Surgical treatment of pulmonary aspergilloma

The objective of this study was to analyze the outcome of surgical treatment of pulmonary aspergilloma. To that end, we evaluated 14 adult patients so treated between 1981 and 2009 at the Botucatu School of Medicine University Hospital, in the city of Botucatu, Brazil. Data were collected from the medical records of the patients. Ten patients (71%) presented with simple pulmonary aspergilloma, and 4 (29%) presented with complex pulmonary aspergilloma. Hemoptysis was the most common symptom, and tuberculosis was the most prevalent preexisting lung disease. Two patients (14%) underwent surgery on more than one occasion. There were no intraoperative deaths. Half of the patients developed postoperative complications, prolonged air leak and empyema being the most common.

Association between left ventricular diastolic dysfunction and severity of chronic obstructive pulmonary disease

OBJECTIVES: ,,,,,The prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease according to disease severity has not yet been established. The aim of this study was to assess the prevalence of electrocardiographic and echocardiographic abnormalities in chronic obstructive pulmonary disease patients according to disease severity. ,,,, ,,,, ,,,,,METHODS: ,,,,,The study included 25 mild/moderate chronic obstructive pulmonary disease patients and 25 severe/very severe chronic obstructive pulmonary disease patients. All participants underwent clinical evaluation, spirometry and electrocardiography/echocardiography. ,,,, ,,,, ,,,,,RESULTS: ,,,,,Electrocardiography and echocardiography showed Q-wave alterations and segmental contractility in five (10%) patients. The most frequent echocardiographic finding was mild left diastolic dysfunction (88%), independent of chronic obstructive pulmonary disease stage. The proportion of right ventricular overload (p<0.05) and blockage of the anterosuperior division of the left bundle branch were higher in patients with greater obstruction. In an echocardiographic analysis, mild/moderate chronic obstructive pulmonary disease patients showed more abnormalities in segmental contractility (p<0.05), whereas severe/very severe chronic obstructive pulmonary disease patients showed a higher prevalence of right ventricular overload (p<0.05), increased right cardiac chamber (p<0.05) and higher values of E-wave deceleration time (p<0.05). Age, sex, systemic arterial hypertension, C-reactive protein and disease were included as independent variables in a multiple linear regression; only disease severity was predictive of the E-wave deceleration time [r2 = 0.26, p = 0.01]. ,,,, ,,,, ,,,,,CONCLUSION: ,,,,,Chronic obstructive pulmonary disease patients have a high prevalence of left ventricular diastolic dysfunction, which is associated with disease severity. Because of this association, it is important to exclude decompensated heart failure during chronic obstructive pulmonary disease exacerbation.

L-carnitine as an ergogenic aid for patients with chronic obstructive pulmonary disease submitted to whole-body and respiratory muscle training programs

The effects of adding L-carnitine to a whole-body and respiratory training program were determined in moderate-to-severe chronic obstructive pulmonary disease (COPD) patients. Sixteen COPD patients (66 ± 7 years) were randomly assigned to L-carnitine (CG) or placebo group (PG) that received either L-carnitine or saline solution (2 g/day, orally) for 6 weeks (forced expiratory volume on first second was 38 ± 16 and 36 ± 12%, respectively). Both groups participated in three weekly 30-min treadmill and threshold inspiratory muscle training sessions, with 3 sets of 10 loaded inspirations (40%) at maximal inspiratory pressure. Nutritional status, exercise tolerance on a treadmill and six-minute walking test, blood lactate, heart rate, blood pressure, and respiratory muscle strength were determined as baseline and on day 42. Maximal capacity in the incremental exercise test was significantly improved in both groups (P < 0.05). Blood lactate, blood pressure, oxygen saturation, and heart rate at identical exercise levels were lower in CG after training (P < 0.05). Inspiratory muscle strength and walking test tolerance were significantly improved in both groups, but the gains of CG were significantly higher than those of PG (40 ± 14 vs 14 ± 5 cmH2O, and 87 ± 30 vs 34 ± 29 m, respectively; P < 0.05). Blood lactate concentration was significantly lower in CG than in PG (1.6 ± 0.7 vs 2.3 ± 0.7 mM, P < 0.05). The present data suggest that carnitine can improve exercise tolerance and inspiratory muscle strength in COPD patients, as well as reduce lactate production.

Effects of desflurane, sevoflurane and isoflurane on pulmonary shunt in dogs during spontaneous ventilation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of temperature on the interaction between the nonionic surfactant C(12)E(5) and poly(ethylene oxide) investigated by dynamic light scattering and fluorescence methods

The interaction between the nonionic surfactant C(12)E(5) and a high molar mass (M = 5.94 x 10(5)) poly(ethylene oxide) (PEG) in aqueous solution has been examined as a function of temperature by dynamic light scattering and fluorescence methods over a broad concentration range. Clusters of small surfactant micelles form within the PEO coil, leading to its extension. The hydrodynamic radius of the complex increases strongly with temperature as well as with the concentrations of surfactant and polymer. At high concentrations of the surfactant, the coil/micellar cluster complex coexists with free C(12)E(5) micelles in the solution. Fluorescence quenching measurements show a moderate micellar growth from 155 to 203 monomers in PEO-free solutions of C(12)E(5) over a wide concentration range (0.02-2.5%) at 8 degrees C. Below 0.25% C(12)E(5), the average aggregation number (N) of the micelles is smaller in the presence of PEO than in its absence. However, N increases with increasing surfactant concentration up to a plateau value of about 270 at about 1.2% (ca. 30 mM) C(12)E(5). At high surfactant concentrations, N is larger in the presence of polymer than in its absence, a finding which is connected to a significant lowering of the clouding temperature due to the PEO at these compositions. Similar results of increasing aggregation number followed by a plateau were also found at a fixed concentration of surfactant (2.5%) and varied PEO.

Study of pulmonary experimental paracoccidioidomycosis by analysis of bronchoalveolar lavage cells: Resistant vs. susceptible mice

Adult Swiss (susceptible) and BALB/c (non-susceptible) mice were inoculated by the intravenous route with 1 x 10(6) yeast cells of Paracoccidioides brasiliensis, strain 18. Immunologic parameters, histopathology and features of the bronchoalveolar lavage (BAL) were evaluated at week 2, 4, 8 and 16 post-infection. The pulmonary infection was progressive in Swiss mice and regressive in BALB/c mice. The numbers of total cells, lymphocytes and polymorphonuclear neutrophils increased in BAL, as well as the percentages of giant cells, and CD4 and CD8 positive cells. The ultrastructural study of BAL cells revealed a predominance of macrophages and a frequency of 13.2% of type II pneumocytes. As the infection progressed, the number of fungal cells and spreading macrophages, as well as the stimulated release of H2O2 by macrophages, increased. The animals exhibited an exacerbation of the humoral immune response and a depression of cellular immunity during the infection. There was a good correlation between the intensity and the pattern of the pulmonary histopathology and the cellular findings in the BAL. The present model reproduces some anatomoclinical patterns of the human disease and shows that BAL may be a useful tool in monitoring the pulmonary infection caused by P. brasiliensis.

Mixed micelles of the anionic surfactant sodium dodecyl sulfate and the nonionic pentaethylene glycol mono-n-dodecyl ether in solution

Dynamic light scattering, surface tension, and clouding temperature have been monitored to elucidate the solution properties of mixed micelles formed between the anionic surfactant sodium dodecyl sulfate (SDS) and the nonionic surfactant pentaethylene glycol mono-n-dodecyl ether (C12E5) over a wide range of surfactant concentration and temperature. Addition of 0.1 M NaCl shifts the relaxational modes to higher frequency and lowers the clouding temperature (T-c) of the nonionic surfactant solution by about 1 degrees C compared to the salt-free system. T-c for the mixed surfactant solutions is higher than that of the binary C12E5 solutions and depends sensitively on the concentration of the two surfactants but increases only slightly when the total surfactant concentration is increased at a given molar C12E5/SDS concentration ratio. With C12E5/SDS = 5.7, for example, T-c is 46.0 and 47.5 degrees C, respectively, at 5 and 70 mM of C12E5 the mixed solutions are homogeneous and stable and contain nonspherical micelles, which are close to monodisperse over a range of surfactant concentrations and temperature. The mixed system has a lower Krafft point than binary SDS solutions and shows an approximately ideal behavior in contrast to the binary C12E5 solution. The hydrodynamic radius (RH) of the mixed micelle increases with temperature as do C12E5 micelles in the binary solutions and also with increasing C12E5/SDS ratio. At 25 degrees C, the critical micelle concentration of the mixed solution lies between those of the individual surfactants and decreases as the C12E5/SDS ratio is increased.

INCIDENCE OF MYCOBACTERIUM-TUBERCULOSIS AND OTHER MYCOBACTERIA ON PULMONARY INFECTIONS IN ARARAQUARA - SP, 1993

The incidence of tuberculosis and other infections by mycobacteria was analyzed in 559 patients admitted to the Tisiology Section of the Special Health Care Unit of Araraquara (SESA). Mycobacteria were isolated from 78 individuals out of this total. Among these patients, 15 were also HIV positive. The occurrence of isolated species was: M. tuberculosis: 69 patients; M. avium-intracellulare: 5 patients; M. fortuitum: 2 patients; M. chelonae: 1 patient; and M. simiae 1 patient. The latter was for the first time isolated from humans in Brazil. In most cases, non tubercular mycobacteria (NTM) were found in the HIV positive patients.

Use of cationic surfactant-xylenol orange indicator in metals complexometry by back-titration with EDTA.

The interaction of the xilenol orange and commercial disinfectant containing itself cationic-surfactant allowed the use indicator up to pH 11 by back-titration with EDTA, and the determination of total or partial concentration of metallic ions samples using the same indicator at the highest pH range.

Interactions between the non-ionic surfactant C(12)E(5) and poly(ethylene oxide) studied using dynamic light scattering and fluorescence quenching

Dynamic light scattering measurements have been made to elucidate changes in the coil conformation of a high molecular weight poly(ethylene oxide) (PEG) fraction when the non-ionic surfactant C(12)E(5) is present in dilute solutions. The measurements were made at 20 degrees C as functions of(a) the C(12)E(5) concentration at constant PEO concentration, (b) the PEO concentration at constant C(12)E(5) concentration, and (c) the C(12)E(5)/PEO concentration ratio. The influence of temperature on the interactions in terms of the relaxation time distributions was also examined up to the cloud point. It was found that when the C(12)E(5)/PEO weight ratio was >2 and when the temperature was >14 degrees C, the correlation functions became bimodal with well-separated components. The fast mode derives fi om individual surfactant micelles which are present in the solution at high number density. The appearance of the slow mode, which dominates the scattering, is interpreted as resulting from the formation of micellar clusters due to an excluded-volume effect when the high molar mass (M = 6 x 10(5)) PEO is added to the surfactant solution. It is shown that the micellar clusters form within the PEO coils and lead to a progressive swelling of the latter for steric reasons. The dimensions of the PEO/C(12)E(5) complex increase with increasing surfactant concentration to a value of R(H) approximate to 94 nm (R(g) approximate to 208 nm) at C-C12E5 = 3.5%. Fluorescence quenching measurements show that the average aggregation number of C(12)E(5) increases significantly on addition of the high molar mass PEG. With increasing temperature toward the cloud point the clusters increase in number density and/or become larger. The cloud point is substantially lower than that for C12E5 in water solution and is strongly dependent on the PEO concentration.