14 research outputs found
Enhanced melioidosis surveillance in patients attending four tertiary hospitals in Yangon, Myanmar
To investigate the current epidemiology of melioidosis in Yangon, Myanmar, between June 2017 and May 2019 we conducted enhanced surveillance for melioidosis in four tertiary hospitals in Yangon, where the disease was first discovered in 1911. Oxidase-positive Gram-negative rods were obtained from the microbiology laboratories and further analysed at the Department of Medical Research. Analysis included culture on Ashdown agar, the three disc sensitivity test (gentamicin, colistin and co-amoxiclav), latex agglutination, API 20 NE, antibiotic susceptibility testing, and a subset underwent molecular confirmation with a Burkholderia pseudomallei specific assay. Twenty one of 364 isolates (5.7%) were confirmed as B. pseudomallei and were mostly susceptible to the antibiotics used in standard therapy for melioidosis. Ten patients were from Yangon Region, nine were from Ayeyarwaddy region, and one each was from Kayin and Rakhine States. A history of soil contact was given by seven patients, five had diabetes mellitus and one had renal insufficiency. The patients presented with septicaemia (12 cases), pneumonia (three cases), urinary tract infection (two cases) and wound infection (four cases). Eighteen patients survived to hospital discharge. This study highlights the likelihood that melioidosis may be far more common, but underdiagnosed, in more rural parts of Myanmar as in other countries in SE Asia
FLOW-i ventilator performance in the presence of a circle system leak
Recently, the FLOW-i anaesthesia ventilator
was developed based on the SERVO-i intensive care ventilator.
The aim of this study was to test the FLOW-i\u2019s tidal
volume delivery in the presence of a leak in the breathing
circuit. We ventilated a test lung model in volume-, pressure-,
and pressure-regulated volume-controlled modes
(VC, PC, and PRVC, respectively) with a FLOW-i. First,
the circuit remained airtight and the ventilator was tested
with fresh gas flows of 6, 1, and 0.3 L/min in VC, PC, and
PRVC modes and facing 4 combinations of different
resistive and elastic loads. Second, a fixed leak in the
breathing circuit was introduced and the measurements
repeated. In the airtight system, FLOW-i maintained tidal
volume (VT) and circuit pressure at approximately the set
values, independently of respiratory mode, load, or fresh
gas flow. In the leaking circuit, set VT = 500 mL, FLOWi
delivered higher VTs in PC (about 460 mL) than in VC
and PRVC, where VTs were substantially less than
500 mL. Interestingly, VT did not differ appreciably from
6 to 0.3 L/min of fresh air flow among the 3 ventilatory
modes. In the absence of leakage, peak inspiratory pressures
were similar, while they were 35\u201345 % smaller in
PRVC and VC than in PC mode in the presence of leaks. In
conclusion, FLOW-i maintained VT (down to fresh gas
flows of 0.3 L/min) to 90 % of its preset value in PC mode,
which was 4\u20135 times greater than in VC or PRVC modes