Combination aerosol therapy to treat Burkholderia cepacia complex

Burkholderia cepacia infection in cystic fibrosis (CF) patients is associated with significant morbidity and mortality, yet no definitive treatment is currently available. This report describes a new approach to treat B. cepacia infection in CF patients, using a combination of amiloride and tobramycin aerosols. Four adults with the typical clinical syndrome of CF were recruited after repeated positive sputum cultures for B. cepacia. Aerosols of amiloride and tobramycin were given three times daily for 1-6 months, and repeated sputum cultures were collected to assess efficacy. Three of the four patients treated with the combined therapy eradicated B. cepacia from their sputum cultures for at least 2 yrs, and there were no adverse events. This novel combination may provide a new therapeutic option for Burkholderia cepacia infections. Furthermore, the strategy of combining antibiotics with ion transport agents may have ramifications for the treatment of other multi-resistant organisms.

Distribuição por tamanhos do aerosol atmosférico na Península Ibérica

Um dos principais fatores que afetam negativamente a qualidade do ambiente em muitas cidades em todo o mundo é o material particulado (PM). A sua presença na atmosfera pode ter impactos negativos na saúde humana, clima, património edificado e ecossistemas. Muitos dos estudos realizados em áreas urbanas focam apenas as frações respiráveis (PM10 e PM2,5). No entanto, os processos de formação, a identificação das fontes emissoras e os efeitos dependem muito da distribuição granulométrica das partículas. A atenção tem recaído na análise de hidrocarbonetos poliaromáticos (PAHs), devida à sua carcinogenicidade e a informação disponível sobre outros compostos é escassa. O presente estudo consistiu na obtenção do PM distribuído por diferentes frações de tamanho e na análise detalhada da sua composição química, em dois locais urbanos da Península Ibérica (Madrid e Lisboa). Dado que os veículos representam uma das principais fontes emissoras em ambientes urbanos, efetuou-se uma caracterização mais detalhada deste tipo de emissões, conduzindo uma campanha de amostragem num túnel rodoviário (Marquês de Pombal, Lisboa). As amostragens, em ambas as cidades, decorreram durante um mês, quer no verão quer no inverno, em dois locais urbanos distintos, um junto a uma via com influência de tráfego e outro numa área urbana de fundo. No túnel a amostragem foi realizada apenas durante uma semana. Em Madrid e no túnel, o PM foi recolhido utilizando um amostrador de elevado volume com impactor em cascata com quatro tamanhos: 10-2,5, 2,5-0,95, 0,95-0,49 e < 0,49 μm. Em Lisboa, foi utilizado um impactor em cascata com apenas dois tamanhos, 10- 2,5 e < 2,5 μm. As amostras foram quimicamente analisadas e determinadas as concentrações de compostos carbonados (OC, EC e carbonatos), iões inorgânicos solúveis em água (Cl−, NO3−, SO42−, Na+, NH4+, K+, Mg2+, Ca2+),metais e compostos orgânicos. Em Madrid, as concentrações médias de PM10 foram 44 e 48% maiores nas amostras recolhidas junto à estrada do que as de fundo urbano no verão e inverno, respetivamente. A fração grosseira e o PM0,5 apresentaram concentrações mais elevadas no verão do que no inverno devido às condições climatéricas pouco usuais. No verão, as amostragens decorreram num mês em que as temperaturas foram muito elevadas e em que ocorreram vários episódios de intrusão de poeira africana. Durante o período de amostragem de inverno, as temperaturas foram muito baixas e registaram-se vários dias de precipitação quer sob a forma de chuva, quer sob a forma de neve. As situações meteorológicas sinóticas mais comuns, incluindo aquelas que causam o transporte de massas de ar com poeiras Africanas, foram identificadas em ambas as estações do ano. As concentrações mássicas de PM10, EC e OC foram encontrados predominantemente na fração de tamanho ultrafino em ambos os locais de amostragem e estações do ano. Nas restantes frações não se observou nenhuma tendência sazonal. O carbono orgânico secundário (SOC) mostrou um claro padrão sazonal, com concentrações muito mais elevadas no verão do que no inverno, em ambos os lugares. A partir do balanço mássico de iões, observou-se que, no verão, a formação de compostos inorgânicos secundários (SIC) conduziu a um enriquecimento pouco comum de Ca2+ na fração submicrométrica, quer nas amostras de tráfego, quer em fundo urbano. Os alcanos, PAHs, os álcoois e os ácidos foram as classes de compostos orgânicos identificados e quantificados no material particulado. Globalmente, representaram 0,26 e 0,11 μg m−3 no verão e inverno, respetivamente, no local de tráfego e 0,28 e 0,035 μg m−3 na área urbana de fundo. Os diferentes compostos orgânicos também apresentaram padrões sazonais, sugerindo fontes de emissão (e.g. escapes dos veículos e fontes biogénicas) ou processos de formação com contribuições variáveis ao longo do ano. As concentrações de benzoapireno equivalente foram menores que 1 ng m-3 e o risco carcinogénico estimado é baixo. No verão, os maiores enriquecimentos de metais ocorreram na fração submicrométrica, e no inverno na fração grosseira. No verão, os enriquecimentos foram ≥ 80% para o Mn, Ni, Cu, Zn, Cd, Sb e Co, no inverno, estes traçadores de emissões do tráfego foram menores, exceto para o Zn. Em Lisboa, a concentração média de PM10 foi de 48 μg m-3 no verão e de 44 μg m-3 no inverno, junto à estrada. Na área de fundo urbano, registaram-se níveis comparáveis nas duas estações (27 μg m-3 e 26 μg m-3). A média do rácio PM2,5/PM10 foi de 65% no verão e 44% no inverno na área de tráfego e 62% e 59% na área urbana de fundo. Estes resultados significam que o PM2,5 é um dos principais contaminantes que afetam a qualidade do ar no centro da cidade de Lisboa. A relação OC/EC, que reflete a composição das emissões de combustão dos veículos, variou entre 0,3 e 0,4 no interior do túnel. Os rácios de OC/EC mínimos obtidos junto às vias de tráfego em Madrid e em Lisboa encontram-se entre os do túnel e os registados em atmosferas urbanas de fundo, sugerindo que os valores mínimos habitualmente obtidos para este parâmetro em ambientes urbanos abertos sobrestimam as emissões diretas de OC pelo transporte rodoviário. Espera-se que os resultados deste trabalho contribuam para suprir, pelo menos em parte, as lacunas de informação quer sobre a composição de várias granulometrias de PM, quer sobre fontes e processos de formação em atmosferas urbanas. Como a exposição a poluentes do ar ultrapassa o controle dos indivíduos e exige ação das autoridades públicas a nível nacional, regional e até mesmo internacional, é importante propor medidas mitigadoras focadas nas principais fontes de emissão identificadas.

Aerosol-Radiation Feedback and PM10 Air Concentrations Over Poland

We have implemented the WRF-Chem model version 3.5 over Poland to quantify the direct and indirect feedback effects of aerosols on simulated meteorology and aerosol concentrations. Observations were compared with results from three simulations at high spatial resolutions of 5 × 5 km: (1) BASE—without any aerosol feedback effects; (2) DIR—with direct aerosol-radiative effects (3) INDIR—with direct and indirect aerosol-radiative effects. We study the overall effect during January 2011 as well as selected episodes of the highest differences in PM10 concentrations between the three simulations. For the DIR simulation, the decrease in monthly mean incoming solar radiation (SWDOWN) appears for the entire study area. It changes geographically, from about −8.0 to −2.0 W m−2, respectively for the southern and northern parts of the country. The highest changes do not correspond to the highest PM10 concentration. Due to the solar radiation changes, the surface mean monthly temperature (T2) decreases for 96 % of the area of Poland, but not more than 1.0 °C. Monthly mean PBLH changes by more than ±5 m for 53 % of the domain. Locally the differences in PBLH between the DIR and BASE are higher than ± 20 m. Due to the direct effect, for 84 % of the domain, the mean monthly PM10 concentrations increase by up to 1.9 µg m−3. For the INDIR simulation the spatial distribution of changes in incoming solar radiation as well as air temperature is similar to the DIR simulation. The decrease of SWDOWN is noticed for the entire domain and for 23 % of the domain is higher than −5.0 W m−2. The absolute differences of PBLH are slightly higher for INDIR than DIR but similarly distributed spatially. For daily episodes, the differences between the simulations are higher, both for meteorology and PM10 concentrations, and the pattern of changes is usually more complex. The results indicate the potential importance of the aerosol feedback effects on modelled meteorology and PM10 concentrations.

Physicochemical aspects and efficiency of albuterol nebulization: comparison of three aerosol types in an in vitro pediatric model.

BACKGROUND: Advances in nebulizer design have produced both ultrasonic nebulizers and devices based on a vibrating mesh (vibrating mesh nebulizers), which are expected to enhance the efficiency of aerosol drug therapy. The aim of this study was to compare 4 different nebulizers, of 3 different types, in an in vitro model using albuterol delivery and physical characteristics as benchmarks. METHODS: The following nebulizers were tested: Sidestream Disposable jet nebulizer, Multisonic Infra Control ultrasonic nebulizer, and the Aerogen Pro and Aerogen Solo vibrating mesh nebulizers. Aerosol duration, temperature, and drug solution osmolality were measured during nebulization. Albuterol delivery was measured by a high-performance liquid chromatography system with fluorometric detection. The droplet size distribution was analyzed with a laser granulometer. RESULTS: The ultrasonic nebulizer was the fastest device based on the duration of nebulization; the jet nebulizer was the slowest. Solution temperature decreased during nebulization when the jet nebulizer and vibrating mesh nebulizers were used, but it increased with the ultrasonic nebulizer. Osmolality was stable during nebulization with the vibrating mesh nebulizers, but increased with the jet nebulizer and ultrasonic nebulizer, indicating solvent evaporation. Albuterol delivery was 1.6 and 2.3 times higher with the ultrasonic nebulizer and vibrating mesh nebulizers devices, respectively, than with the jet nebulizer. Particle size was significantly higher with the ultrasonic nebulizer. CONCLUSIONS: The in vitro model was effective for comparing nebulizer types, demonstrating important differences between nebulizer types. The new devices, both the ultrasonic nebulizers and vibrating mesh nebulizers, delivered more aerosolized drug than traditional jet nebulizers.

Development and characterization of concentric capillary nebulizer used in inductively coupled plasma analysis /

A simple, low-cost concentric capillary nebulizer (CCN) was developed and evaluated for ICP spectrometry. The CCN could be operated at sample uptake rates of 0.050-1.00 ml min'^ and under oscillating and non-oscillating conditions. Aerosol characteristics for the CCN were studied using a laser Fraunhofter diffraction analyzer. Solvent transport efficiencies and transport rates, detection limits, and short- and long-term stabilities were evaluated for the CCN with a modified cyclonic spray chamber at different sample uptake rates. The Mg II (280.2nm)/l\/lg 1(285.2nm) ratio was used for matrix effect studies. Results were compared to those with conventional nebulizers, a cross-flow nebulizer with a Scott-type spray chamber, a GemCone nebulizer with a cyclonic spray chamber, and a Meinhard TR-30-K3 concentric nebulizer with a cyclonic spray chamber. Transport efficiencies of up to 57% were obtained for the CCN. For the elements tested, short- and long-term precisions and detection limits obtained with the CCN at 0.050-0.500 ml min'^ are similar to, or better than, those obtained on the same instrument using the conventional nebulizers (at 1.0 ml min'^). The depressive and enhancement effects of easily ionizable element Na, sulfuric acid, and dodecylamine surfactant on analyte signals with the CCN are similar to, or better than, those obtained with the conventional nebulizers. However, capillary clog was observed when the sample solution with high dissolved solids was nebulized for more than 40 min. The effects of data acquisition and data processing on detection limits were studied using inductively coupled plasma-atomic emission spectrometry. The study examined the effects of different detection limit approaches, the effects of data integration modes, the effects of regression modes, the effects of the standard concentration range and the number of standards, the effects of sample uptake rate, and the effect of Integration time. All the experiments followed the same protocols. Three detection limit approaches were examined, lUPAC method, the residual standard deviation (RSD), and the signal-to-background ratio and relative standard deviation of the background (SBR-RSDB). The study demonstrated that the different approaches, the integration modes, the regression methods, and the sample uptake rates can have an effect on detection limits. The study also showed that the different approaches give different detection limits and some methods (for example, RSD) are susceptible to the quality of calibration curves. Multicomponents spectral fitting (MSF) gave the best results among these three integration modes, peak height, peak area, and MSF. Weighted least squares method showed the ability to obtain better quality calibration curves. Although an effect of the number of standards on detection limits was not observed, multiple standards are recommended because they provide more reliable calibration curves. An increase of sample uptake rate and integration time could improve detection limits. However, an improvement with increased integration time on detection limits was not observed because the auto integration mode was used.

A Study on Aerosol Transport Dynamics over the Indian Landmass and the Adjoining Oceanic Regions Using Satellite Data

The present study brings out the influence of transport dynamics on the aerosol distribution over the Indian region at a few selected geographically distinct locations. Over the Bay of Bengal the dominant pathway of aerosol transport during the pre-monsoon period is through higher altitudes (~ 3 km); directed from the Indian main land. In contrast, the aerosol pathways over the Arabian Sea during the same period are quite complex. They are directed from geographically different environments around the ocean through different altitudes. However in general, the day-to-day variability of AOD at both these regions is significantly influenced by the features of atmospheric circulation especially, the wind convergence at higher altitudes (around 3 km). Over the Ganga Basin during the winter period, the wind convergence at lower altitudes (< I km) govems the shon term variations in AOD, while the mean AOD distribution at this location is mainly governed by the local anthropogenic sources.

Role of sea-surface wind and transport on enhanced aerosol optical depth observed over the Arabian Sea

The objective of this study is to understand the reasons for the enhancement in aerosol optical depth (AOD) over the Arabian Sea observed during June, July and August. During these months, high values of AOD are found over the sea beyond 10◦ N and adjacent regions. The Arabian Sea is bounded by the lands of Asia and Africa on its three sides. So the region is influenced by transported aerosols from the surroundings as well as aerosols of local origin (marine aerosols). During the summer monsoon season in India, strong surface winds with velocities around 15 m s−1 are experienced over most parts of the Arabian Sea. These winds are capable of increasing sea spray activity, thereby enhancing the production of marine aerosols. The strong winds increase the contribution of marine aerosols over the region to about 60% of the total aerosol content. The main components of marine aerosols include sea salt and sulphate particles. The remaining part of the aerosol particles comes from the western and northern land masses around the sea, of which the main component is transported dust particles. This transport is observed at higher altitudes starting from 600 m. At low levels, the transport occurs mainly from the Indian Ocean and the Arabian Sea itself, indicating the predominance of marine aerosols at these levels. The major portion of the total aerosol loading was contributed by coarse-mode particles during the period of study. But in the winter season, the concentration of coarse-mode aerosols is found to be less. From the analysis, it is concluded that the increase in marine aerosols and dust particles transported from nearby deserts results in an increase in aerosol content over the Arabian Sea during June, July and August.

Modeled and observed atmospheric radiation balance during the West African dry season: role of mineral dust, biomass burning aerosol, and surface albedo

The global radiation balance of the atmosphere is still poorly observed, particularly at the surface. We investigate the observed radiation balance at (1) the surface using the ARM Mobile Facility in Niamey, Niger, and (2) the top of the atmosphere (TOA) over West Africa using data from the Geostationary Earth Radiation Budget (GERB) instrument on board Meteosat-8. Observed radiative fluxes are compared with predictions from the global numerical weather prediction (NWP) version of the Met Office Unified Model (MetUM). The evaluation points to major shortcomings in the NWP model's radiative fluxes during the dry season (December 2005 to April 2006) arising from (1) a lack of absorbing aerosol in the model (mineral dust and biomass burning aerosol) and (2) a poor specification of the surface albedo. A case study of the major Saharan dust outbreak of 6–12 March 2006 is used to evaluate a parameterization of mineral dust for use in the NWP models. The model shows good predictability of the large-scale flow out to 4–5 days with the dust parameterization providing reasonable dust uplift, spatial distribution, and temporal evolution for this strongly forced dust event. The direct radiative impact of the dust reduces net downward shortwave (SW) flux at the surface (TOA) by a maximum of 200 W m−2 (150 W m−2), with a SW heating of the atmospheric column. The impacts of dust on terrestrial radiation are smaller. Comparisons of TOA (surface) radiation balance with GERB (ARM) show the “dusty” forecasts reduce biases in the radiative fluxes and improve surface temperatures and vertical thermodynamic structure.

Aerosol optical depths over North Africa: 2. Modeling and model validation

An operational dust forecasting model is developed by including the Met Office Hadley Centre climate model dust parameterization scheme, within a Met Office regional numerical weather prediction (NWP) model. The model includes parameterizations for dust uplift, dust transport, and dust deposition in six discrete size bins and provides diagnostics such as the aerosol optical depth. The results are compared against surface and satellite remote sensing measurements and against in situ measurements from the Facility for Atmospheric Airborne Measurements for a case study when a strong dust event was forecast. Comparisons are also performed against satellite and surface instrumentation for the entire month of August. The case study shows that this Saharan dust NWP model can provide very good guidance of dust events, as much as 42 h ahead. The analysis of monthly data suggests that the mean and variability in the dust model is also well represented.

Impact of biomass burning on aerosol properties over tropical wet evergreen forests of Arunachal Pradesh, India

Trends in aerosol optical depth in the Russian Arctic and their links with synoptic climatology

Temporal and spatial variability of aerosol optical depth (AOD) are examined using observations of direct solar radiation in the Eurasian Arctic for 1940-1990. AOD is estimated using empirical methods for 14 stations located between 66.2 degrees N and 80.6 degrees N, from the Kara Sea to the Chukchi Sea. While AOD exhibits a well-known springtime maximum and summertime minimum at all stations, atmospheric turbidity is higher in spring in the western (Kara-Laptev) part of the Eurasian Arctic. Between June and August, the eastern (East Siberian-Chukchi) sector experiences higher transparency than the western part. A statistically significant positive trend in AOD was observed in the Kara-Laptev sector between the late 1950s and the early 1930s predominantly in spring when pollution-derived aerosol dominates the Arctic atmosphere but not in the eastern sector. Although all stations are remote, those with positive trends are located closer to the anthropogenic sources of air pollution. By contrast, a widespread decline in AOD was observed between 1982 and 1990 in the eastern Arctic in spring but was limited to two sites in the western Arctic. These results suggest that the post-1982 decline in anthropogenic emissions in Europe and the former Soviet Union has had a limited effect on aerosol load in the Arctic. The post-1982 negative trends in AOD in summer, when marine aerosol is present in the atmosphere, were more common in the west. The relationships between AOD and atmospheric circulation are examined using a synoptic climatology approach. In spring, AOD depends primarily on the strength and direction of air flow. Thus strong westerly and northerly flows result in low AOD values in the East Siberian-Chukchi sector. By contrast, strong southerly flow associated with the passage of depressions results in high A OD in the Kara-Laptev sector and trajectory analysis points to the contribution of industrial regions of the sub-Arctic. In summer, low pressure gradient or anticyclonic conditions result in high atmospheric turbidity. The frequency of this weather type has declined significantly since the early 1980s in the Kara-Laptev sector, which partly explains the decline in summer AOD values. (c) 2004 Elsevier B.V. All rights reserved.