un paciente puede cambiar en el tiempo, aumentar en las exacerbaciones, disminuir durante el tratamiento con antiinflamatorios y estar ausente en periodos asintomáticos (1,2,3). Por esto, el resultado del examen debe considerarse dentro del contexto del paciente a evaluar. Esta prueba de provocación se utiliza para evaluar la hiperreactividad de la vía aérea, que se define como un aumento de la sensibilidad y respuesta exagerada a estímulos no alergénicos que causan broncoconstricción.
Neumología Pediátrica, 2017
C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r ... more C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r i c a. c l 101 En memoria: Klgo. Darwin Gatica Solís C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r i c a. c l
Neumología Pediátrica, 2021
La respiración es un proceso continuo donde los músculos respiratorios tienen un rol central e im... more La respiración es un proceso continuo donde los músculos respiratorios tienen un rol central e imprescindible para la vida. Su óptimo funcionamiento involucra diversas estructuras que deben funcionar de forma armónica y coordinada, para que el gasto energético asociado a sus demandas permita aumentos considerables de carga sin afectar mayormente la función esencial de intercambio gaseoso. Comprender la fisiología muscular, desde la base anatómica hasta su comportamiento en el ejercicio y la enfermedad, es fundamental para detectar con anticipación las diversas disfunciones que se producen cuando este equilibrio se descompensa. El objetivo de esta revisión es entregar las bases fisiológicas del comportamiento de la musculatura respiratoria que permitan comprender y aplicar las mejores estrategias de evaluación y tratamiento, cuando la función normal se ve alterada, ya sea por enfermedad, desuso o altas cargas asociadas al ejercicio físico.
Neumología Pediátrica, 2020
La espirometría es la prueba de función pulmonar más adecuada para evaluar a preescolares con enf... more La espirometría es la prueba de función pulmonar más adecuada para evaluar a preescolares con enfermedades pulmonares crónicas y sibilancias recurrentes. Es útil, accesible y de buen rendimiento. Para una correcta interpretación debe realizarse bajo las condiciones especialmente normadas para este grupo etario. En esta revisión, producto del trabajo realizado durante el año 2018, por la comisión de función pulmonar de la sociedad Chilena de Neumología Pediátrica, se expondrán los aspectos actualizados para la realización e interpretación de la espirometría en preescolares, con énfasis en las diferencias de los criterios clásicamente descritos para niños mayores y adultos.
Introduccion: Las enfermedades neuromusculares se caracterizan por presentar diminucion de la fu... more Introduccion: Las enfermedades neuromusculares se caracterizan por presentar diminucion de la fuerza y resistencia de la musculatura respiratoria. La debilidad muscular respiratoria impacta la evolucion clinica y la calidad de vida de los pacientes. El objetivo de este estudio fue evaluar los efectos del Entrenamiento Muscular Inspiratorio (EMI) en la fuerza y resistencia de estos musculos en ninos y adolescentes con enfermedades neuromusculares. Metodos: Fueron incluidos ninos y adolescentes con enfermedades neuromusculares controlados de forma ambulatoria en los servicios de Neumologia Infantil de los hospitales de la Region Metropolitana de Chile. Los pacientes realizaron un protocolo de EMI con una carga del 30% de la presion inspiratoria maxima (Pimax), 15 minutos diarios, 5 veces a la semana, durante 6 semanas con una valvula IMT Threshold ® . Los parametros evaluados fueron la Pimax, la presion espiratoria maxima (Pemax) y el tiempo limite (Tlim) cada 15 dias. Resultados: S...
Pulmonology, 2021
Background: Evidence suggests lungs as the organ most affected by coronavirus disease 2019 (COVID... more Background: Evidence suggests lungs as the organ most affected by coronavirus disease 2019 (COVID-19). The literature on previous coronavirus infections reports that patients may experience persistent impairment in respiratory function after being discharged. Our objective was to determine the prevalence of restrictive pattern, obstructive pattern and altered diffusion in patients post-COVID-19 infection and to describe the different evaluations of respiratory function used with these patients. Methods: A systematic review was conducted in five databases. Studies that used lung function testing to assess post-infection COVID-19 patients were included for review. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. Results: Of the 1973 reports returned by the initial search, seven articles reporting on 380 patients were included in the data synthesis. In the sensitivity analysis, we found a prevalence of 0.39 (CI 0.24-0.56, p < 0.01, I 2 = 86%), 0.15 (CI 0.09-0.22, p = 0.03, I 2 = 59%), and 0.07 (CI 0.04-0.11, p = 0.31, I 2 = 16%) for altered diffusion capacity of the lungs for carbon monoxide (DL CO), restrictive pattern and obstructive pattern, respectively.
Neumología Pediátrica, 2019
La prueba de provocación bronquial con ejercicio tiene como objetivo demostrar la presencia de hi... more La prueba de provocación bronquial con ejercicio tiene como objetivo demostrar la presencia de hiperreactividad bronquial inducida por ejercicio, característica del asma bronquial. Su realización está bien estandarizada, requiriendo de condiciones ambientales especiales, preparación y esfuerzo submáximo del paciente. La respuesta se mide mediante espirometría, y se considera una prueba de provocación con ejercicio positivo, a una caída del volumen espirado al primer segundo (VEF1) del 10%. En este artículo se describen los elementos necesarios para facilitar la realización de este examen, acorde a normas y guías nacionales e internacionales.
Archives of Physical Medicine and Rehabilitation, 2021
Archives of Physical Medicine and Rehabilitation, 2020
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Journal of the peripheral nervous system : JPNS, Dec 1, 2016
The Guillain-Barre Syndrome (GBS) incidence rate (IR) varies between 0.16 and 3.00 cases per 100,... more The Guillain-Barre Syndrome (GBS) incidence rate (IR) varies between 0.16 and 3.00 cases per 100,000 inhabitants. Little data exist on the epidemiology of GBS in Latin American countries. Our objective was to describe GBS epidemiology based on a national database in a Latin American country and to contribute to the global map of GBS epidemiology. This was a retrospective study that included all reported GBS cases in Chile between 2001 and 2012. Gender, age, seasonal occurrence, and geographical distribution were analyzed. 4,158 GBS cases were identified from 19,513,655 registries. The mean age was 37 ± 24 years, and 59% of patients were male (male to female ratio of 1.5:1). Gender IR was 2.53/100,000 for males and 1.68/100,000 for females. The overall standardized IR was 2.1/100,000, although this varied between 1.61/100,000 (2001) and 2.35/100,000 (2010). The seasonal distribution was as follows: autumn 22%; winter 25%; spring 27%; and summer 26%. The geographical IR were as follow...
British Journal of Medicine and Medical Research, 2016
Objective: To compare the effects of Air Stacking (AS) and Glossopharyngeal Breathing (GPB) on th... more Objective: To compare the effects of Air Stacking (AS) and Glossopharyngeal Breathing (GPB) on the Maximum Insufflation Capacity (MIC) in patients with Neuromuscular Disease (NMD). Methods: We design a randomized cross-over study. Children and adolescents with NMD who were users of non-invasive mechanical ventilation were recruited. Vital capacity (VC) and MIC were measured before and after the intervention with AS and GPB. Values were compared pre- and postintervention and were considered statistically significant if p <0.05. Results: We selected 14 patients with a median age of 12.5 years (range 9-18) with the following diagnoses: Duchenne Muscular Dystrophy (7), Spinal Muscular Atrophy Type II (3), Spinal Cord
Medicine & Science in Sports & Exercise, 2002
Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mell... more Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method.
European Journal of Physical and Rehabilitation Medicine
Rev Chil Enferm Respir, Mar 1, 1998
Frontiers in Physiology
Purpose: To evaluate the concordance between the value of the actual maximum voluntary ventilatio... more Purpose: To evaluate the concordance between the value of the actual maximum voluntary ventilation (MVV) and the estimated value by multiplying the forced expiratory volume in the first second (FEV 1) and a different value established in the literature. Methods: A retrospective study was conducted with healthy subjects and patients with stable chronic obstructive pulmonary disease (COPD). Five prediction formulas MVV were used for the comparison with the MVV values. Agreement between MVV measured and MVV obtained from five prediction equations were studied. FEV 1 values were used to estimate MVV. Correlation and agreement analysis of the values was performed in two groups using the Pearson test and the Bland-Altman method; these groups were one group with 207 healthy subjects and the second group with 83 patients diagnosed with COPD, respectively. Results: We recruited 207 healthy subjects (105 women, age 47 ± 17 years) and 83 COPD patients (age 66 ± 6 years; 29 GOLD II, 30 GOLD III, and 24 GOLD IV) for the study. All prediction equations presented a significant correlation with the MVV value (from 0.38 to 0.86, p < 0.05) except for the GOLD II subgroup, which had a poor agreement with measured MVV. In healthy subjects, the mean difference of the value of bias (and limits of agreement) varied between-3.9% (-32.8 to 24.9%), and 27% (-1.4 to 55.3%). In COPD patients, the mean difference of value of bias (and limits of agreement) varied between-4.4% (-49.4 to 40.6%), and 26.3% (-18.3 to 70.9%). The results were similar in the subgroup analysis.
Clocks & Sleep
Obstructive sleep apnoea (OSA) constitutes a public health problem, with various systemic consequ... more Obstructive sleep apnoea (OSA) constitutes a public health problem, with various systemic consequences that can increase cardiovascular morbidity and mortality as well as increase healthcare expenditure. This review discusses the rationale and effects of using general physical exercise, oropharyngeal exercises, and respiratory muscle training as an adjunctive treatment for patients with sleep apnoea. The recommended treatment for OSA is the use of continuous positive airway pressure, which is a therapy that prevents apnoea events by keeping the airways open. In the last decade, coadjuvant treatments that aim to support weight loss (including diet and physical exercise) and oropharyngeal exercises have been proposed to lower the apnoea/hypopnoea index among patients with OSA. Based on the available evidence, health professionals could decide to incorporate these therapeutic strategies to manage patients with sleep apnoea.
Clocks & Sleep
Background: Effective treatments for obstructive sleep apnoea (OSA) include positive pressure, we... more Background: Effective treatments for obstructive sleep apnoea (OSA) include positive pressure, weight loss, oral appliances, surgery, and exercise. Although the involvement of the respiratory muscles in OSA is evident, the effect of training them to improve clinical outcomes is not clear. We aimed to determine the effects of respiratory muscle training in patients with OSA. Methods: A systematic review was conducted in seven databases. Studies that applied respiratory muscle training in OSA patients were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. Results: Of the 405 reports returned by the initial search, eight articles reporting on 210 patients were included in the data synthesis. Seven included inspiratory muscle training (IMT), and one included expiratory muscle training (EMT). Regarding IMT, we found significant improvement in Epworth sleepiness scale in −4.45 points (95%CI −7.64 to −1.27 points, p = 0.006),...
Neumol. pediátr. (En línea), 2016
Background: Coughing is the most important mechanism for evacuating mucus secretions from the air... more Background: Coughing is the most important mechanism for evacuating mucus secretions from the airways. Its efSicacy directly depends on the Peak Cough Flow (PCF), which corresponds to the maximum air-Slow generated during a cough. PCF is used to assess cough in patients with respiratory muscle weakness, mainly in neuromuscular diseases. This measurement is performed using a peak Slow meter. However, the literature describes two forms of evaluation: one using a facemask or using a cylindrical mouthpiece and a nose clip. Objective: The aim of this study was to analyze the differences in PCF values obtained when using a mouthpiece or a facemask in healthy subjects. Methods: We recruited 42 healthy volunteers, of which 34 (16 men) were able to Sinish the study. The PCF was measured using both interfaces (PCFmouth and PCFmask) applied in a random order. At least three valid maneuvers were performed by each one of the subjects to obtain reproducible values. Results: The population charact...
Neumología Pediátrica, Jul 10, 2019
C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r ... more C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r i c a. c l INTRODUCCIÓN La prueba de provocación bronquial con metacolina es una prueba inespecífica y directa, que evalúa el grado de reactividad de la vía aérea. Constituye la prueba de provocación bronquial más indicada en la práctica clínica habitual. El aumento de la reactividad bronquial es una característica distintiva del asma, pero también está presente en otras condiciones como displasia broncopulmonar, bronquiectasias, rinitis alérgica, fibrosis quística, infecciones virales y también en niños sanos. Además, la reactividad bronquial en un paciente puede cambiar en el tiempo, aumentar en las exacerbaciones, disminuir durante el tratamiento con antiinflamatorios y estar ausente en periodos asintomáticos (1,2,3). Por esto, el resultado del examen debe considerarse dentro del contexto del paciente a evaluar. Esta prueba de provocación se utiliza para evaluar la hiperreactividad de la vía aérea, que se define como un aumento de la sensibilidad y respuesta exagerada a estímulos no alergénicos que causan broncoconstricción.
Neumología Pediátrica, 2017
C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r ... more C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r i c a. c l 101 En memoria: Klgo. Darwin Gatica Solís C o n t e n i d o d i s p o n i b l e e n h t t p : / / w w w. n e u m o l o g i a-p e d i a t r i c a. c l
Neumología Pediátrica, 2021
La respiración es un proceso continuo donde los músculos respiratorios tienen un rol central e im... more La respiración es un proceso continuo donde los músculos respiratorios tienen un rol central e imprescindible para la vida. Su óptimo funcionamiento involucra diversas estructuras que deben funcionar de forma armónica y coordinada, para que el gasto energético asociado a sus demandas permita aumentos considerables de carga sin afectar mayormente la función esencial de intercambio gaseoso. Comprender la fisiología muscular, desde la base anatómica hasta su comportamiento en el ejercicio y la enfermedad, es fundamental para detectar con anticipación las diversas disfunciones que se producen cuando este equilibrio se descompensa. El objetivo de esta revisión es entregar las bases fisiológicas del comportamiento de la musculatura respiratoria que permitan comprender y aplicar las mejores estrategias de evaluación y tratamiento, cuando la función normal se ve alterada, ya sea por enfermedad, desuso o altas cargas asociadas al ejercicio físico.
Neumología Pediátrica, 2020
La espirometría es la prueba de función pulmonar más adecuada para evaluar a preescolares con enf... more La espirometría es la prueba de función pulmonar más adecuada para evaluar a preescolares con enfermedades pulmonares crónicas y sibilancias recurrentes. Es útil, accesible y de buen rendimiento. Para una correcta interpretación debe realizarse bajo las condiciones especialmente normadas para este grupo etario. En esta revisión, producto del trabajo realizado durante el año 2018, por la comisión de función pulmonar de la sociedad Chilena de Neumología Pediátrica, se expondrán los aspectos actualizados para la realización e interpretación de la espirometría en preescolares, con énfasis en las diferencias de los criterios clásicamente descritos para niños mayores y adultos.
Introduccion: Las enfermedades neuromusculares se caracterizan por presentar diminucion de la fu... more Introduccion: Las enfermedades neuromusculares se caracterizan por presentar diminucion de la fuerza y resistencia de la musculatura respiratoria. La debilidad muscular respiratoria impacta la evolucion clinica y la calidad de vida de los pacientes. El objetivo de este estudio fue evaluar los efectos del Entrenamiento Muscular Inspiratorio (EMI) en la fuerza y resistencia de estos musculos en ninos y adolescentes con enfermedades neuromusculares. Metodos: Fueron incluidos ninos y adolescentes con enfermedades neuromusculares controlados de forma ambulatoria en los servicios de Neumologia Infantil de los hospitales de la Region Metropolitana de Chile. Los pacientes realizaron un protocolo de EMI con una carga del 30% de la presion inspiratoria maxima (Pimax), 15 minutos diarios, 5 veces a la semana, durante 6 semanas con una valvula IMT Threshold ® . Los parametros evaluados fueron la Pimax, la presion espiratoria maxima (Pemax) y el tiempo limite (Tlim) cada 15 dias. Resultados: S...
Pulmonology, 2021
Background: Evidence suggests lungs as the organ most affected by coronavirus disease 2019 (COVID... more Background: Evidence suggests lungs as the organ most affected by coronavirus disease 2019 (COVID-19). The literature on previous coronavirus infections reports that patients may experience persistent impairment in respiratory function after being discharged. Our objective was to determine the prevalence of restrictive pattern, obstructive pattern and altered diffusion in patients post-COVID-19 infection and to describe the different evaluations of respiratory function used with these patients. Methods: A systematic review was conducted in five databases. Studies that used lung function testing to assess post-infection COVID-19 patients were included for review. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. Results: Of the 1973 reports returned by the initial search, seven articles reporting on 380 patients were included in the data synthesis. In the sensitivity analysis, we found a prevalence of 0.39 (CI 0.24-0.56, p < 0.01, I 2 = 86%), 0.15 (CI 0.09-0.22, p = 0.03, I 2 = 59%), and 0.07 (CI 0.04-0.11, p = 0.31, I 2 = 16%) for altered diffusion capacity of the lungs for carbon monoxide (DL CO), restrictive pattern and obstructive pattern, respectively.
Neumología Pediátrica, 2019
La prueba de provocación bronquial con ejercicio tiene como objetivo demostrar la presencia de hi... more La prueba de provocación bronquial con ejercicio tiene como objetivo demostrar la presencia de hiperreactividad bronquial inducida por ejercicio, característica del asma bronquial. Su realización está bien estandarizada, requiriendo de condiciones ambientales especiales, preparación y esfuerzo submáximo del paciente. La respuesta se mide mediante espirometría, y se considera una prueba de provocación con ejercicio positivo, a una caída del volumen espirado al primer segundo (VEF1) del 10%. En este artículo se describen los elementos necesarios para facilitar la realización de este examen, acorde a normas y guías nacionales e internacionales.
Archives of Physical Medicine and Rehabilitation, 2021
Archives of Physical Medicine and Rehabilitation, 2020
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Journal of the peripheral nervous system : JPNS, Dec 1, 2016
The Guillain-Barre Syndrome (GBS) incidence rate (IR) varies between 0.16 and 3.00 cases per 100,... more The Guillain-Barre Syndrome (GBS) incidence rate (IR) varies between 0.16 and 3.00 cases per 100,000 inhabitants. Little data exist on the epidemiology of GBS in Latin American countries. Our objective was to describe GBS epidemiology based on a national database in a Latin American country and to contribute to the global map of GBS epidemiology. This was a retrospective study that included all reported GBS cases in Chile between 2001 and 2012. Gender, age, seasonal occurrence, and geographical distribution were analyzed. 4,158 GBS cases were identified from 19,513,655 registries. The mean age was 37 ± 24 years, and 59% of patients were male (male to female ratio of 1.5:1). Gender IR was 2.53/100,000 for males and 1.68/100,000 for females. The overall standardized IR was 2.1/100,000, although this varied between 1.61/100,000 (2001) and 2.35/100,000 (2010). The seasonal distribution was as follows: autumn 22%; winter 25%; spring 27%; and summer 26%. The geographical IR were as follow...
British Journal of Medicine and Medical Research, 2016
Objective: To compare the effects of Air Stacking (AS) and Glossopharyngeal Breathing (GPB) on th... more Objective: To compare the effects of Air Stacking (AS) and Glossopharyngeal Breathing (GPB) on the Maximum Insufflation Capacity (MIC) in patients with Neuromuscular Disease (NMD). Methods: We design a randomized cross-over study. Children and adolescents with NMD who were users of non-invasive mechanical ventilation were recruited. Vital capacity (VC) and MIC were measured before and after the intervention with AS and GPB. Values were compared pre- and postintervention and were considered statistically significant if p <0.05. Results: We selected 14 patients with a median age of 12.5 years (range 9-18) with the following diagnoses: Duchenne Muscular Dystrophy (7), Spinal Muscular Atrophy Type II (3), Spinal Cord