RESUMEN
This study focuses on developing an encapsulated and dehydrated formulation of vegetative actinobacteria cells for an efficient application in sustainable agriculture, both as a fungicidal agent in crop protection and as a growth-stimulating agent in plants. Three strains of actinobacteria were used: one from a collection (Streptomyces sp.) and two natives to agricultural soil, which were identified as S3 and S6. Vegetative cells propagated in a specific liquid medium for mycelium production were encapsulated in various alginate-chitosan composites produced by extrusion. Optimal conditions for cell encapsulation were determined, and cell damage from air-drying at room temperature was evaluated. The fresh and dehydrated composites were characterized by porosity, functional groups, size and shape, and their ability to protect the immobilized vegetative cells' viability. Actinomycetes were immobilized in capsules of 2.1-2.7 mm diameter with a sphericity index ranging from 0.058 to 0.112. Encapsulation efficiency ranged from 50% to 88%, and cell viability after drying varied between 44% and 96%, depending on the composite type, strain, and airflow. Among the three immobilized and dried strains, S3 and S6 showed greater resistance to encapsulation and drying with a 4 L·min-1 airflow when immobilized in coated and core-shell composites. Encapsulation in alginate-chitosan matrices effectively protects vegetative actinobacteria cells during dehydration, maintaining their viability and functionality for agricultural applications.
RESUMEN
Ultra-Clean-Air (UCA) operating theatres aim to minimise surgical instrument contamination and wound infection through high flow rates of ultra-clean air, reducing the presence of Microbe Carrying Particles (MCPs). This study investigates the airflow patterns and ventilation characteristics of a UCA operating theatre (OT) under standard ventilation system operating conditions, considering both empty and partially occupied scenarios. Utilising a precise computational model, quasi-Direct Numerical Simulations (qDNS) were conducted to delineate flow velocity profiles, energy spectra, distributions of turbulent kinetic energy, energy dissipation rate, local Kolmogorov scales, and pressure-based coherent structures. These results were also complemented by a tracer gas decay analysis following ASHRAE standard guidelines. Simulations showed that contrary to the intended laminar regime, the OT's geometry inherently fosters a predominantly turbulent airflow, sustained until evacuation through the exhaust vents, and facilitating recirculation zones irrespective of occupancy level. Notably, the occupied scenario demonstrated superior ventilation efficiency, a phenomenon attributed to enhanced kinetic energy induced by the additional obstructions. The findings underscore the critical role of UCA-OT design in mitigating MCP dissemination, highlighting the potential to augment the design to optimise airflow across a broader theatre spectrum, thereby diminishing recirculation zones and consequently reducing the propensity for Surgical Site Infections (SSIs). The study advocates for design refinements to harness the turbulent dynamics beneficially, steering towards a safer surgical environment.
RESUMEN
This work presents an exhaustive visualization of the airflow expulsed by a person while breathing, talking, exhaling, and blowing inside a closed room wearing a disposable face mask like those used in hospitals for patient protection and those who care for them. An optical schlieren experimental arrangement was used to obtain some of the relevant physical characteristics of the airflow, such as its refractive index gradient, the distribution of temperature, and the associated velocity field for all the tests developed. We tested three face masks, one of the surgical types and the others of the N95 series with denominations KN95 and 3MN95 (Aura TC-84A-8590). The results show appreciable differences between the masks evaluated; the surgical mask was the one that allowed the most abrupt output airflow through it in the field of view of the experimental setup. However, were also found some differences in the performance of the KN95 and 3MN95 masks. The KN95 face mask had the best performance since it expulsed to its surroundings the lowest airflow with different physical properties to the input airflow. The results obtained are relevant since it was possible to estimate the expulsed airflow velocity as a function of the distance for every face mask tested, which allows for understanding its filtering capacity by restricting the flow of potential pathogens from the mouth or nose of one person to another. Undoubtedly, the airflow behavior determination around a face mask can help to reduce the risk of spreading infectious airborne particles.
RESUMEN
The small airway, present since the origins of humanity and described barely a century ago, has recently been discovered as the anatomical site where inflammation begins in some obstructive lung diseases, such as asthma and Chronic Obstructive Pulmonary Disease (COPD), per se. Small airway dysfuction was identified in up to 91% of asthmatic patients and in a large proportion of COPD patients. In subjects without pathology, small airway represent 98.8% (approximately 4500 ml) of the total lung volume, contributing only between 10-25% of the total lung resistance; however, in subjects with obstruction, it can represent up to 90% of the total resistance. Despite this, its morphological and functional characteristics allow its dysfunction to remain undetected by conventional diagnostic methods, such as spirometry. Hence the importance of this review, which offers an overview of the tools available to assess small airway dysfunction and the possible therapies that act in this silent zone.
La vía aérea pequeña, presente desde los orígenes de la humanidad y descrita hace apenas un siglo, se ha descubierto recientemente como el sitio anatómico donde inicia la inflamación provocada por algunas enfermedades pulmonares obstructivas: asma y enfermedad pulmonar obstructiva crónica (EPOC), per se. Se ha identificado disfunción de la vía aérea pequeña en el 91% de los pacientes asmáticos y en una gran proporción de quienes padecen EPOC. En los pacientes sin enfermedad, la vía aérea pequeña representa el 98.8% (4500 mL) del volumen pulmonar total, y solo aporta del 10 al 25% de la resistencia pulmonar total; sin embargo, en sujetos con obstrucción puede suponer el 90% de la resistencia total. A pesar de esto, sus características morfológicas y funcionales permiten que la disfunción pase inadvertida por métodos diagnósticos convencionales, por ejemplo la espirometría. Con base en lo anterior, el objetivo de este estudio fue revisar el panorama general de los métodos disponibles para evaluar la vía aérea pequeña y los posibles tratamientos asociados con esta zona silente.
RESUMEN
Background: Preserved ratio impaired spirometry (PRISm) has been associated with adverse outcomes and increased transition to other spirometric categories over time. We aimed to examine its prevalence, trajectories over time, and outcomes in a population-based sample from Latin America. Methods: Data were obtained from two population-based surveys of adults from three cities in Latin America (PLATINO study), conducted on the same individuals 5-9 years after their baseline examination. We estimated the frequency of PRISm defined by FEV1/FVC≥0.70 with FEV1 <80%, describing their clinical characteristics, longitudinal transition trajectories over time, factors associated with the transition. Results: At baseline, 2942 participants completed post-bronchodilator spirometry, and 2026 at both evaluations. The prevalence of normal spirometry was 78%, GOLD-stage 1 10.6%, GOLD 2-4 6.5%, and PRISm was: 5.0% (95% CI 4.2-5.8). PRISm was associated with less schooling, more reports of physician-diagnosis of COPD, wheezing, dyspnea, missing days at work, having ≥2 exacerbations in the previous year but without accelerated lung function decline. Mortality risk was significantly higher in PRISm (HR 1.97, 95% CI 1.2-3.3) and COPD GOLD 1-4 categories (HR 1.79, 95% CI 1.3-2.4) compared with normal spirometry. PRISm at baseline most frequently transitioned to another category at follow-up (46.5%); 26.7% to normal spirometry and 19.8% to COPD. The best predictors of transition to COPD were closeness of FEV1/FVC to 0.70, older age, current smoking, and a longer FET in the second assessment. Conclusion: PRISm, is a heterogeneous and unstable condition prone to adverse outcomes that require adequate follow-up.
Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Adulto , Humanos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , América Latina/epidemiología , Espirometría , Pruebas de Función Respiratoria , Prevalencia , Volumen Espiratorio Forzado , Capacidad VitalRESUMEN
All known species of the Triassic archosauromorph genus Tanystropheus are known to have had the longest neck in proportion to their torso. This feature is related to a series of ventilatory challenges since an increase in neck length also increases airway length and, therefore, the volume of stagnant air that does not reach the lungs, the dead space volume. Based on this challenge, the objective of the present study was to model the type of respiratory system of Tanystropheus able to meet its metabolic demands during the early Triassic period. The modeling was based on allometric relations for morphological and physiological ventilatory and metabolic variables, and to do so, the mean body mass of Tanystropheus was estimated based on three different methods. In addition, the tracheal airflow was also estimated based on the proportions of Tanystropheus elongated neck, the results of allometric modeling, and fundamental equations of fluid mechanics. The estimation of the body mass indicated that an animal of 3.6 m would possess a body mass of 50.6 ± 21.6 kg. Allometric modeling suggested that the respiratory system best suited to Tanystropheus' oxygen demands, especially during activity, would be a generic reptilian-like respiratory system composed of multicameral lungs. The best respiratory pattern to maintain adequate tracheal flow rates and effective pulmonary ventilation would be one ventilating the relatively narrower trachea at lower frequencies to deal with tracheal dead space volume.
Asunto(s)
Pulmón , Tráquea , Animales , Pulmón/fisiología , Tráquea/fisiología , ReptilesRESUMEN
ANTECEDENTES Y OBJETIVO La actual pandemia de COVID-19 ha traído desafíos en las formas de prevención, como la ventilación de espacios cerrados. Mantener espacios ventilados, ha sido recomendado para disminuir la transmisibilidad de COVID-19. Ante este escenario, el uso de filtros de aire, tipo HEPA (High Efficiency Particulate Air) o MERV (Minimum Efficiency Reporting Value) ha tomado relevancia para mantener una carga viral baja en espacios cerrados. En este contexto la Secretaría Técnica Ejecutiva de la Comisión Nacional de Respuesta Pándemica solicita este resumen con el objetivo de determinar la efectividad del uso de los filtros tipo HEPA o MERV frente a condiciones de ventilación habitual en espacios cerrados no hospitalarios. METODOLOGÍA Se buscaron revisiones sistemáticas que respondieron la pregunta en las bases de datos MEDLINE y EMBASE a través de OVID y en Epistemonikos, con fecha 03 de junio de 2022. Además, se construyó una matriz de evidencia con el objetivo de encontrar literatura adicional y se realizó citación cruzada a través Google Scholar. Se utiliza la metodología de la certeza de evidencia GRADE. Los criterios de inclusión son: efectividad filtros HEPA o MERV, virus SARS-CoV-2, y Espacios cerrados Los criterios de exclusión son: ambientes hospitalarios, y los Patógenos no SARS-CoV-2. RESULTADOS Se utilizó una revisión sistemática, de la cual se obtuvieron los siguientes resultados: -No se encontró evidencia de efectividad de filtros MERV en el contexto de prevención de SARS-CoV-2. -No se encontró evidencia sobre efectividad de filtros HEPA en contexto escolar. -Se encontraron 2 estudios de modelamiento que evalúan la probabilidad de contagio por SARS-CoV-2 en espacios cerrados con filtro HEPA. -Con baja certeza en evidencia se observa que el uso de filtros HEPA junto a mascarillas N95 en espacios cerrados tiene un efecto imperceptible sobre la probabilidad de contagio por SARS-CoV-2 en comparación al no uso. -Con moderada certeza en la evidencia se observa que el uso de filtros HEPA cuando no se está en uso de mascarilla en espacios cerrados similares a oficinas disminuye la probabilidad de contagio por SARS-CoV-2 en comparación a no usarlos.
Asunto(s)
Chile , Transmisión de Enfermedad Infecciosa , SARS-CoV-2RESUMEN
OBJECTIVE: To establish the prevalence of upper airway resistance syndrome (UARS) according to different diagnostic criteria and evaluate its epidemiological characteristics in a representative sample of a large urban center. METHODS: This was a single-center evaluation involving volunteers from EPISONO, an epidemiological study focused on sleep disturbances and related factors in adults from São Paulo, Brazil in 2007. RESULTS: Considering the diagnostic criteria for UARS to be an apnea-hypopnea index of <5 events/h, minimum SpO2 ≥ 92%, the presence of airflow limitation during sleep for ≥5% of total sleep time, and daytime symptoms (sleepiness and/or fatigue), we observed a prevalence of the condition of 3.1% (4.4% in women and 1.5% in men). CONCLUSIONS: Although the diagnostic criteria for UARS, or even its existence as a syndrome, are still a subject of debate in the literature, the findings from this epidemiological study highlights UARS as a non-hypoxic sleep-disordered breathing condition with a significant prevalence in the general population, being more frequent among female young adults.
Asunto(s)
Resistencia de las Vías Respiratorias , Apnea Obstructiva del Sueño , Brasil/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Sueño , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/epidemiología , Adulto JovenRESUMEN
Natural ventilation (NV) is a key passive strategy to design energy-efficient buildings and improve indoor air quality. Therefore, accurate modeling of the NV effects is a basic requirement to include this technique during the building design process. However, there is an important lack of wind pressure coefficients (C p ) data, essential input parameters for NV models. Besides this, there are no simple but still reliable tools to predict C p data on buildings with arbitrary shapes and surrounding conditions, which means a significant limitation to NV modeling in real applications. For this reason, the present contribution proposes a novel cloud-based platform to predict wind pressure coefficients on buildings. The platform comprises a set of tools for performing fully unattended computational fluid dynamics (CFD) simulations of the atmospheric boundary layer and getting reliable C p data for actual scenarios. CFD-expert decisions throughout the entire workflow are implemented to automatize the generation of the computational domain, the meshing procedure, the solution stage, and the post-processing of the results. To evaluate the performance of the platform, an exhaustive validation against wind tunnel experimental data is carried out for a wide range of case studies. These include buildings with openings, balconies, irregular floor-plans, and surrounding urban environments. The C p results are in close agreement with experimental data, reducing 60%-77% the prediction error on the openings regarding the EnergyPlus software. The platform introduced shows being a reliable and practical C p data source for NV modeling in real building design scenarios. Electronic Supplementary Material ESM: The appendix is available in the online version of this article at 10.1007/s12273-021-0881-9.
RESUMEN
The Structured Bed Reactor with Recirculation and Intermittent Aeration (SBRRIA) is a reactor configuration that presents high efficiency of organic matter and nitrogen removal, besides low sludge production. However, operational parameters, as the recirculation rate, aeration time, and airflow, are not fully established. A bench-scale structured bed reactor with intermittent aeration was fed with synthetic effluent simulating the characteristics of sanitary sewage. The reactor was operated for 280 days with an operational hydraulic retention time (HRT) of 10â h. The reactor was operated without effluent recirculation for the first time since this approach was not yet reported, and was named Structured Bed Reactor with Intermittent Aeration (SBRIA). The COD removal was higher than 81% for all operational conditions, and the total nitrogen removal ranged from 10 to 80%. The highest efficiencies were obtained with an aeration time of 1â h 45â min (total cycle of 3â h) and an airflow rate of 4.5â L.min-1. Different nitrification and denitrification behaviours were observed, resulting in nitrification efficiencies over 90% when the reactor was submitted to higher aeration times and denitrification efficiencies above 90% when the reactor was submitted to low aeration times. The airflow ranges tested in this study affected the nitrification and the total nitrogen efficiencies. Even without effluent recirculation, the temporal profile showed that there were no peaks in the concentration of the nitrogen forms in the reactor effluent, saving electrical energy up to 75% due to pumping.
Asunto(s)
Carbono , Nitrógeno , Reactores Biológicos , Desnitrificación , Nitrificación , Aguas del Alcantarillado , Eliminación de Residuos Líquidos/métodosRESUMEN
Normative trachea dimensions and aerodynamic information during development was collected to establish clinical benchmarks and showed that airway development seems to outpace respiratory demands. Infants and toddlers' trachea exhibit higher aerodynamic stress that significantly decreases by teenage years. This implies large airway pathology in younger children may have a more substantial clinical impact.
Asunto(s)
Resistencia de las Vías Respiratorias/fisiología , Simulación por Computador , Hidrodinámica , Estrés Fisiológico/fisiología , Tráquea/crecimiento & desarrollo , Tráquea/fisiopatología , Adolescente , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , MasculinoRESUMEN
BACKGROUND: Eosinophil counts increase during chronic obstructive pulmonary disease (COPD) exacerbation and influence the response to different agents (such as inhaled and systemic corticosteroids), as well as increase the production of other inflammatory cytokines. However, few studies have evaluated the association between peripheral blood eosinophils with mortality rate. OBJECTIVE: To evaluate the association between peripheral blood eosinophils and mortality rate in COPD patients over a nine-year period. STUDY DESIGN AND METHODS: This cohort included 133 COPD patients assessed at baseline by spirometry, pulse oximetry (SpO2), complete blood count, body composition, dyspnea intensity [Modified Medical Research Council (mMRC)] and the six-minute distance test (6MWD). The Kaplan-Meier curve followed by a Log rank test was used to evaluate mortality rate related to eosinophil cutoff point categorization. Multivariate Cox regression analysis was performed to identify the association between eosinophils and mortality with all subjects evaluated at baseline, adjusted for age, gender, mMRC, 6MWT, forced expiratory volume in the first second (FEV1) and SpO2. RESULTS: Nineteen patients did not complete follow-up and it was not possible to identify the date of death in four others. Therefore, 110 patients were included in the analysis. At baseline, 81% presented ≥150 eosinophil cells and 72% presented ≥2%. We identified a three-fold higher risk of death in those with <2% eosinophils and <150 cells. We did not identify statistical differences when using other cutoff points. CONCLUSION: The decrease in number of peripheral eosinophils, with cutoff points at 2% and 150 cells, may be associated with a higher risk of death in COPD patients over nine years.
Asunto(s)
Eosinófilos , Enfermedad Pulmonar Obstructiva Crónica , Volumen Espiratorio Forzado , Humanos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Pruebas de Función Respiratoria , EspirometríaRESUMEN
BACKGROUND: Past studies reported a low correlation between rhinomanometry and computational fluid dynamics (CFD), but the source of the discrepancy was unclear. Low correlation or lack of correlation has also been reported between subjective and objective measures of nasal patency. OBJECTIVE: This study investigates (1) the correlation and agreement between nasal resistance derived from CFD (RCFD) and rhinomanometry (RRMN), and (2) the correlation between objective and subjective measures of nasal patency. METHODS: Twenty-five patients with nasal obstruction underwent anterior rhinomanometry before and after mucosal decongestion with oxymetazoline. Subjective nasal patency was assessed with a 0-10 visual analog scale (VAS). CFD simulations were performed based on computed tomography scans obtained after mucosal decongestion. To validate the CFD methods, nasal resistance was measured in vitro (REXPERIMENT) by performing pressure-flow experiments in anatomically accurate plastic nasal replicas from 6 individuals. RESULTS: Mucosal decongestion was associated with a reduction in bilateral nasal resistance (0.34 ± 0.23 Pa.s/ml to 0.19 ± 0.24 Pa.s/ml, p = 0.003) and improved sensation of nasal airflow (bilateral VAS decreased from 5.2 ± 1.9 to 2.6 ± 1.9, p < 0.001). A statistically significant correlation was found between VAS in the most obstructed cavity and unilateral airflow before and after mucosal decongestion (r = -0.42, p = 0.003). Excellent correlation was found between RCFD and REXPERIMENT (r = 0.96, p < 0.001) with good agreement between the numerical and in vitro values (RCFD/REXPERIMENT = 0.93 ± 0.08). A weak correlation was found between RCFD and RRMN (r = 0.41, p = 0.003) with CFD underpredicting nasal resistance derived from rhinomanometry (RCFD/RRMN = 0.65 ± 0.63). A stronger correlation was found when unilateral airflow at a pressure drop of 75 Pa was used to compare CFD with rhinomanometry (r = 0.76, p < 0.001). CONCLUSION: CFD and rhinomanometry are moderately correlated, but CFD underpredicts nasal resistance measured in vivo due in part to the assumption of rigid nasal walls. Our results confirm previous reports that subjective nasal patency correlates better with unilateral than with bilateral measurements and in the context of an intervention.
Asunto(s)
Hidrodinámica , Obstrucción Nasal , Resistencia de las Vías Respiratorias , Humanos , Obstrucción Nasal/diagnóstico , Nariz , Rinomanometría , Escala Visual AnalógicaRESUMEN
A pesquisa teve como objetivo avaliar se radiografias panorâmicas de boca fechada podem ser usadas para observação dos tecidos moles e resistência do fluxo aéreo nas vias aéreas (VA), principalmente da faringe (naso, velo, oro e hipofaringe). Para averiguação do potencial obstrutivo das vias aéreas foram estudados 65 indivíduos adultos (54 do gênero feminino e 11 do gênero masculino), 45 com dores orofaciais e 20 assintomáticos. Estabeleceram-se parâmetros através de uma nova análise radiográfica para avaliação da presença de estruturas de tecido mole potencialmente obstrutoras do fluxo respiratório. Investigou-se a influência que a dor orofacial poderia exercer no fluxo aéreo destas vias respiratórias da cavidade nasal até a entrada dos pulmões. Estes parâmetros foram correlacionados à presença e localização de obstruções de vias aéreas (VA), através da técnica de oscilometria, mensurando diferenças do fluxo aéreo durante o repouso por via nasal e bucal. Secundariamente averiguou-se a possibilidade do uso das radiografias panorâmicas para a determinação da classificação de Angle dos pacientes determinada clinicamente. A classe molar de Angle foi confirmada com facilidade através das radiografias panorâmicas de boca fechada, acrescida da vantagem de visualização bilateral da mandíbula, ao invés da superposição dos lados direito e esquerdo como ocorre nas radiografias cefalométricas, comumente utilizadas para este fim. Concluiu-se que as radiografias panorâmicas de boca fechada são úteis para visualização e investigação preliminar de tecidos moles e do fluxo das vias aéreas superiores, principalmente da nasofaringe, velo e orofaringe, e a cavidade nasal, permitindo a detecção de locais com estreitamento potencialmente obstrutivos ao fluxo aéreo. A análise panorâmica facilitou a avaliação da simetria entre os lados direito e esquerdo das estruturas supracitadas. A presença de dor orofacial não influenciou o fluxo aéreo das VAS(AU)
The objective of this study was to evaluate the use of closed-mouth panoramic radiographs for visualization of soft tissues and airflow resistance of upper airways, especially the pharynx (naso, velo, oro, and hipopharynx regions). This study analyzed 65 adult individuals (54 of the feminine gender and 11 of the masculine gender), 45 with orofacial pain and 20 with no symptoms. Parameters were stablished using a new radiographic analysis for evaluation of the potentially obstructive soft tissues in the airways from the nasal cavity to the lungs. The influence of orofacial pain on the respiratory airflow was investigated. These parameters were correlated to the presence and level of the airway obstruction (VA), using forced oscillation technique or oscillometry were measured by the nose and mouth. The Angle's classes previously determined on the clinical way were verified. The results demonstrated that the closed-mouth panoramic radiographs can be used to soft tissues visualization and initial investigation of airways, mostly at nasopharynx and oropharynx, their potentially obstructive sites, nasal cavity, symmetry between right and left sides of these structures. The analysis of the results also demonstrated, as a specific objective, that the closed-mouth panoramic radiographs could be used easily to the confirmation of the Angle's clinical classification. The closed mouth panoramic radiography showed an advantage of maxillar and mandibular bilateral visualization, instead of the right and left sides overlapping as it occurs in the usually used cephalometric radiography. The closed mouth panoramic radiography showed an advantage of maxillar and mandibular bilateral visualization, instead of the right and left sides overlapping as it occurs in the usually used cephalometric radiography. The orofacial pain did not influence the upper airways
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Radiografía Panorámica , Obstrucción de las Vías Aéreas/diagnóstico por imagen , Maloclusión/diagnóstico por imagen , Faringe/diagnóstico por imagen , Cavidad Nasal/diagnóstico por imagenRESUMEN
Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity among miners. There is an increasing number of women in the mining industry and the differences in their risk for COPD compared to men miners are not understood. Our objective is to compare the odds for COPD between male and female miners. Using cross-sectional data from the Mining Dust in the United States (MiDUS) Cohort, that included New Mexico miners between 1989 and 2018, we compared the odds for airflow obstruction or chronic bronchitis between women and men. There were 299 women in this diverse cohort of 7,464 miners. Compared to men, female miners reported lower cumulative smoking but higher prevalence of current smoking. Multivariable analysis showed that women miners had significantly lower odds for having airflow obstruction (OR 0.40; 95% CI (0.26, 0.6)) and chronic bronchitis (OR 0.31, 95% CI (0.19, 0.53)) than men. Future studies need to determine whether this sex difference is explained by residual confounders or true biological difference.
Asunto(s)
Minería , Enfermedades Profesionales/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Adulto , Anciano , Estudios de Cohortes , Estudios Transversales , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , New Mexico , Oportunidad Relativa , Prevalencia , Distribución por Sexo , FumarRESUMEN
INTRODUCTION: Osteoarticular infections represent a major complication in orthopaedic surgery. The aim is to identify the percentage of suction cannulas colonised and to determine the relationship between the time they are used in surgery and the colonisation of these cannulas. MATERIALS AND METHODS: Descriptive and prospective study that analysed 546 suction cannulas used in clean orthopaedic surgery in a trauma centre, between November 2017 and March 2018. The distal end of the cannula was cultured to determine the colonisation rate. RESULTS: 7.3% of the cultured cannulas were positive for pathogens, the most frequent being Staphylococcus epidermidis at 27.5%. In addition, an association was found between colonisation and the length of time the cannula was used. The possibility of colonisation of cannulas used for between 60minutes or more, is greater than those used for less than 60minutes; between 60 and 90minutes the possibility is twice as high OR= 2.2 (CI:95% 1.1 - 4.1) and in cannulas used for more than 90minutes it is 8 times higher OR= 8.49 (CI:95% 1.77 - 40.86). CONCLUSIONS: The colonisation rate of cannulas is lower than reported in the literature. The longer the cannula is used in surgery increases the risk of their colonisation. Follow-up studies are being considered to determine whether suction cannula colonisation is associated with increased postoperative infection.
Asunto(s)
Bacterias/aislamiento & purificación , Cánula/microbiología , Contaminación de Equipos , Procedimientos Ortopédicos/instrumentación , Succión/instrumentación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenRESUMEN
Introduction It has been hypothesized that increasing the interstitial hydrostatic pressure within the sinonasal mucosa of patients with nasal polyposis (NP) might decrease the size of nasal polyps. Objective To evaluate the effects of positive airway pressure, delivered by a continuous positive airway pressure (CPAP) device, in patients with NP and in control subjects. Methods Twelve patients with NP and 27 healthy subjects were exposed to CPAP (20 cm H2O) for 2 hours. Visual analog scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE) scale, acoustic rhinometry (AR), peak nasal inspiratory flow (PNIF) and nasal endoscopy (NE-Meltzer polyp grading system) were performed before and after the intervention, for all patients. Results The control group showed a significant worsening in nasal obstruction symptoms, as measured by VAS and NOSE ( p < 0.01), and a significant decrease in nasal patency, as measured by the PNIF and AR ( p < 0.01). For the NP group, VAS, NOSE, and AR did not differ significantly ( p = 0.72, p = 0.73, and p = 0.17, respectively), but PNIF values worsened ( p = 0.04) after exposure to CPAP. There was a statistically significant reduction in the nasal polyps' size ( p = 0.04). Conclusions Positive pressure worsened the nasal obstruction symptoms and decreased objective parameters of nasal patency in control subjects. In patients with NP, exposure to CPAP reduced the nasal polyps' size, and the nasal patency, as measured by PNIF. However, it had no significant effects in AR and in nasal obstruction symptoms.
RESUMEN
Introduction: It has been hypothesized that increasing the interstitial hydrostatic pressure within the sinonasal mucosa of patients with nasal polyposis (NP) might decrease the size of nasal polyps. Objective: To evaluate the effects of positive airway pressure, delivered by a continuous positive airway pressure (CPAP) device, in patients with NP and in control subjects. Methods: Twelve patients with NP and 27 healthy subjects were exposed to CPAP (20 cm H2O) for 2 hours. Visual analog scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE) scale, acoustic rhinometry (AR), peak nasal inspiratory flow (PNIF) and nasal endoscopy (NE-Meltzer polyp grading system) were performed before and after the intervention, for all patients. Results: The control group showed a significant worsening in nasal obstruction symptoms, as measured by VAS and NOSE (p < 0.01), and a significant decrease in nasal patency, as measured by the PNIF and AR (p < 0.01). For the NP group, VAS, NOSE, and AR did not differ significantly (p = 0.72, p = 0.73, and p = 0.17, respectively), but PNIF values worsened (p = 0.04) after exposure to CPAP. There was a statistically significant reduction in the nasal polyps' size (p = 0.04). Conclusions: Positive pressure worsened the nasal obstruction symptoms and decreased objective parameters of nasal patency in control subjects. In patients with NP, exposure to CPAP reduced the nasal polyps' size, and the nasal patency, asmeasured by PNIF. However, it had no significant effects in AR and in nasal obstruction symptoms (AU)
Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Pólipos Nasales , Presión de las Vías Aéreas Positiva Contínua/efectos adversos , Obstrucción Nasal/diagnóstico , Ápice del Flujo Espiratorio , Estudios Transversales , Rinometría Acústica , Endoscopía , Matriz Extracelular , Escala Visual Analógica , Mucosa Nasal/fisiopatologíaRESUMEN
BACKGROUND: We aimed to study the adverse outcomes of symptomatic and asymptomatic non-obstructed individuals and those with mild COPD longitudinally in participants from three Latin-American cities. METHODS: Two population-based surveys of adults with spirometry were conducted for these same individuals with a 5- to 9-year interval. We evaluated the impact of respiratory symptoms (cough, phlegm, wheezing or dyspnea) in non-obstructed individuals, and among those classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1, COPD on exacerbation frequency, mortality and FEV1 decline, compared with asymptomatic individuals without airflow obstruction or restriction. RESULTS: Non-obstructed symptomatic individuals had a marginal increased risk of mortality (HR 1.3; 95% CI 0.9-1.94), increased FEV1 decline (-4.5 mL/year; 95% CI -8.6, -0.4) and increased risk of 2+ exacerbations in the previous year (OR 2.6; 95% CI 1.2-6.5). Individuals with GOLD stage 1 had a marginal increase in mortality (HR 1.5; 95% CI 0.93-2.3) but a non-significant impact on FEV1 decline or exacerbations compared with non-obstructed individuals. CONCLUSIONS: The presence of respiratory symptoms in non-obstructed individuals was a predictor of mortality, lung-function decline and exacerbations, whereas the impact of GOLD stage 1 was mild and inconsistent. Respiratory symptoms were associated with asthma, current smoking, and the report of heart disease. Spirometric case-finding and treatment should target individuals with moderate-to-severe airflow obstruction and those with restriction, the groups with consistent increased mortality.
Asunto(s)
Pulmón/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Adulto , Anciano , Asma/epidemiología , Asma/fisiopatología , Progresión de la Enfermedad , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Pronóstico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Factores de Riesgo , Índice de Severidad de la Enfermedad , Fumar/efectos adversos , Fumar/epidemiología , Fumar/fisiopatología , América del Sur/epidemiología , Espirometría , Factores de TiempoRESUMEN
Ventilation systems used in swine facilities deserve to be studied because they directly affect productivity in the pig farming sector. Bearing this in mind the uniformity of air distribution and temperature is essential to animal welfare in this breeding environment. Thus, the purpose of this study was to identify whether changes in air entrances and exhaust fan positioning could influence air velocity and temperature distribution. The experimental data were collected in a commercial full-scale sow facility. Validation was carried out by comparing the simulated air temperatures and data measured in the field. These results showed agreement between data with a maximum relative error of approximately 3 %. The real settings showed a gradual increase in the air velocity from the air entrances and dead zones due to the change in airflow direction. There was no difference when the positioning of the exhaust fans was altered or was maintained in the original air entrances. The proposed arrangement with only one air inlet reduced the areas of low air movement as a consequence of the change in flow direction. Furthermore, the variables have the same pattern along the transversal plane. The simulations showed that the position of the air inlets had a higher influence on temperature distribution.