No abstract

Background. Mucociliary transport (MCT) is a defense mechanism of the airway. To study the underlying mechanisms of MCT, we have both developed an experimental model of cultures, from human adenoid tissue of ciliated and secretory cells, and characterized the response to local chemical signals that control ciliary activity and the secretion of respiratory mucins in vitro. Materials and Methods. In ciliated cell cultures, ciliary beat frequency (CBF) and intracellular Ca2+ levels were measured in response to ATP, UTP, and adenosine. In secretory cultures, mucin synthesis and secretion were identified by using immunodetection. Mucin content was taken from conditioned medium and analyzed in the presence or absence of UTP. Results. Enriched ciliated cell monolayers and secretory cells were obtained. Ciliated cells showed a basal CBF of 10.7 Hz that increased significantly after exposure to ATP, UTP, or adenosine. Mature secretory cells showed active secretion of granules containing different glycoproteins, including MUC5AC. Conclusion. Culture of ciliated and secretory cells grown from adenoid epithelium is a reproducible and feasible experimental model, in which it is possible to observe ciliary and secretory activities, with a potential use as a model to understand mucociliary transport control mechanisms.

Invasive fungal rhinosinusitis (IFR) is a complication that presents mainly in immunocompromised patients. Paranasal sinuses computed tomography (PCT) is frequently obtained during initial evaluation of suspected cases. The objective of the study was to determine the imaging findings that suggest IFR in patients with hematological malignancies. In the retrospective case/control study, we included 14 patients with hematological malignancies that developed IFR in the Hospital Clínico de la Pontificia Universidad Católica de Chile between January 2005 and June 2009. Twenty patients with hematological malignancies, with suspected sinonasal infectious involvement requiring a PCT for initial evaluation, were chosen as the control group. Thirteen imaging parameters were compared between both groups. Osseous erosion and facial soft tissue thickening were statistically associated with the presence of IFR (p < 0.05). The presence of osseous erosion, facial soft tissue thickening, extrasinus extension or unilateral involvement had a positive predictive value of 100%, with an incidence among the total group of 12, 15, 9 and 9%, respectively. No patients with IFR had a normal PCT. Most PCTs in the initial evaluation of suspected IFR had nonspecific findings. The clinician must have a high index of suspicion and complement the workup with other diagnostic techniques to initiate appropriate treatment.

Validation of the sino-nasal outcome test in Chile Background: Allergic rhinitis and sinusitis are common diseases that affect quality of life of pediatric and adult patients. Aim: To adapt and validate the Sino-Nasal Outcome Test 20 indicators (SNOT-20) survey in Chilean subjects. Material and Methods: In a psychometric validation study, an adapted version of the SNOT-20 adapted version was applied to 181 volunteers on two different occasions, three weeks apart. Feasibility (response time and perceived diffi culty), reliability (internal consistency and test-retest) and validity (concurrent validity, correlating results with an independent instrument; predictive validity assessing its sensitivity to detect changes and discriminant validity, assessing receiver operating characteristic (ROC) curves), were assessed. An exploratory factor analysis was performed to confi rm the presence of previously described underlying constructs. Results: Eighty percent of participants considered SNOT-20 easy to complete. This task was completed in less than 5 minutes. Cronbach's alpha was 0.946. Temporal stability on a healthy subgroup was strong with an intraclass correlation coeffi cient of 0.92. SNOT-20 had a correlation coefficient of 0.82 with an independent instrument and its score signifi cantly decreased after 3 weeks of treatment (p = 0.003).The area under ROC curve was 0.895. Factor analysis identifi ed four principal components which possessed identical structure as previously described. Conclusions: SNOT-20 survey was valid, reliable and easy to implement among Chilean subjects.

Introducción: El clearance mucociliar normal es el mecanismo de defensa básico de las vías respiratorias. Sin embargo, los mecanismos de control ciliar aún se desconocen. Con el fin de entenderlo mejor, se han desarrollado diferentes técnicas de cultivo de células ciliadas. Objetivos: Desarrollar un modelo experimental a partir de cultivos primarios de tejido adenoídeo y cornete medio. Caracterizar la respuesta a adenosin trifosfato (ATP), agonista conocido de la frecuencia de batido ciliar (FBC). Material y método: Cultivos primarios a partir de explantes de epitelio adenoídeo y cornete medio humano. Medición de FBC, con técnica de microfotodensitometría, en condición basal y en respuesta a ATP a diferentes concentraciones. Resultados: La FBC basal (promedio (X) ±desv. estándar (DE)) para los cultivos de cornete medio fue 11,9 ±1,5 Hz y para tejido adenoídeo fue 10,9 ±1,9 (p >0,05). Se observó un aumento en la FBC en respuesta a ATP, dosis dependiente. No hubo diferencia significativa en la FBC basal ni en la respuesta a ATP entre cultivos de cornete medio y adenoides. Conclusión: El cultivo primario de células ciliadas nasales a partir de explantes de adenoides, es un modelo experimental reproducible, en el que es posible observar actividad ciliar y una respuesta funcional concordante con lo descrito en la literatura.

No abstract

Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology. N. Aguirre et al. 242

No abstract