Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. Conclusions: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images

Interaction of lime with minor elements and phosphorus in cassava production

Meeting: International Society for Tropical Root Crops Symposium, 4th, 1-7 Aug. 1976, Cali, COIn IDL-133

Anilisis economico de un ensayo de fertilizacion en yuca

In May 1980 the soil section of CIAT's cassava program established a fertilization trial with 3 cassava var. [Barranquena (regional), M Col 113, and CMC 921 to measure its effect on yield and establish optimum levels from an economical point of view. The trial took place in Mondomito and Agua Blanca, municipality of Santander de Quilichao, Cauca (Colombia). Twelve levels of NPK (0-0- 0; 0-100-100; 50-100-100; 100-100-100; 200-100-100; 100-0-100; 100- 50-100; 100-200-100; 100-100-0; 100-100-50; 100-100-200; 200-200- 200) were applied. Partial budgeting was used for the economic analysis. The highest income was reached with M Col 113 in the 100- 100-200 treatment and the lowest income with CMC 92 in the check treatment. Tables and diagrams with the variable costs and clear profits corresponding to each treatment are given. (CIAT)En mayo de 1980 en la seccion de suelos del programa de yuca del CIAT se establecio un ensayo de fertilizacion con 3 var. de yuca (Barranquena (regional), M Col 113 y CMC 92) para medir su efecto en el rendimiento y establecer los niveles optimos desde el punto de vista economico. El ensayo se localizo en Mondomito y Agua Blanca del municipio de Santander de Quilichao, Cauca (Colombia). Se aplicaron 12 niveles de NPK (0-0-0; 0-100-100; 50-100-100; 100- 100-100; 200-100-100; 100-0-100; 100-50-100; 100-200-100; 100-100- 0; 100-100-50; 100-100-200; 200-200-200). Para el analisis economico se empleo el metodo del presupuesto parcial. El mayor ingreso se logro con la var. M Col 113 en el tratamiento 100-100- 200 y el menor ingreso con CMC 92 en el tratamiento testigo. Se incluyen cuadros y graficas con los costos variables y los beneficios netos correspondientes a cada tratamiento. (CIAT

Response of cassava to VA mycorrhizal inoculation and phosphorus application in greenhouse and field experiments

Cassava (Manihot esculenta Crantz) was grown in the greenhouse and in the field at different levels of phosphorus applied, with or without inoculation with VA mycorrhiza in sterilized or unsterilized soil. When grown in a sterilized soil to which eight levels of P had been applied the non-inoculated plants required the application of 3200 kg P ha?1 to reach near-maximum yield of plant dry matter (DM) at 3 months. Inoculated plants, however, showed only a minor response to applied P. Mycorrhizal inoculation in the P check increased top growth over 80 fold and total P uptake over 100 fold. Relating dry matter produced to the available P concentration in the soil (Bray II), a critical level of 15 ppm P was obtained for mycorrhizal and 190 ppm P for non-mycorrhizal plants. This indicates that the determination of critical levels of P in the soil is highly dependent on the degree of mycorrhizal infection of the root system. In a second greenhouse trial with two sterilized and non-sterilized soils it was found that in both sterilized soils, inoculation was most effective at intermediate levels of applied P resulting in a 15 30 fold increase in DM at 100 kg P ha?1. In the unsterilized soil inoculation had no significant effect in the quilichao soil, but increased DM over 3 fold in the Carimagua soil, indicating that the latter had a native mycorrhizal population less effective than the former. When cassava was grown in the field in plots with 11 levels of P applied, uninoculated plants grown in sterilized soil remained extremely P deficient for 4 5 months after which they recuperated through mycorrhizal infection from unsterilized borders or subsoil. Still, after 11 months inoculation had increased root yields by 40%. In the non-sterilized soil inoculation had no significant effect as the introduced strain was equally as effective as the native mycorrhizal population. These trials indicate that cassava is extremely dependent on an effective mycorrhizal association for normal growth in low-P soils, but that in most natural soils this association is rapidly established and inoculation of cassava in the field can only be effective in soils with a low quantity and quality of native mycorrhiza. In that case, plants should be inoculated with highly effective strains

Rehabilitación de músculos orofaríngeos con ejercicios y electroterapia para el síndrome de apnea-hipoapnea obstructiva del sueño, Rehabilitación

5 páginasIntroduction Obstructive sleep apnea syndrome (OSA) is associated with increased morbidity and mortality. Alternative interventions to continuous positive airway pressure (CPAP) lack efficacy and safety or are highly complex. Objective To describe the effects of an outpatient program of orofacial and extralaryngeal muscle re-education combined with electro-stimulation (TENS) of the same muscle groups in patients with OSA attending a tertiary level university hospital. Design Prospective, incident case series, with consecutively selected patients. Methods Participants consisted of 17 patients with mild, moderate or severe OSA who attended 24 thirty-minute sessions (three per week) of oropharyngeal exercises and electro-stimulation. The patients were evaluated at the beginning and end of the intervention by anthropometry, polysomnography, the Epworth sleepiness scale, and the Calgary Sleep Apnea Quality of Life (SAQLI) index. CPAP tolerance was evaluated by a visual scale rated from 1 to 10 (10 indicating maximum tolerance). Qualitative variables were described by frequencies, and quantitative variables by means and medians, depending on the type of distribution. Results After the intervention, the apnea - hypopnea index improved from 22 to 13 per hour, the SAQLI index improved from 4.65 to 5.33, and the Epworth scale from 7 to 5. CPAP tolerance increased from 3 to 9. The sessions were well tolerated with no adverse events of importance. Four patients reported facial muscular pain. Conclusions Electrotherapy plus active exercises of the oropharyngeal muscles are easy, feasible, safe, and potentially beneficial for OSA, with minimal side effects.Introducción El síndrome de apnea obstructiva del sueño (SAOS) tiene repercusiones importantes en la morbimortalidad de los pacientes. Los tratamientos alternos a la presión positiva continua en la vía aérea (CPAP) han resultado poco eficaces, poco seguros o de alta complejidad. Objetivo Describir los efectos de un programa ambulatorio de reeducación de la musculatura orofacial y extralaríngea y aplicación de electroestimulación (TENS) aplicado a pacientes con SAOS en un hospital universitario de nivel III. Diseño Estudio de serie de casos incidentes, prospectivo, con pacientes seleccionados consecutivamente. Material y métodos Diecisiete pacientes con SAOS leve, moderado o severo que asistieron a 24 sesiones (3 semanales) de 30 minutos, de ejercicios orofaríngeos y electroestimulación. Los pacientes fueron evaluados al inicio y al final de la intervención mediante antropometría, polisomnografía, escala de somnolencia de Epworth, SAQLI y tolerancia al CPAP. La tolerancia al CPAP fue evaluada por una escala visual calificada de 1 a 10 (10 correspondía a tolerancia máxima). Las variables cualitativas se describieron en frecuencias y las variables cuantitativas en promedios o medianas dependiendo del tipo de distribución. Resultados El índice de apnea-hipoapnea mejoró de 22 a 13 por hora, el SAQLI mejoró de 4,65 a 5,33 y Epworth pasó de 7 a 5 después de la intervención. La tolerancia al CPAP mejoró de 3 a 9. Las sesiones fueron bien toleradas, no se presentaron eventos adversos importantes. Cuatro pacientes presentaron dolor muscular facial. Conclusiones Los ejercicios de reeducación con electroterapia son fáciles, reproducibles, seguros y potencialmente beneficiosos para el SAOS, con mínimos efectos secundarios

Utilidad de la ecografía diafragmática para predecir el éxito en la extubación

10 páginasAbstract Objective To evaluate the diagnostic accuracy of diaphragmatic ultrasound in predicting extubation success. Design A diagnostic accuracy study was carried out. Scope Intensive Care Unit of an Academic hospital in the city of Bogotá (Colombia). Patients or participants A consecutive sample of patients > 18 years of age subjected to invasive mechanical ventilation for > 48 h. Interventions Diaphragmatic ultrasound evaluation at the end of spontaneous ventilation testing. Main variables of interest Diaphragmatic excursion (DE, cm), inspiration time (TPIA dia , s), diaphragm contraction speed (DE/TPIA dia , cm/s) and total time (Ttot, s) were evaluated, together with thickening fraction (TF di , %). Results A total of 84 patients were included, 79.8% (n = 67) with successful extubation and 20.2% (n = 17) with failed extubation. The variable with the best discriminatory capacity in predicting extubation success was diaphragm contraction speed, with AUC-ROC 0.70 (p = 0.008). Conclusions Diaphragm contraction speed exhibited acceptable discriminatory capacity. Ultrasound could be part of a multifactorial approach in the extubation process.Resumen Objetivo Evaluar la exactitud diagnóstica de la ecografía diafragmática para predecir el éxito en la extubación. Diseño Estudio de exactitud diagnóstica. Ámbito Unidad de Cuidado Intensivo Médico de un hospital académico de la ciudad de Bogotá (Colombia). Pacientes o participantes Muestra consecutiva de pacientes mayores de 18 años con ventilación mecánica invasiva durante más de 48 h. Intervenciones Evaluación ecográfica diafragmática al finalizar la prueba de ventilación espontánea. Variables de interés principales Se evaluó la excursión diafragmática (ED, cm), el tiempo de inspiración (TPIA dia , s), la velocidad de contracción del diafragma (ED/TPIA dia , cm/s), el tiempo total (Ttot, s) y la fracción de engrosamiento (TF di , %). Resultados Se incluyeron 84 pacientes, el 79,8% (n = 67) con extubación exitosa y el 20,2% (n = 17) con extubación fallida. La variable con mejor capacidad discriminatoria para predecir éxito en la extubación fue la velocidad de contracción, con un AUC-ROC de 0,70 (p = 0,008). Conclusiones La velocidad de contracción diafragmática mostró una capacidad discriminatoria aceptable. La ultrasonografía podría formar parte de un abordaje multifactorial en el proceso de extubación