The results of this study demonstrate that the behavior of respiratory muscle strength in healthy preschool and school children can be explained by age, height and weight.

Low levels of peak oxygen uptake are associated with an increase of 4.9 in the risk of mortality in subjects with CF. This indicates that V̇ could be an important follow-up variable to measure, in addition to FEV.

No abstract

Background: Several tests may be used to assess exercise intolerance in cystic fibrosis (CF), including the gold standard cardiopulmonary exercise test (CPET) and the Modified Shuttle Test (MST).Objective: To evaluate the use of the MST as a predictor of peak oxygen uptake (VO 2 peak) and to compare VO 2 peak and maximal heart rate (HRmax) obtained in both tests.Methods: Cross-sectional study including individuals with CF aged between 6 and 20 years old. Participants who were unable to perform the tests and/or presented signs of pulmonary exacerbation were excluded. Demographic, anthropometric, clinical and spirometric values were collected. CPET and the MST were performed in two consecutive outpatient visits. HRmax, peripheral oxygen saturation, dyspnea, and VO 2 peak measured and estimated were compared.Results: Twenty-four patients, mean age 15.7 ± 4.2 years and FEV 1 (% predicted) 76.4 ± 23.8, were included. Mean values of HRmax (bpm) and HRmax in percent of predicted (HRmax%) were lower (P = 0.01) in the MST (171.6 ± 14.5 and 87.1 ± 7.5) compared to CPET (180.9 ± 10.0 and 91.9 ± 5.4). However, there was no significant differences between tests in the variation (delta) for HRmax and HRmax% (P = 0.17). A strong correlation (r = 0.79; P < 0.0001) was found between distance achieved (MST) and VO 2 peak (CPET). The regression model to estimate VO 2 peak resulted in the following equation: VO 2 (mL · kg −1 · min −1 ) = 20.301 + 0.019 × MST distance (meters). There was no difference (P = 0.50) between VO 2 peak measured (CPET) and estimated by the equation. Conclusion:The MST may be an alternative method to evaluate exercise capacity and to predict VO 2 peak in children and adolescents with CF.

Results demonstrate a reduction in the IME in asthmatic adolescents with overweight and obesity, indicating an association between asthma, nutritional status and respiratory muscle function.

In this retrospective report, the use of omalizumab in Brazilian children with STRA significantly improved disease control, decreased hospitalizations, and allowed suspension of continuous oral corticosteroids.

No abstract

Objective: To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil. Methods: We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting ß2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputum, chest CT findings, and esophageal pH monitoring results. Results: We analyzed 21 patients (mean age, 9.2 ± 2.98 years). Of those, 18 (86%) were atopic. Most had uncontrolled asthma and near-normal baseline lung function. In 4 and 7, induced sputum was found to be eosinophilic and neutrophilic, respectively; the inflammatory cell profile in induced sputum having changed in 67% of those in whom induced sputum analysis was repeated. Of the 8 patients receiving treatment with omalizumab (an anti-IgE antibody), 7 (87.5%) showed significant improvement in quality of life, as well as significant reductions in the numbers of exacerbations and hospitalizations. Conclusions: Children with STRA present with near-normal lung function and a variable airway inflammatory pattern during clinical follow-up, showing a significant clinical response to omalizumab. In children, STRA differs from that seen in adults, further studies being required in order to gain a better understanding of the disease mechanisms.