Titration with automatic continuous positive airway pressure in obstructive sleep apnea

Background and objective Autotitrating positive airway pressure (APAP) is an accepted titration method to determine the optimal positive airway pressure (PAP), for the treatment of obstructive sleep apnea (OSA). The required duration of APAP monitoring to determine a fixed continuous positive airway pressure level still remains to be established. We aimed to evaluate the variation in PAP level, delivered by APAP devices, at different periods of treatment, to determine the APAP treatment duration required to reach an effective and stable PAP level. Methods A cross-sectional study of 62 patients newly diagnosed with OSA were evaluated after 3 months of APAP therapy. APAP data corresponding to the first day (D1), first week (W1), seventh week (W7) and twelfth week (W12) under APAP therapy was collected. For the analysis of the pressure behaviour, the difference of P95th pressure level between W12 and W7 (P W12–W7), W12 and W1 (P W12–W1) and W12 and D1 (P W12–D1) was calculated. Results There was a high correlation in P95th pressure level between D1 and W12 (r = 0.771; p > 0.0001), W1 and W12 (r = 0.817; p > 0.0001), and W7 and W12 (r = 0.926; p > 0.0001). This correlation progressively increased with APAP use. A significance difference was found in concordance between P W12–W7 and P W12–D1 (p = 0.046) within the pressure range ±2 cmH2O. However there was no significant difference in concordance between P W12–W7 and P W12–W1. Conclusions One week of APAP therapy seems sufficient to determine an effective and stable PAP level, within the pressure range ±2 cmH2O.info:eu-repo/semantics/publishedVersio

Prevalência de Obstrução numa População Exposta ao Fumo do Tabaco - Projecto PNEUMOBIL

A espirometria não atingiu ainda a divulgação que se justificaria em patologia respiratória, ou indivíduos que se encontram em risco relativamente a esta patologia, cujo diagnóstico é insuficiente, havendo um escasso conhecimento, e consequente controlo, dos custos atribuíveis a estas doenças, com destaque para a doença pulmonar obstrutiva crónica (DPOC). O PNEUMOBIL, iniciativa que visa esta divulgação entre fumadores e ex -fumadores, foi reactivado, após 10 anos de aplicação em Portugal, revelando agora, numa amostra de 5324 indivíduos, em que cerca de 50% ainda mantêm os hábitos tabágicos, sejam do sexo masculino ou feminino, que houve uma elevada prevalência de obstrução detectada por espirometria (30% e 25%, respectivamente) nas pessoas rastreadas perto de centros de saúde (grupo público) e em empresas (grupo privado). Este risco não se explica em regra por exposição ocupacional, nem se relaciona com a maioria dos sintomas respiratórios, muito frequentes nos rastreados. Apenas a dispneia (OR=1,28; p=0,02) e os episódios frequentes de expectoração (OR=1,21; p=0,008) ou de bronquite aguda (OR=1,31; p=0,05) revelam alguma relação com a obstrução. O reconhecimento prévio da DPOC é muito reduzido e a presença de obstrução não se correlaciona (p=0,204) com o assumir da condição de portador

Eficácia e tolerância da azitromicina versus claritromicina no tratamento das infecções do tracto respiratório inferior

ABSTRACTSeventy one patients were enrolled to an opened, comparative and randomized study to evalute the safety and efficacy of azitbromycin administered during 3 days versus clarithromycin during 10 days in the out treatment of lower respiratory tract infections. Azithromycin was given 500mg once daily and clarithromycin 250mg twice daily. A total of 51 patients (25 to azithromycin and 26 to clarythromycin) were eligible for efficacy assessment. Mean age was 42.3years (19-25), 29 (57%) patients were male and diagnosis were the following:40 (78%) exacerbations of COPD and 11 (22%) pneumonia. Both groups were similar in terms obasic details. Clinical success or improvement on final evaluation was noted in 92% of patients in the azithromycin group and in 85% in the claritbromycin group. There were no clinical failures on the azithromycin group and there were 3 on the clarithromycin group (on one of these patients there was a superinfection with E. coil). Safety was assessed in all patients randomized to the treatment groups (71 patients; 40 received azitbromycin and 31 received clarythromycin). One azitbromycin treated patient with lung cancer died with fulminating haemoptysis on the second day of treatment which was norelated to the study drug. Adverse events were reported in 3 patients all treated with clarythromycin. Regarding laboratory values there was an hematologic change related with infection resolution (leucocytes and neutrophils reduction and limphocytes increase) and there was no significant chemistry changes. Thirteen patients (8 of azithromycin group and 5 of clarithromycin group) showed laboratory abnormalities with no attributable clinical significance. In conclusion, Ibis study showed a high effectiveness of both azithromycin and clarithromycin in the treatment of lower respiratory tract infections. The study was inconclusive about the superiority of one drug over the other.REV PORT PNEUMOL 1999; V (2): 216-22

Evaluation of turbulent dissipation rate retrievals from Doppler Cloud Radar

Turbulent dissipation rate retrievals from cloud radar Doppler velocity measurements are evaluated using independent, in situ observations in Arctic stratocumulus clouds. In situ validation data sets of dissipation rate are derived using sonic anemometer measurements from a tethered balloon and high frequency pressure variation observations from a research aircraft, both flown in proximity to stationary, ground-based radars. Modest biases are found among the data sets in particularly low- or high-turbulence regimes, but in general the radar-retrieved values correspond well with the in situ measurements. Root mean square differences are typically a factor of 4-6 relative to any given magnitude of dissipation rate. These differences are no larger than those found when comparing dissipation rates computed from tetheredballoon and meteorological tower-mounted sonic anemometer measurements made at spatial distances of a few hundred meters. Temporal lag analyses suggest that approximately half of the observed differences are due to spatial sampling considerations, such that the anticipated radar-based retrieval uncertainty is on the order of a factor of 2-3. Moreover, radar retrievals are clearly able to capture the vertical dissipation rate structure observed by the in situ sensors, while offering substantially more information on the time variability of turbulence profiles. Together these evaluations indicate that radar-based retrievals can, at a minimum, be used to determine the vertical structure of turbulence in Arctic stratocumulus clouds

Radon and material radiopurity assessment for the NEXT double beta decay experiment

The Neutrino Experiment with a Xenon TPC (NEXT), intended to investigate the neutrinoless double beta decay using a high-pressure xenon gas TPC filled with Xe enriched in 136Xe at the Canfranc Underground Laboratory in Spain, requires ultra-low background conditions demanding an exhaustive control of material radiopurity and environmental radon levels. An extensive material screening process is underway for several years based mainly on gamma-ray spectroscopy using ultra-low background germanium detectors in Canfranc but also on mass spectrometry techniques like GDMS and ICPMS. Components from shielding, pressure vessel, electroluminescence and high voltage elements and energy and tracking readout planes have been analyzed, helping in the final design of the experiment and in the construction of the background model. The latest measurements carried out will be presented and the implication on NEXT of their results will be discussed. The commissioning of the NEW detector, as a first step towards NEXT, has started in Canfranc; in-situ measurements of airborne radon levels were taken there to optimize the system for radon mitigation and will be shown too.Comment: Proceedings of the Low Radioactivity Techniques 2015 workshop (LRT2015), Seattle, March 201