Computational fluid dynamics simulations of single-phase flow in a filter-press flow reactor having a stack of three cells

Computational fluid dynamics (CFD) simulations were carried out for single-phase flow in a pre-pilot filter press flow reactor with a stack of three cells. Velocity profiles and streamlines were obtained by solving the Reynolds-Averaged Navier-Stokes (RANS) equations with a standard k?? turbulence model. The flow behaviour shows the appearance of jet flow at the entrance to each cell. At lengths from 12 to 15 cm along the cells channels, a plug flow pattern is developed at all mean linear flow rates studied here, 1.2 ? u ? 2.1 cm s-1. The magnitude of the velocity profiles in each cell was different, due to the turbulence generated by the change of flow direction in the last fluid manifold. Residence time distribution (RTD) simulations indicated that the fluid behaviour tends towards a continuous mixing flow pattern, owing to flow at the output of each cell across the upper cell link pipe, which acts as a mixer. Close agreement between simulations and experimental RTD was obtained

Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia

Background: Community-acquired pneumonia (CAP) has a potential complication of bacteremia. The objective of this study was to define the clinical outcomes of patients with CAP and bacteremia treated with and without a macrolide. Materials and methods: Secondary analysis of the Community-Acquired Pneumonia Organization database of hospitalized patients with CAP. Patients with a positive blood culture were categorized based on the presence or absence of a macrolide in their initial antimicrobial regimen, and severity of their CAP. Outcomes included in-hospital all-cause mortality, 30-day mortality, length of stay, and time to clinical stability. Results: Among 549 patients with CAP and bacteremia, 247 (45%) were treated with a macrolide and 302 (55%) were not. The primary pathogen was Streptococcus pneumoniae (74%). Poisson regression with robust error variance models were used to compare the adjusted effects of each study group on the outcomes. The unadjusted 30-day mortality was 18.4% in the macrolide group, and 29.6% in the non-macrolide group (adjusted relative risk (aRR)0.81; 95% confidence interval (CI)0.50\u20131.33; P = 0.41). Unadjusted in-hospital all-cause mortality was 7.3% in the macrolide group, and 18.9% in the non-macrolide group (aRR 0.54, 95% CI 0.30\u20130.98; P = 0.043). Length of stay and time to clinical stability were not significantly different. Conclusions: In-hospital mortality, but not 30-day mortality, was significantly better in the macrolide group. Our data support the use of a macrolide in hospitalized patients with CAP and bacteraemia