Effects of anatomical position on esophageal transit time:A biomagnetic diagnostic technique

AIM: To study the esophageal transit time (ETT) and compare its mean value among three anatomical inclinations of the body; and to analyze the correlation of ETT to body mass index (BMI). METHODS: A biomagnetic technique was implemented to perform this study: (1) The transit time of a magnetic marker (MM) through the esophagus was measured using two fluxgate sensors placed over the chest of 14 healthy subjects; (2) the ETT was assessed in three anatomical positions (at upright, fowler, and supine positions; 90o, 45o and 0o, respectively). RESULTS: ANOVA and Tuckey post-hoc tests demonstrated significant differences between ETT mean of the different positions. The ETT means were 5.2 ± 1.1 s, 6.1 ± 1.5 s, and 23.6 ± 9.2 s for 90o, 45o and 0o, respectively. Pearson correlation results were r = -0.716 and P < 0.001 by subjects' anatomical position, and r = -0.024 and P > 0.05 according the subject's BMI. CONCLUSION: We demonstrated that using this biomagnetic technique, it is possible to measure the ETT and the effects of the anatomical position on the ETT.

Diagnosis of Developmental Dysplasia of the Hip Using Sound Transmission in Neonates

The developmental dysplasia of the hip disease is in 1% of newborns, and it is a risk factor for dislocation of the hip;only 1 from 7000 newborns develops dislocation of the hip. Newborns were selected from public and private hospitals in Celaya, Guanajuato. Parents were asked to sign informed consent. Clinical maneuvers were applied for diagnosis of developmental dysplasia of the hip, on three consecutive occasions, two by the same investigator and the third by a different observer: Ortolani, Barlow, Piston, Galeazzi, Peter Baden, the comparative sound transmission test, and comparative sound transmission with extension/flexion test were applied. The diagnosis was confirmed with ultrasound of hip, technique Graf, I healthy hip, II functionally immature, III subluxation, and IV dislocation. Sample size was 8 affected hips and 56 healthy hips. Kappa for intra observer and inter observer reliability were measured;the validity was measured by sensitivity, specificity, positive and negative predictive values, using the ultrasound diagnosis as the gold standard. The sample consisted of 78 neonates hips with female’s predominance. With comparative sound transmission test was obtained Kappa intra observer 0.80, Kappa inter observer 0.93, sensitivity 45.45%, specificity 96.27%, positive predictive value 66.67% and negative predictive value 91.49%;with comparative sound transmission with extension/flexion, was 0.83, 0.92, 72.73%, 95.52%, 72.73%, and 95.52%, respectively. The tests compared the sound transmission help better diagnose developmental dysplasia disease of the hip.

Biomagnetic techniques for evaluating gastric emptying,peristaltic contraction and transit time

Biomagnetic techniques were used to measure motility in various parts of the gastrointestinal(GI) tract,particularly a new technique for detecting magnetic markers and tracers.A coil was used to enhance the signal from a magnetic tracer in the GI tract and the signal was detected using a fluxgate magnetometer or a magnetoresistor in an unshielded room.Estimates of esophageal transit time were affected by the position of the subject.The reproducibility of estimates derived using the new biomagnetic technique was greater than 85% and it yielded estimates similar to those obtained using scintigraphy.This technique is suitable for studying the effect of emotional state on GI physiology and for measuring GI transit time.The biomagnetic technique can be used to evaluate digesta transit time in the esophagus,stomach and colon,peristaltic frequency and gastric emptying and is easy to use in the hospital setting.

Validity and Reliability of a Measuring Device Based on Sound Transmission for Diagnosis of Hip Dysplasia in Newborns

Sound transmission has been used for diagnosis of hip dysplasia in newborns and infants with tunning fork and sthetoscope. The study aims to identify the validity of a device based on sound transmission. Male and female newborns from Celaya, Gto, ranging from 4 to 28-day-old were selected for the study. The sound transmission device was used both, in bilateral assessment (compared sound transmission) and on each hip separately (sound transmission with extension/flexion). In the first application if the sound is lower by a digit, there is a hip unhealthy. In the second application if the sound is increased by a digit, there is also an alteration of the hip. A hip ultrasound was applied using the Graf technique as a gold standard. Sensitivity, specificity and predictive values were calculated to identify validity. The intra-observer and inter-observer Kappa Test was applied to identify reliability. The hips of 103 newborns were assessed, obtaining a sensitivity of 60.9%, and a specificity of 92%;it should be a positive predictive value of 51.9% and a negative predictive value of 95% for the compared sound transmission test. In the sound transmission test with extension/flexion, the values were 82.6%, 96.2%, 73.1% and 97.8% for sensitivity, specificity, positive predictive value and negative predictive value, respectively. The result of the intra-observer kappa was 0.80 and the inter-observer was 0.70 for the compared sound transmission. The intra-observer Kappa was 0.88 and the inter-observer was 0.78 for the compared sound transmission test with extension/flexion. The device for sound transmission is valid and reliable for the diagnosis of dysplastic development hip disease in newborns.

Use of an Electroacoustic Device and Bone Densitometry in the Diagnosis of Osteoporosis: Utility, Validation, and Comparison

According to the World Health Organization (WHO), men and women older than 50 years present osteoporosis with reduced bone mass, this is one of the major impact morbidities causes in the world. It may be present in the hip, spine, and wrist. The gold standard technique for osteoporosis diagnosis is the Bone Densitometry (DXA). The evaluation of an electroacoustic device is as an alternative procedure for the validation and diagnosis of osteoporosis. Diagnosis of osteoporosis severity was carried out in 49 females by using the registers of the DEXA’s T-Score values. These were statistically compared with the measurements performed using the electroacoustic device. Non-Significative difference between measurements was found with ANOVA and Chi-square tests and the area for the ROC curve on electroacoustic devices was 0.551. The Bland Altman suggests an excellent concordance between both techniques. This is a non-invasive method that has a proper match with the gold standard. The study suggests that procedure measurements with the electroacoustic device could be implemented as an alternative clinical practice for osteoporosis diagnosis.