Exhaled Breath Condensate (EBC) for SARS-CoV-2 diagnosis still an open debate

: The real-time PCR (RT-PCR) on nasopharyngeal swabs (NPS) is the gold standard for the diagnosis of SARS-CoV-2. The exhaled breath condensate (EBC) is used to perform collection of biological fluid condensed in a refrigerated device from deep airways' exhaled air. We aimed to verify the presence of SARS-CoV-2 virus in the EBC from patients with confirmed SARS-CoV-2 infection by RT-PCR, and to determine if the EBC may represent a valid alternative to the NPS. Methods: Seventeen consecutive patients admitted to the Emergency Department of the Policlinico were enrolled in the present study with RT-PCR, clinical and radiological evidence of SARS-CoV-2. Within 24 hours from the NPS collection the EBC collection was performed on SARS-CoV-2 positive patients. Informed written consent was gathered and the Ethic Committee approved the study. Results: The mean age of patients was 60 years (24-92) and 64.7% (11/17) were male. Patient n. 9 and n.17 died. All NPS resulted positive for SARS-CoV-2 at RT-PCR. RT-PCR on EBC resulted negative for all but one patients (patient n.12). Conclusion: In this study we did not find any correlation between positive NPS and the EBC in all but one patients enrolled. Based on these data which greatly differ from previous reports on the topic, this study opens several questions related to small differences in the complex process of EBC collection and how EBC could be really standardized for the diagnosis of SARS-CoV-2 infection. Further studies will be warranted to deepen this topic

Hemoptysis due to a large endobronchial mass successful regression after the use of high flow nasal cannula

In recent years, high flow nasal cannula is being increasingly used. Most studies showed positive results when used in hypoxaemic respiratory failure. Its use in a patient with a large endobronchial mass has not yet being described. We report a patient who presented with hemoptysis and hypoxaemic respiratory failure second to a large mass obstructing the right main bronchus. High flow oxygen via nasal cannula was initiated with a quick improvement of the hemoptysis and the oxygen saturation. Thus, allowing the patient to be rapidly stabilized

COPD patients' pre-flight check: A narrative review

For most of the people with stable and well-controlled chronic obstructive pulmonary disease (COPD), air travel is safe and comfortable, but the flight environment may pose clinical challenges. This narrative review aims to update the requirements for allowance to fly of people with COPD without chronic respiratory failure. A literature review was performed on platforms: Pubmed, Scopus and Ovid, for citations in English from 2000 to 2021. The following key words were used: COPD AND: air-travel, in-flight hypoxemia, fitness to air travel. Official regulatory documents and guidelines were also examined. Current air travel statements recommend supplemental oxygen when in flight arterial oxygen tension (PaO2) is expected to fall below 6.6 or 7.3 kPa. Several lung function variables, prediction equations and algorithms have been proposed to estimate in-flight PaO2, the need for in-flight supplemental oxygen, and to select individuals needing more advanced pre-flight testing, such as the hypoxia-altitude simulation test. Exercise induced desaturation and aerobic capacity correlate significantly with in-flight PaO2. COPD patients with late intensification of disease, new changes in medications, recent acute exacerbation/ hospitalization or anticipated emotional and physical stress during the proposed air-travel should be carefully evaluated by the caring family or specialist physician

Long-term home noninvasive ventilation (LTHNIV) in restrictive thoracic diseases: The Italian snapshot

Long-term home noninvasive ventilation (LTHNIV) in restrictive thoracic diseases was explored via the recently published international REINVENT ERS survey. The Italian subset of respondents (ITA-r), the highest above all participating nations, was analyzed and compared to non-Italian respondents (NO-ITA-r). The ITA-r represented 20% of the total answers examined. Ninety-four percent were physicians, whose half worked in a respiratory ICU (RICU). ITA-r mainly worked in community hospitals vs NO-ITA-r who are largely affiliated with university hospitals (p<0.0001). Amyotrophic lateral sclerosis (ALS) was considered the most common medical condition leading to NIV indication by both ITA-r and NO-ITA-r (93% vs 78%, p>0.5). A greater proportion of ITA-r considered MIP/MEP the most important test for NIV initiation as compared to NO-IRA-r (p<0.05). There was no significant difference for both ITA-r and NO-ITA-r as regards the other questions. This study illustrates Italian LTHNIV practices in patients with NMD and it shows some important differences with the other countries' practices but agreement in terms of goals to achieve, reasons to initiate NIV, and practices among the two communities

Technique for Outdoor Test on Concentrating Photovoltaic Cells

Outdoor experimentation of solar cells is essential to maximize their performance and to assess utilization requirements and limits. More generally tests with direct exposure to the sun are useful to understand the behavior of components and new materials for solar applications in real working conditions. Insolation and ambient factors are uncontrollable but can be monitored to know the environmental situation of the solar exposure experiment. A parallel characterization of the photocells can be performed in laboratory under controllable and reproducible conditions. A methodology to execute solar exposure tests is proposed and practically applied on photovoltaic cells for a solar cogeneration system. The cells are measured with concentrated solar light obtained utilizing a large Fresnel lens mounted on a sun tracker. Outdoor measurements monitor the effects of the exposure of two multijunction photovoltaic cells to focused sunlight. The main result is the continuous acquisition of the V-I (voltage-current) curve for the cells in different conditions of solar concentration and temperature of exercise to assess their behavior. The research investigates electrical power extracted, efficiency, temperatures reached, and possible damages of the photovoltaic cell

Menarca e antropometria em atletas adolescentes de pentatlo moderno

A menarca é um importante indicador da maturação sexual e sua ocorrência pode variar de acordo com as características antropométricas e do treinamento de modalidades esportivas. Os objetivos foram: comparar a idade da menarca e a antropometria em grupos de atletas adolescentes de pentatlo moderno que iniciaram o treinamento antes e após a menarca; analisar as relações entre o tempo pósmenarca com a antropometria em grupos de atletas adolescentes de pentatlo moderno que iniciaram o treinamento antes e após a menarca; analisar as relações entre a idade cronológica e a antropometria em atletas adolescentes de pentatlo moderno não menarqueadas. Participaram 31 atletas menarqueadas(14,69±2,03anos de idade) e 15 não menarqueadas (12,22±1,07anos de idade). Foram avaliadas a idade da menarca, tempo pós-menarca, medidas antropométricas e características do treinamento. Utilizou-se a estatística descritiva, comparações para amostras independentes e a correlação de Pearson (p<0,05). A idade da menarca foi 11,80±0,95 anos. Após divisão do grupo das menarqueadas, diferença significativa(p=0,006) foi observada na idade da menarca entre meninas que iniciaram o treinamento antes (12,62±0,95) e após (11,42±1,17) a menarca. A análise descritiva permitiu observar a idade cronológica do grupo não menarqueadas sendo maior que a idade da menarca no grupo das menarqueadas, assim como foi maior o tempo de treinamento e menor a adiposidade. A idade de início do treinamento aparenta ser o maior responsável pelas características da menarca apresentadas em pentatletas, sem descartar possíveis efeitos do baixo percentual de gordura

SARS-CoV-2 pneumonia and Eisenmenger’s Syndrome: doubling the challenge

Eisenmenger’s syndrome (ES) is the most severe phenotype of pulmonary arterial hypertension (PAH) secondary to congenital heart disease. In these cases, a significant systemic-to-pulmonary (left-to-right) shunting triggers the development of pulmonary vascular disease (PVD) and pulmonary hypertension. In cases of acute hypoxemic respiratory failure in patients with ES, high flow nasal cannula (HFNC) oxygen therapy should be considered as a first-line approach in order to avoid pulmonary complications and right ventricular overload related to positive pressure ventilation. Here, we report a case of HFNC use in a patient with COVID-19 infection and ES

Enhancing satiety and aerobic performance with beer microparticles-based non-alcoholic drinks: exploring dose and duration effects

Beer is an alcoholic beverage, rich in carbohydrates, amino acids, vitamins and polyphenols, consumed worldwide as a social drink. There is a large number of beer styles which depends on the ingredients and brewing process. The consumption of beer as a fluid replacement after sport practice is a current discussion in literature. A non-alcoholic pale-ale microparticles-based beverage (PABM) have been previously designed, however, its phenolic profile and ergogenic effect remain unknown. Thus, this study aims to verify the ergogenic potential (increase of running performance) of PAMB in male Wistar rats. Beer microparticles were obtained by spray drying and beverages with different concentrations were prepared in water. Wistar rats were subjected to a training protocol on a treadmill (5 times/week, 60 min/day) and daily intake of PABM (20 mg.kg-1 or 200 mg.kg-1) or water by gavage. Chlorogenic acid was found to be the main component in the phenolic profile (12.28 mg·g-1) of PABM analyzed with high-performance liquid chromatography and mass spectrometry. An increase in the aerobic performance was observed after 4 weeks in the 20 mg.kg-1 group, but the same dose after 8 weeks and a higher dose (200 mg.kg-1) blunted this effect. A higher dose was also related to decrease in food intake. These data suggest that PABM can improve satiety and aerobic performance, but its effect depends on the dose and time of consumption

Comparison of the effects of pea protein and whey protein on the metabolic profile of soccer athletes: a randomized, double-blind, crossover trial

IntroductionPea protein (PP) concentrate is a plant-based alternative to animal protein sources, such as whey protein (WP). In addition to its valuable amino acid composition, PP has a low environmental impact, making it a sustainable, nutritious, and viable alternative for enhanced sports performance, such as in soccer. PP Therefore, this study aimed to evaluate the effects of PP and WP supplementation on biochemical and metabolic parameters in soccer players.MethodsTwelve male under-20 soccer players were included in this double-blind, randomized crossover intervention study. For 10 consecutive days, each participant received either 0.5 g/kg of the PP or WP supplementation after training, starting 7 days before the test game, and continuing until 2 days after. After a 4-day washout period, the athletes switched groups and the intervention was restarted. Blood samples were collected before and after the game, as well as 24 h, 48 h, and 72 h intervals thereafter. Creatine kinase (CK), aspartate transaminase, alanine transaminase (ALT), lactate (LA), urea, creatinine, and uric acid were analyzed using commercial kits. Exploratory metabolic profiling of the serum samples was performed using nuclear magnetic resonance spectroscopy.ResultsA comparison of biochemical markers showed that the PP group had lower CK in the post-game moment, 24 h, and 48 h. Lower LA in the post-game moment, and lower ALT in the post-game moment and at 24 h. Of the 48 metabolites analyzed, 22 showed significant differences between the time points, such as amino acids, ketone bodies, and glucose metabolism. Glutamate and lactate levels significantly increased between the pre- and post-game moments in the WP group. After the game, the WP group exhibited reduced levels of metabolites such as arginine and taurine, whereas no such change was observed in the PP group. There was no difference in metabolites 72 h after the game.ConclusionsDespite the slight advantage of the PP group in specific biochemical markers, these differences are not sufficient to justify the choice of a particular type of protein. However, the results highlight the viability of plant protein as a potential alternative to animal protein without compromising athletic performance or recovery