Wheezingul la copil – abordare diagnostică și terapeutică

Wheezing-ul reprezintă o problemă frecvent întâlnită în practica pediatrică. Fiind unul din cele mai des întîlnite semne clinice în afecțiunile respiratorii la populația pediatrică. Aproximativ 30 din copii prezintă cel puțin un episod de weezing pe parcursul vieții. Există evidențe puține privind diagnosticul și conduita în afecțiunile cu wheezing la copil. Investigațiile paraclinice nu sunt practic specifice și semnificative desigur într-un context viral, în cazul în care putem face determinări etiologice prin PCR, diagnosticul poate fi retrospectiv, determinările bacteriologice uzuale nu au nicio sensibiliate în cazul depistării agenților etiologici pulmonari. Indici de inflamație în mod obișnuit sunt normali iar imunograma poate arăta eventual o IgE mai mare. Evaluarea alergologică:Eo-marker predictiv asociat, IgE, ECP- fără valoarea predictivă, valorile normale nu exclud alergiile, teste cutanate, IgE specific alergeni respiratori pot să sugereze statusul atopic. Este important să diagnosticăm și diferențil , pentru că nu de puține ori, există riscul ca acest wheezing recurent să ascundă boli mai severe, cum ar fi fibroza chistică, corp strain aspirat. De aceea la pacienții care nu răspund la tratament ar fi indicat pentru un diagnostic diferențial, efectuarea investigațiilor suplimentare imagistice: Rx, EKG, Echo cardiac pentru evidențierea uneo posibile malformații vasculare cum ar fi arcul aortic supranumerar, IDR, testul sudorii, Ph metrie, Ba pasaj, angioCT, BAL, bronhoscopie. Concluzii: Consecințele wheezing-ului sunt semnificative deoarece în contextul în care prezența inflamației sau a obstrucției în căile respiratorii distale poate produce emfizem, poate produce tulburări de ventilație și implicit de perfuzie. Toate acestea având ca consecințe și risc dezvoltarea insuficienței respiratorii

The outer low-α disc of the Milky Way – I: evidence for the first pericentric passage of Sagittarius?

Phase-space data, chemistry, and ages together reveal a complex structure in the outer low-α disc of the Milky Way. The age-vertical velocity dispersion profiles beyond the Solar Neighbourhood show a jump at 6 Gyr for stars beyond the Galactic plane. Stars older than 6 Gyr are significantly hotter than younger stars. The chemistry and age histograms reveal a bump at [Fe/H] = −0.5, [α/Fe] = 0.1, and an age of 7.2 Gyr in the outer disc. Finally, viewing the stars beyond 13.5 kpc in the age-metallicity plane reveals a faint streak just below this bump, towards lower metallicities at the same age. Given the uncertainty in age, we believe these features are linked and suggest a pericentric passage of a massive satellite ∼6 Gyr ago that heated pre-existing stars, and led to a starburst in existing gas. New stars also formed from the metal-poorer infalling gas. The impulse approximation was used to characterize the interaction with a satellite, finding a mass of ∼1011 M⊙, and a pericentric position between 12 and 16 kpc. The evidence points to an interaction with the Sagittarius dwarf galaxy, likely its first pericentric passage

Radial Distribution of Stellar Motions in Gaia DR2

By taking advantage of the superb measurements of position and velocity for an unprecedented large number of stars provided in Gaia DR2, we have generated the first maps of the rotation velocity, $V_{\rm rot}$, and vertical velocity, $V_{\rm z}$, distributions as a function of the Galactocentric radius, $R_{\rm gal}$, across a radial range of $5<R_{\rm gal}<12$~kpc. In the $R-V_{\rm rot}$ map, we have identified many diagonal ridge features, which are compared with the location of the spiral arms and the expected outer Lindblad resonance of the Galactic bar. We have detected also radial wave-like oscillations of the peak of the vertical velocity distribution.Comment: 5 pages, 3 figures, accepted for publication in MNRAS Lette

Unveiling the Distinct Formation Pathways of the Inner and Outer Discs of the Milky Way with Bayesian Machine Learning

We develop a Bayesian Machine Learning framework called BINGO (Bayesian INference for Galactic archaeOlogy) centred around a Bayesian neural network. After being trained on the APOGEE and \emph{Kepler} asteroseismic age data, BINGO is used to obtain precise relative stellar age estimates with uncertainties for the APOGEE stars. We carefully construct a training set to minimise bias and apply BINGO to a stellar population that is similar to our training set. We then select the 17,305 stars with ages from BINGO and reliable kinematic properties obtained from \textit{Gaia} DR2. By combining the age and chemo-kinematical information, we dissect the Galactic disc stars into three components, namely, the thick disc (old, high-[$\alpha$/Fe], [$\alpha$/Fe] $\gtrsim$ 0.12), the thin disc (young, low-[$\alpha$/Fe]) and the Bridge, which is a region between the thick and thin discs. Our results indicate that the thick disc formed at an early epoch only in the inner region, and the inner disc smoothly transforms to the thin disc. We found that the outer disc follows a different chemical evolution pathway from the inner disc. The outer metal-poor stars only start forming after the compact thick disc phase has completed and the star-forming gas disc extended outwardly with metal-poor gas accretion. We found that in the Bridge region the range of [Fe/H] becomes wider with decreasing age, which suggests that the Bridge region corresponds to the transition phase from the smaller chemically well-mixed thick to a larger thin disc with a metallicity gradient.Comment: 11 pages, 11 figures, accepted in MNRA

3D NLTE Lithium abundances for late-type stars in GALAH DR3

Lithium's susceptibility to burning in stellar interiors makes it an invaluable tracer for delineating the evolutionary pathways of stars, offering insights into the processes governing their development. Observationally, the complex Li production and depletion mechanisms in stars manifest themselves as Li plateaus, and as Li-enhanced and Li-depleted regions of the HR diagram. The Li-dip represents a narrow range in effective temperature close to the main-sequence turn-off, where stars have slightly super-solar masses and strongly depleted Li. To study the modification of Li through stellar evolution, we measure 3D non-local thermodynamic equilibrium (NLTE) Li abundance for 581 149 stars released in GALAH DR3. We describe a novel method that fits the observed spectra using a combination of 3D NLTE Li line profiles with blending metal line strength that are optimized on a star-by-star basis. Furthermore, realistic errors are determined by a Monte Carlo nested sampling algorithm which samples the posterior distribution of the fitted spectral parameters. The method is validated by recovering parameters from a synthetic spectrum and comparing to 26 stars in the Hypatia catalogue. We find 228 613 Li detections, and 352 536 Li upper limits. Our abundance measurements are generally lower than GALAH DR3, with a mean difference of 0.23 dex. For the first time, we trace the evolution of Li-dip stars beyond the main sequence turn-off and up the subgiant branch. This is the first 3D NLTE analysis of Li applied to a large spectroscopic survey, and opens up a new era of precision analysis of abundances for large surveys.Comment: 20 pages, 17 figures, accepted for publication in MNRA

Spectral and spatial analysis of the dark matter subhalo candidates among Fermi Large Area Telescope unidentified sources

Fermi-LAT unidentified sources (unIDs) have proven to be compelling targets for performing indirect dark matter (DM) searches. In a previous work, we found that among the 1235 unIDs in Fermi-LAT catalogs (3FGL, 2FHL and 3FHL) only 44 of those are DM subhalos candidates. We now implement a spectral analysis to test whether these remaining sources are compatible or not with DM origin. This analysis is executed using almost 10 years of Pass 8 Fermi-LAT data. None of the unIDs are found to significantly prefer DM-induced emission compared to other, more conventional, astrophysical sources. In order to discriminate between pulsar and DM sources, we developed a new method which is based on the source's spectral curvature, peak energy, and its detection significance. We also look for spatial extension, which may be a hint for a DM origin according to our N-body simulation studies of the subhalo population. In addition, we used Gaia DR2 data to search for a potential stellar counterpart to our best DM subhalo candidates and, although no firm associations could be found, one of them coincides with the Sagittarius stream. Finally, previous constraints on the DM annihilation cross section are updated with the new number of remaining DM subhalo candidates among unIDs. Our limits now rule out canonical thermal WIMPs up to masses of 10 GeV for $b\bar{b}$ and 20 GeV for $\tau^+\tau^-$ annihilation channels, in this way being as sensitive and complementary to those obtained from other targets and probes.Comment: 27 pages, 10 figures, JCAP accepted. Matches the accepted versio

Chasing the impact of the Gaia-Sausage-Enceladus merger on the formation of the Milky Way thick disc

We employ our Bayesian Machine Learning framework BINGO (Bayesian INference for Galactic archaeOlogy) to obtain high-quality stellar age estimates for 68,360 red giant and red clump stars present in the 17th data release of the Sloan Digital Sky Survey, the APOGEE-2 high-resolution spectroscopic survey. By examining the denoised age-metallicity relationship of the Galactic disc stars, we identify a drop in metallicity with an increase in [Mg/Fe] at an early epoch, followed by a chemical enrichment episode with increasing [Fe/H] and decreasing [Mg/Fe]. This result is congruent with the chemical evolution induced by an early-epoch gas-rich merger identified in the Milky Way-like zoom-in cosmological simulation Auriga. In the initial phase of the merger of Auriga 18 there is a drop in metallicity due to the merger diluting the metal content and an increase in the [Mg/Fe] of the primary galaxy. Our findings suggest that the last massive merger of our Galaxy, the Gaia-Sausage-Enceladus, was likely a significant gas-rich merger and induced a starburst, contributing to the chemical enrichment and building of the metal-rich part of the thick disc at an early epoch.Comment: 5 pages, 5 figures, submitted to MNRAS Letters (comments are welcome

Cosmological evolution of metallicity correlation functions from the Auriga simulations

We study the cosmological evolution of the two-point correlation functions of galactic gas-phase metal distributions using the 28 simulated galaxies from the Auriga Project. Using mock observations of the z = 0 snapshots to mimic our past work, we show that the correlation functions of the simulated mock observations are well matched to the correlation functions measured from local galaxy surveys. This comparison suggests that the simulations capture the processes important for determining metal correlation lengths, the key parameter in metallicity correlation functions. We investigate the evolution of metallicity correlations over cosmic time using the true simulation data, showing that individual galaxies undergo no significant systematic evolution in their metal correlation functions from z ∼ 3 to today. In addition, the fluctuations in metal correlation length are correlated with but lag ahead fluctuations in star formation rate. This suggests that re-arrangement of metals within galaxies occurs at a higher cadence than star formation activity, and is more sensitive to the changes of environment, such as galaxy mergers, gas inflows/outflows, and fly-bys

Metallicity gradient of the thick disc progenitor at high redshift

© 2017 The Authors. We have developed a novel Markov Chain Monte Carlo chemical 'painting' technique to explore possible radial and vertical metallicity gradients for the thick disc progenitor. In our analysis, we match an N-body simulation to the data from the Apache Point Observatory Galactic Evolution Experiment survey.We assume that the thick disc has a constant scaleheight and has completed its formation at an early epoch, after which time radial mixing of its stars has taken place. Under these assumptions, we find that the initial radial metallicity gradient of the thick disc progenitor should not be negative, but either flat or even positive, to explain the current negative vertical metallicity gradient of the thick disc. Our study suggests that the thick disc was built-up in an inside-out and upside-down fashion, and older, smaller and thicker populations are more metal poor. In this case, star-forming discs at different epochs of the thick disc formation are allowed to have different radial metallicity gradients, including a negative one, which helps to explain a variety of slopes observed in high-redshift disc galaxies. This scenario helps to explain the positive slope of the metallicity-rotation velocity relation observed for the Galactic thick disc. On the other hand, radial mixing flattens the slope of an existing gradient

Adverse effects of new psychoactive drug use. Psychological insights of addiction

Background. When it comes to addicts, the main goal is to solve their addiction, but the real challenge is to understand the patient along with identifying those specific trigger factors that lead to the addictive behavior inset and outlining a pattern for it. Although the current information on drugs is accessible to almost everyone, young people continue to use them, and the national trend is on the rise. Objectives. The present research includes aim to highlight the main side effects experienced in the past by addict patients, currently undergoing methadone substitution treatment at the C.E.T.T.T. St. Stelian in Bucharest. Based mostly on Adlerian concepts, the study aims to outline the possible triggers that determine certain social behaviors, for example, prone to various addictions. Methods. To characterize the study group from a psychological point of view, the methods of qualitative research interview and observation and survey were applied. The possible triggers of addictive behavior were highlighted by comparison with a group of non-drug users who voluntarily participated in the study. Results. The results obtained from the total of 40 subjects included in the study (20 addicts and 20 non-drug users) outlined significant correlations between drug use and the level of education, the sex of the patients, and the degree of awareness of health problems arising from drug use. Drug addicts also identified addiction as a lifeline to their problems. Violence and a history of an unhappy childhood could also lead to addictive behavior. The connection between place and motive for drug use was also outlined. In some cases, concepts such as inferiority complex, sense of social community or social interest, and self-esteem and compensation have been outlined. Conclusion. Combining toxicology and psychology the anonymous interview/survey used on a wider scale in both detoxification centers and as well as in schools could provide clues on possible prone to various addictions. The research could be therefore useful for the early detection of possible addiction tendencies