Mucosal injury following short term tracheal intubation: a novel animal model and composite injury score

Objectives: Postintubation laryngotracheal injury is common. Assessment of histopathological changes currently requires animal models. We set about developing a viable, resource effective animal model to study these effects and to develop a detailed tissue injury score. Methods: Six pigs were anaesthetised using a standard regimen. We intubated the tracheas using a standard endotracheal tube modified to include optical sensors. Animals were anaesthetised for a duration of two to four hours, and their lungs were ventilated using a normoxic gas mixture. Following euthanasia, the tracheas were removed and underwent histological assessment by two independent veterinary pathologists. The histological lesions, including controls, were described and quantified, and two pathologists classified tissues according to a novel injury score. Results: Mean duration of tracheal intubation was 191 minutes (SD±41.6). In all except one animal, cuff pressures were maintained in the range of 25 – 45 cmH20. Histopathological findings in all study animals showed more extensive changes than previously described with short-term intubation. Changes were seen in all mucosal layers consistent with acute, suppurative and ulcerative tracheitis. The range of scores of the developed composite scoring system among the animals was wider than in earlier descriptions. There was a high percentage of agreement between both pathologists. Conclusions: We have described a novel tissue injury score to assess pathological changes following short term intubation in a viable animal model. The scoring system distinguished between the test animals as well as controls and may be appropriate for continuing study of intubation injury

Recent research on Gulf War illness and other health problems in veterans of the 1991 Gulf War: Effects of toxicant exposures during deployment

Veterans of Operation Desert Storm/Desert Shield - the 1991 Gulf War (GW) - are a unique population who returned from theater with multiple health complaints and disorders. Studies in the U.S. and elsewhere have consistently concluded that approximately 25-32% of this population suffers from a disorder characterized by symptoms that vary somewhat among individuals and include fatigue, headaches, cognitive dysfunction, musculoskeletal pain, and respiratory, gastrointestinal and dermatologic complaints. Gulf War illness (GWI) is the term used to describe this disorder. In addition, brain cancer occurs at increased rates in subgroups of GW veterans, as do neuropsychological and brain imaging abnormalities. Chemical exposures have become the focus of etiologic GWI research because nervous system symptoms are prominent and many neurotoxicants were present in theater, including organophosphates (OPs), carbamates, and other pesticides; sarin/cyclosarin nerve agents, and pyridostigmine bromide (PB) medications used as prophylaxis against chemical warfare attacks. Psychiatric etiologies have been ruled out. This paper reviews the recent literature on the health of 1991 GW veterans, focusing particularly on the central nervous system and on effects of toxicant exposures. In addition, it emphasizes research published since 2008, following on an exhaustive review that was published in that year that summarizes the prior literature (RACGWI, 2008). We conclude that exposure to pesticides and/or to PB are causally associated with GWI and the neurological dysfunction in GW veterans. Exposure to sarin and cyclosarin and to oil well fire emissions are also associated with neurologically based health effects, though their contribution to development of the disorder known as GWI is less clear. Gene-environment interactions are likely to have contributed to development of GWI in deployed veterans. The health consequences of chemical exposures in the GW and other conflicts have been called "toxic wounds" by veterans. This type of injury requires further study and concentrated treatment research efforts that may also benefit other occupational groups with similar exposure-related illnesses

Formation and maintenance of the territorial balance in the conditions of high-rise construction in the city

High-rise construction results in the need of planning of infrastructure facilities, taking into account the increase in loading, as high-rise construction allows to place considerably bigger number of residents in the limited territory. For this purpose it is necessary to estimate the required and actual level of providing the population with each particular type of the facilities of social infrastructure. The compliance of required and actual level of providing can be characterized as the territorial balance, while the discrepancy acts as the territorial imbalance. The article is devoted to the development of such instruments of planning of urban development, which will allow to create the qualitative urban environment, founded on the territorial balances. Namely, it is devoted to the calculation of level of providing the population with the facilities of social infrastructure, to the determination of level of the imbalance in absolute and relative units and also to the ranging of imbalances on urgency of their elimination. The size of the imbalance is of great importance for planning and realization of managerial influences from the executive authorities, operating the city development. In order to determine the urgency of realization of actions for the construction of facilities of social infrastructure it is offered to range the imbalances according to their size, having determined the deviation size from balance, which is so insignificant that it does not demand any managerial influences (it can be characterized as balance) and also the groups of the imbalances, differing in urgency of managerial influences, directed to the decrease and elimination of the revealed imbalance

Characterizing and Tuning Perfusion Parameters Within an Innovative, Versatile Oxygenating Perfusion System

The advantages of oxygenated perfusion are continuing to be demonstrated by many groups focused on improving the efficacy of tissue preservation for transplant, bioreactors for studies of basic tissue physiology, and closed-loop resuscitation. This work presents a novel and portable device that supplies oxygenated and pulsatile perfusion, both of which are regulated by a single pump-oxygenator component comprised of silicone tubes that are cyclically inflated/deflated with compressed oxygen. In this study, pump variables (oxygen supply pressure and length of a silicone tube) were evaluated against hydraulic elements that mimicked the vascular resistance of kidneys, livers, and hearts. The perfusion pressures, flow rates, and oxygenation rates produced by the device were characterized for all configurations of pump variables, and the pulse rates were tuned to improve performance. The device supplied perfusion pressures ranging from 3.5 to 109 mmHg, flow rates ranging from 1.4 to 71.8 mL min−1, and oxygenation rates up to 316.6 µmol min−1. From those results, it was determined that the device was capable of achieving perfusion parameters used in previous kidney, liver, and heart preservation studies. Ultimately, this research demonstrated the efficacy of a novel device that is designed to supply oxygenated perfusion across a range of applications