Upper and lower airway cultures in children with cystic fibrosis: Do not neglect the upper airways

AbstractBackgroundAirways of cystic fibrosis (CF) patients are colonised with bacteria early in life. We aimed to analyse differences between results of simultaneously taken upper airway (UAW) and lower airway (LAW) cultures, to describe clinical characteristics of patients with positive versus negative cultures and to follow up the patients with P. aeruginosa positive UAW cultures.MethodsBacteriological and clinical data from 157 children were collected during annual check up. The number of positive UAW and LAW cultures and correspondence between these results and clinical characteristics were analysed.ResultsPositive LAW and UAW cultures were found in 79.6% and 43.9% of patients respectively (p<0.001). Patients with positive LAW cultures were significantly older (11.9 vs. 9.8years, p<0.05) and had more LAW symptoms (73.6% vs. 46.7%, p<0.05), especially when P. aeruginosa was found. Patients with positive UAW cultures (especially S. aureus) had more nasal discharge (50.7% vs. 25.0%, p<0.001). In 65% of patients with positive UAW and negative LAW culture for P. aeruginosa the next LAW became P. aeruginosa positive.ConclusionUAW cultures and LAW cultures differ in children with CF and there are differences in clinical characteristics between patients with positive versus negative culture results. P. aeruginosa positive UAW cultures appeared to precede positive LAW cultures in a substantial part of patients, suggesting some kind of cross-infection between the UAW and LAW

A comprehensive overview of radioguided surgery using gamma detection probe technology

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology

Reciclagem de Precipitação na Bacia Amazônica: O Papel do Transporte de Umidade e da Evapotranspiração da Superfície

The objective of this study is to evaluate the distribution of water budget components and precipitation recycling in the Amazon basin addressing the physical mechanisms involved in the recycling process. In general, the Amazon basin acts as a sink for atmospheric moisture, receiving water vapor transported from the ocean and from precipitation recycled from evapotranspiration by the forest. At the regional scale, the Amazon basin is an important source of water vapor, contributing to precipitation in other remote locations of South America. Here we show, on average, 20% of precipitation in the Amazon basin is recycled, varying between 15% in the northern portion and 40% in the southern portion. Thus, approximately 20% of the total rainfall in the basin is derived from local evapotranspiration processes indicating that the local contribution to the total precipitation represents a significant contribution to the regional water budget and plays an important role in the Amazon hydrological cycle. However, the variability and changes in the climate system due to both natural and anthropogenic forcings (such as the increase in the concentration of greenhouse gases in the atmosphere and changes in land use and land cover – deforestation) can affect the precipitation recycling and regional hydrologic cycle. © 2017, Sociedade Brasileira de Meteorologia. All rights reserved

Why does air passage over forest yield more rain? examining the coupling between rainfall, pressure and atmospheric moisture content

The influence of forest loss on rainfall remains poorly understood. Addressing this challenge Spracklen et al. recently presented a pan-tropical study of rainfall and land-cover that showed that satellite-derived rainfall measures were positively correlated with the degree to which model-derived air trajectories had been exposed to forest cover. This result confirms the influence of vegetation on regional rainfall patterns suggested in previous studies. However, we find that the conclusion of Spracklen et al. – that differences in rainfall reflect air moisture content resulting from evapotranspiration while the circulation pattern remains unchanged – appears undermined by methodological inconsistencies. We identify methodological problems with the underlying analyses and the quantitative estimates for rainfall change predicted if forest cover is lost in the Amazon. We discuss some alternative explanations that include the distinct role of forest evapotranspiration in creating low pressure systems that draw moisture from the oceans to the continental hinterland. Our analysis of meteorological data from three regions in Brazil, including the central Amazon forest, reveal a tendency for rainy days during the wet season with column water vapor (CWV) exceeding 50 mm to have higher pressure than rainless days; while at lower CWV rainy days tend to have lower pressure than rainless days. The coupling between atmospheric moisture content and circulation dynamics underlines that the danger posed by forest loss is greater than suggested by focusing only on moisture recycling alone