Diaphragmatic mobility influences dyspnea and exercise tolerance in patients with COPD.

The results of this study suggest that the reduction in diaphragm mobility in COPD patients is mainly due to air trapping and is not influenced by respiratory muscle strength or pulmonary hyperinflation.

The results suggest that, during spontaneous ventilation, the dependent portion of the diaphragm presents greater mobility than does the nondependent portion, and that the technique used was sufficiently sensitive to detect variations in diaphragmatic mobility related to changes in posture.

CONTEXT AND OBJECTIVE: Low birth weight is associated with higher blood pressure in childhood and adulthood. The aim of this study was to investigate the influence of intrauterine growth restriction (IUGR) on newborn systolic blood pressure (SBP). DESIGN AND SETTING: Prospective comparative study at Neonatal and Intensive in Clinical Pediatrics Division, Maternity Hospital in Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: 35 newborns with IUGR and 35 without IUGR were compared. Healthy term newborns without malformations, with Apgar score at fifth minute > 6 were included. Birth weight, kidney weight/birth weight ratio, kidney weight (ultrasound scan), plasma renin activity (PRA) and SBP evolution were analyzed during the first month of life (on 1st, 3rd, 7th and 30th days). RESULTS: SBP evolution, kidney weight/birth weight ratio and PRA did not differ between the two groups. In newborns with IUGR, SBP presented positive correlations with birth weight (r = 0.387 p = 0.026) and BMI (r = 0.412 p = 0.017) on the 7th day of life. Positive correlations with birth weight (r = 0.440 p = 0.01) and birth length (r = 0.386 p = 0.026) were also seen on the 30th day. There was an inverse correlation on the 7th day between SBP and kidney weight/birth weight ratio (r = -0.420 p = 0.014), but this did not persist to the end of the month. CONCLUSIONS: IUGR seems not to have any influence on SBP, PRA or kidney weight among term newborns during their first month of life.

Purpose?Cerebrospinal fluid (CSF) or brain parenchyma lactate detection is important for the diagnosis of some diseases with aerobic cellular metabolism compromise. Our purpose is to correlate intraventricular magnetic resonance spectroscopy (MRS) lactate detection and quantification to CSF and blood lactate concentration. Methods?Twenty-one patients (13 females; mean age 5 years) suspected of having mitochondrial disorders underwent proton MRS with point-resolved spectroscopy (TE?=?144 ms). The volume of interest was positioned in the lateral ventricles, and LCModel was used for the MRS lactate peak detection and quantification. CSF and venous blood samples were obtained for lactate quantification immediately after MRS. Comparisons between MRS, CSF, and blood lactate detection and quantification were performed. p?

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A 46-year-old previously healthy woman presented with recurring left frontal and occipital headache. A brain MRI demonstrated diffuse dural thickening ( figure 1, top). CSF analysis showed no abnormalities. A meningeal biopsy had pathology typical of an amyloid tumor (figure 2). Further investigations did not reveal evidence of plasma-cell tumor, multiple myeloma, systemic amyloidosis, underlying inflammatory disorder, or malignancy. Follow-up brain MRIs revealed regression of the pachymeningeal disease after treatment with corticosteroids and radiotherapy ( figure 1, bottom).Amyloidosis is a group of diseases characterized by the extracellular deposition of amyloid protein.1 Extraaxial locations are rare, 2 but dural amyloidoma should be considered in the differential diagnosis of diffuse meningeal thickening despite the absence of systemic amyloidosis.