Optimização das fugas pela boca durante o CPAP nasal: banda submentoniana versus máscara facial

Introdução: O CPAP nasal é o tratamento de eleição para os pacientes com Síndrome da Apneia Obstrutiva do Sono (SAOS). Com a máscara nasal podem ocorrer fugas de ar pela boca, que podem por em causa a aderência do paciente ao tratamento devido muitas vezes ao desconforto que provocam, ao aumento do trabalho respiratório e por afectarem a qualidade do sono. Objectivos: Este estudo tem como principal objectivo verificar a eficácia da banda submentoniana e da máscara facial na correcção das fugas pela boca em pacientes com SAOS. Métodos e Participantes: Uma amostra de conveniência de 15 pacientes (8 homens) com SAOS e a fazerem CPAP com máscara nasal, foi recrutada. Foram divididos em dois grupos A e B, onde no grupo A se colocou a banda submentoniana e no grupo B se alterou a interface para máscara facial. Medidas e Resultados: As variáveis avaliadas neste estudo foram as fugas, o IAH, o percentil 95 da pressão de tratamento, a Sa,O2 e os efeitos adversos das duas intervenções. O nível de fugas reduziu no grupo A de 38±11,27 para 24,55±14,30L/min (p=0,002) e no grupo B de 34,34±16,50 para 18,51±16,22L/min (p=0,008). O IAH aumentou no grupo B de 2,60±2,13 para 4,41±3,88 (p=0,016). Relativamente ao percentil 95 da pressão de tratamento aumentou nos dois grupos (Grupo A de 10,15±2,63 para 12,08±2,45cmH2O (p=0,008) e no Grupo B 10,51±1,88 para 12,64±1,29cmH2O (p=0,008)). A Sa,O2 mínima aumentou e o tempo<90% diminui no grupo A com p=0,008, p=0,031, respectivamente. Quanto ao uso auto-reportado verificaram-se poucos efeitos adversos, salientando-se apenas a facilidade de colocação da banda submentoniana, a secura da boca nos dois grupos, a pressão no queixo provocada pela banda e a dor no dorso do nariz provocada pela máscara facial. Conclusão: Ambas as estratégias provaram ser mais eficazes a reduzir a fuga que a máscara nasal. Foram bem toleradas e com poucos efeitos adversos.

Extended-spectrum β-lactamases from the North of Portugal in the boundaries to Spain: emergence of high resistance to 4th generation cephalosporins

During the past 15 years, emergence and dissemination of third-generation cephalosporins resistance in nosocomial Enterobacteriaceae became a serious problem worldwide, due to the production of extended-spectrum-β-lactamases (ESBLs). The aim of this study was to investigate among the presence of ESBL-producing enterobacteria among Portuguese clinical isolates nearby Spain, to investigate the antimicrobial susceptibility patterns and to compare the two countries. The β-lactamases genes, blaTEM, blaSHV and blaCTX-M were detected by molecular methods. Among the ESBL-producing isolates it was found extraordinary levels (98.9%) of resistance to the fourth-generation cephalosporin Cefepime. These findings point to the need of reevaluate the definition of ESBL.

Yeast resistance and its reversion

Actualmente, a resistência a drogas é um dos grandes problemas na terapia de diferentes patologias e também na biotecnologia e agricultura. O objectivo do presente estudo foi elucidar a resistência a drogas em leveduras patogénicas ou alimentares, que mais frequentemente são encontradas. Assim, diferentes antifungicos clínicos e novos compostos recentemente sintetizados foram testados por um método para avaliar a resistência e sua reversão que foi previamente desenvolvido. Foi testado um painel de diferentes drogas para reverter a resistência. Mostramos que alguns destes moduladores foram capazes de reverter eficazmente a resistência.

Resistance to β-lactams in bacteria isolated from different types of Portuguese cheese

The purpose of this study was to investigate the presence of beta-lactam-resistant bacteria in six different types of Portuguese cheese. The numbers of ampicillin resistant (AMP(r)) bacteria varied from 4.7 x 10(2) to 1.5 x 10(7) CFU/g. Within 172 randomly selected beta-lactam-resistant bacteria, 44 resistant phenotypes were found and 31.4% were multidrug resistant. The majority (85%) of the isolates identified belonged to the Enterobacteriaceae family. The presence of the bla(TEM) gene was detected in 80.9% of the tested isolates. The results suggest that without thermal processing of the milk and good hygienic practices, cheese may act as a vehicle of transfer of beta-lactam-resistant bacteria to the gastrointestinal tract of consumers.

ß-Lactams: chemical structure, mode of action and mechanisms of resistance

This synopsis summarizes the key chemical and bacteriological characteristics of β-lactams, penicillins, cephalosporins, carbanpenems, monobactams and others. Particular notice is given to first-generation to fifth-generation cephalosporins. This review also summarizes the main resistance mechanism to antibiotics, focusing particular attention to those conferring resistance to broad-spectrum cephalosporins by means of production of emerging cephalosporinases (extended-spectrum β-lactamases and AmpC β-lactamases), target alteration (penicillin-binding proteins from methicillin-resistant Staphylococcus aureus) and membrane transporters that pump β-lactams out of the bacterial cell.

Antibiotic resistance in enterobacteriaceae isolated from Portuguese deli meats

This study aimed to identify the presence of β-lactam-resistant bacteria in different types of Portuguese deli meats. The numbers of ampicillin resistant bacteria varied from negative in 25 g to 1.0 × 108colony-forming units/g. Within 78 randomly selected β-lactam-resistant bacteria, 24 different resistant phenotypes were found and 35.9% were multidrug resistant (MDR). The majority (87.2%) of the isolates identified belonged to the Enterobacteriaceae family. The presence of the blaTEM gene was detected in 23 out of 67 isolates (34.3%) and 16 of them presented MDR phenotypes. Four Klebsiella oxytoca isolates (6%) harbored a gene for the CTX-M/OXY-type enzyme. The direct sequencing of their purified amplicons confirmed the presence of three types of blaOXYgenes (blaOXY-1, blaOXY-2 and blaOXY-5). These results suggest that without good hygienic practices, deli meats may act as a vehicle of transfer of β-lactam-resistant bacteria to the gastrointestinal tract of consumers.

Reliability of nasal auscultation and their relation to middle ear condition – a clinical interest to pediatrics respiratory physiotherapy

Background: Acute respiratory infections are usual in children under three years old occurring in upper respiratory tract, having an impact on child and caregiver’s quality of life predisposing to otitis media or bronchiolitis. There are few valid and reliable measures to determine the child’s respiratory condition and to guide the physiotherapy intervention. Aim: To assess the intra and inter rater reliability of nasal auscultation, to analyze the relation between sounds’ classification and middle ear’s pressure and compliance as well as with the Clinical Severity Score. Methods: A cross-sectional observational study was composed by 125 nursery children aged up to three years old. Tympanometry, pulmonary and nasal auscultation and application of Clinical Severity Score were performed to each child. Nasal auscultation sounds’ were recorded and sent to 3 blinded experts, that classified, as “obstructed” and “unobstructed”, with a 48 hours interval, in order to analyze inter and intra rater reliability. Results: Nasal auscultation revealed a substantial inter and intra rater reliability (=0,749 and evaluator A - K= 0,691; evaluator B - K= 0,605 and evaluator C - K= 0,724, respectively). Both ears’ pressure was significantly lower in children with an "unobstructed" nasal sound when compared with an “obstructed” nasal sound (t=-3,599, p<0,001 in left ear; t=-2,258, p=0,026 in right ear). Compliance in both ears was significantly lower in children with an "obstructed" nasal sound when compared with “unobstructed” nasal sound (t=-2,728, p=0,007 in left ear; t=-3,830, p<0,001 in right ear). There was a statistically significant association between sounds’ classification and tympanograms types in both ear’s (=11,437, p=0,003 in left ear; =13,535, p=0,001 in right ear). There was a trend to children with an "unobstructed" nasal sound that had a lower clinical severity score when compared with “obstructed” children. Conclusion: It was observed a good intra and substantial inter reliability for nasal auscultation. Nasal auscultation sounds’ classification was related to middle ears’ pressure and compliance.

Avaliação da influência de antioxidantes na estabilização de biodiesel

O biodiesel é uma fonte de energia renovável, que se pode obter pela transformação dos resíduos domésticos, e é ambientalmente inócuo, e fácil de transportar, pois tem um ponto de fulgor elevado. Atualmente tem-se focado a atenção nos efeitos da oxidação do biodiesel causados pelo contato com o ar ambiente durante o seu armazenamento. Os produtores, fornecedores e consumidores, pretendem garantir que a qualidade do biodiesel e das suas misturas com combustíveis destilados do petróleo, mantém-se durante longos períodos de armazenamento. A maioria dos óleos vegetais e das gorduras animais, usados como matéria – prima, são triacilgliceróis com grupos ácido gordos de cadeia longa (C16 – C18) ligados por ligações éster a uma estrutura de glicerol. O objetivo deste estudo foi avaliar a eficiência do ácido gálhico e seus derivados alquilo ésteres aumentando a resistência relativa à oxidação do ácido linoléico, inibindo a peroxidação ácido gordos de cadeia longa insaturados. Outro objetivo foi estudar a taxa de inibição da auto-oxidação do ácido linoleico. Foi, ainda estudado o efeito que a concentração do antioxidante, tinha na estabilidade do ácido linoleico. No caso do ácido gálhico verificou-se que o aumento para o dobro da concentração do antioxidante utilizada, obtinha-se quase o dobro da taxa de inibição da oxidação do ácido linoleico. A auto-oxidação de ácido linoleico é acompanhada pela formação do seu dieno conjugado, o qual foi medido sua absorvância, durante 7 dias, por espetrofotometria de absorção UV a 234 nm. Uma diminuição da taxa de formação de dieno conjugado, indica o aumento da atividade antioxidante do composto adicionado à micela de ácido linoleico. Os resultados obtidos permitem concluir que de todos os antioxidantes testados o galhato de butilo é o que possibilita uma maior inibição da oxidação do ácido linoleico para as duas concentrações de antioxidantes testadas (0,1 mM e 1mM), obteve-se uma percentagem de inibição do ácido linoleico de 54,0% e 63,6%, respetivamente. O estudo comparativo da estabilização do ácido linoleico com o antioxidante de referência, o butil -hidroxitolueno, mostrou que este composto tem um poder de estabilização inferior a qualquer dos antioxidantes estudados. Os resultados deste estudo demonstraram que a utilização de compostos fenólicos, em especial o galhato de butilo, constitui uma boa alternativa para a estabilização de matrizes lipídicas, nomeadamente de combustíveis como o biodiesel.

Biofiltration of Air/Styrene and Air/Styrene/Acetone mixtures in a bubble column reactor

The goal of this work was the treatment of polluted waste gases in a bubble column reactor (BCR), in order to determinate the maximum value of reactor’s efficiency (RE), varying the inlet concentration (C in) of the pollutants. The gaseous mixtures studied were: (i) air with styrene and (ii) air with styrene and acetone. The liquid phase used to contain the biomass in the reactor was a basal salt medium (BSM), fundamental for the microorganisms’ development. The reactor used in this project consists of a glass column of 620mm height and inside diameter 75mm. In all essays there were continually measured: pH, dissolved oxygen and liquid’s temperature. Temperature and pH were controlled (T=24ºC, 7.0 ≤ pH ≤ 7.7). In all experiments the liquid volume (including the biomass) used in the reactor was kept constant (1.5L) as well as the total gas flowrate (1 L/min). Concerning the goal of the work, some parameters were calculated: the organic load (OL), removal efficiency (RE), elimination capacity (EC), biomass concentration (xf) and dry biomass concentration (Xdw). In a first series of experiments, the gas mixture used was air with styrene, varying its concentration from 191 mg.m-3 to 6500 mg.m-3.It was concluded that the RE maximum value (97%) was obtained for C in Sty = 4200 mg.m-3. For the maximum tested value of C in Sty, RE obtained was 20%. In a second step, the gaseous mixture included acetone, varying C in Sty between 225 mg.m-3 and 2659 mg.m-3 and C in Ac between 153mg.m-3 and 1389 mg.m-3. The aim of these tests was the determination of C in Ac for which RE was maximum, obtaining C in Ac = 750 mg.m-3. A third series of experiments was performed, in which C in Ac was maintained equal to that value and C in Sty was varied until higher values (5422 mg.m-3). RE maximum values obtained in this last series were 100% for styrene and 40% for acetone. One important conclusion is the fact that the microorganisms available degrade better styrene than acetone. On the ambit of this study, it was possible to identify the species available in biomass: Xanthobacter antotrophicus py2, Enterobacter aerogenes, Nocardia, Corynebacterium Spp., Rhodococcus rhodochrous e Pseudomonas Sp.

Air pollution from traffic emissions in Oporto, Portugal: health and environmental implications

Air pollution represents a serious risk not only to environment and human health, but also to historical heritage. In this study, air pollution of the Oporto Metropolitan Area and its main impacts were characterized. The results showed that levels of CO, PM10 and SO2 have been continuously decreasing in the respective metropolitan area while levels of NOx and NO2 have not changed significantly. Traffic emissions were the main source of the determined polycyclic aromatic hydrocarbons (PAHs; 16 PAHs considered by U.S. EPA as priority pollutants, dibenzo[a,l]pyrene and benzo[j]fluoranthene) in air of the respective metropolitan area. The mean concentration of 18 PAHs in air was 69.9±39.7 ng m−3 with 3–4 rings PAHs accounting for 75% of the total ΣPAHs. The health risk analysis of PAHs in air showed that the estimated values of lifetime lung cancer risks considerably exceeded the health-based guideline level. Analytical results also confirm that historical monuments in urban areas act as passive repositories for air pollutants present in the surrounding atmosphere. FTIR and EDX analyses showed that gypsum was the most important constituent of black crusts of the characterized historical monument Monastery of Serra do Pilar classified as “UNESCO World Cultural Heritage”. In black crusts, 4–6 rings compounds accounted approximately for 85% of ΣPAHs. The diagnostic ratios confirmed that traffic emissions were the major source of PAHs in black crusts; PAH composition profiles were very similar for crusts and PM10 and PM2.5.

Remediation efficiency of vapour extraction of sandy soils contaminated with cyclohexane: influence of air flow rate, water and natural organic matter content

Abstract This work reports the analysis of the efficiency and time of soil remediation using vapour extraction as well as provides comparison of results using both, prepared and real soils. The main objectives were: (i) to analyse the efficiency and time of remediation according to the water and natural organic matter content of the soil; and (ii) to assess if a previous study, performed using prepared soils, could help to preview the process viability in real conditions. For sandy soils with negligible clay content, artificially contaminated with cyclohexane before vapour extraction, it was concluded that (i) the increase of soil water content and mainly of natural organic matter content influenced negatively the remediation process, making it less efficient, more time consuming, and consequently more expensive; and (ii) a previous study using prepared soils of similar characteristics has proven helpful for previewing the process viability in real conditions.

PAH air pollution at a Portuguese urban area: carcinogenic risks and sources identification

This study aimed to characterize air pollution and the associated carcinogenic risks of polycyclic aromatic hydrocarbon (PAHs) at an urban site, to identify possible emission sources of PAHs using several statistical methodologies, and to analyze the influence of other air pollutants and meteorological variables on PAH concentrations.The air quality and meteorological data were collected in Oporto, the second largest city of Portugal. Eighteen PAHs (the 16 PAHs considered by United States Environment Protection Agency (USEPA) as priority pollutants, dibenzo[a,l]pyrene, and benzo[j]fluoranthene) were collected daily for 24 h in air (gas phase and in particles) during 40 consecutive days in November and December 2008 by constant low-flow samplers and using polytetrafluoroethylene (PTFE) membrane filters for particulate (PM10 and PM2.5 bound) PAHs and pre-cleaned polyurethane foam plugs for gaseous compounds. The other monitored air pollutants were SO2, PM10, NO2, CO, and O3; the meteorological variables were temperature, relative humidity, wind speed, total precipitation, and solar radiation. Benzo[a]pyrene reached a mean concentration of 2.02 ngm−3, surpassing the EU annual limit value. The target carcinogenic risks were equal than the health-based guideline level set by USEPA (10−6) at the studied site, with the cancer risks of eight PAHs reaching senior levels of 9.98×10−7 in PM10 and 1.06×10−6 in air. The applied statistical methods, correlation matrix, cluster analysis, and principal component analysis, were in agreement in the grouping of the PAHs. The groups were formed according to their chemical structure (number of rings), phase distribution, and emission sources. PAH diagnostic ratios were also calculated to evaluate the main emission sources. Diesel vehicular emissions were the major source of PAHs at the studied site. Besides that source, emissions from residential heating and oil refinery were identified to contribute to PAH levels at the respective area. Additionally, principal component regression indicated that SO2, NO2, PM10, CO, and solar radiation had positive correlation with PAHs concentrations, while O3, temperature, relative humidity, and wind speed were negatively correlated.

β-Lactams: chemical structure, mode of action and mechanisms of resistance

This synopsis summarizes the key chemical and bacteriological characteristics of β-lactams, penicillins, cephalosporins, carbanpenems, monobactams and others. Particular notice is given to first-generation to fifth-generation cephalosporins. This reviewalso summarizes the main resistancemechanism to antibiotics, focusing particular attention to those conferring resistance to broad-spectrum cephalosporins by means of production of emerging cephalosporinases (extended-spectrum β-lactamases and AmpC β-lactamases), target alteration (penicillin-binding proteins from methicillin-resistant Staphylococcus aureus) and membrane transporters that pump β-lactams out of the bacterial cell.

Wear resistance of TiAlSiN thin coatings

In the last decades TiAlN coatings deposited by PVD techniques have been extensively investigated but, nowadays, their potential development for tribological applications is relatively low. However, new coatings are emerging based on them, trying to improve wear behavior. TiAlSiN thin coatings are now investigated, analyzing if Si introduction increases the wear resistance of PVD films. Attending to the application, several wear test configurations has been recently used by some researchers. In this work, TiAlSiN thin coatings were produced by PVD Unbalanced Magnetron Sputtering technique and they were conveniently characterized using Scanning Electron Microscopy (SEM) provided with Energy Dispersive Spectroscopy (EDS), Atomic Force Microscopy (AFM), Electron Probe Micro-Analyzer (EPMA), Micro Hardness (MH) and Scratch Test Analysis. Properties as morphology, thickness, roughness, chemical composition and structure, hardness and film adhesion to the substrate were investigated. Concerning to wear characterization, two very different ways were chosen: micro-abrasion with ball-on-flat configuration and industrial non-standardized tests based on samples inserted in a feed channel of a selected plastic injection mould working with 30% (wt.) glass fiber reinforced polypropylene. TiAlSiN coatings with a small amount of about 5% (wt.) Si showed a similar wear behavior when compared with TiAlN reported performances, denoting that Si addition does not improve the wear performance of the TiAlN coatings in these wear test conditions.