934 resultados para pulmonary collapse
Resumo:
A novel microarray was constructed with DNA PCR product probes targeting species specific functional genes of nine clinically significant respiratory pathogens, including the Gram-positive organisms (Streptococcus pneumoniae, Streptococcus pyogenes), the Gram-negative organisms (Chlamydia pneumoniae, Coxiella burnetii Haemophilus spp., Legionella pneumophila, Moraxella catarrhalis, and Pseudomonas aeruginosa), as well as the atypical bacterium, Mycoplasma pneumoniae. In a "proof-of-concept" evaluation of the developed microarray, the microarray was compared with real-time PCR from 14 sputum specimens from COPD patients. All of the samples positive for bacterial species in real-time PCR were also positive for the same bacterial species using the microarray. This study shows that a microarray using PCR probes is a potentially useful method to monitor the populations of bacteria in respiratory specimens and can be tailored to specific clinical needs such as respiratory infections of particular patient populations, including patients with cystic fibrosis and bronchiectasis. (C) 2010 Elsevier B.V. All rights reserved.
Resumo:
The final fate of massive stars depends on many factors. Theory suggests that some with initial masses greater than 25 to 30 solar masses end up as Wolf-Rayet stars, which are deficient in hydrogen in their outer layers because of mass loss through strong stellar winds. The most massive of these stars have cores which may form a black hole and theory predicts that the resulting explosion of some of them produces ejecta of low kinetic energy, a faint optical luminosity and a small mass fraction of radioactive nickel. An alternative origin for low-energy supernovae is the collapse of the oxygen-neon core of a star of 7-9 solar masses. No weak, hydrogen-deficient, core-collapse supernovae have hitherto been seen. Here we report that SN 2008ha is a faint hydrogen-poor supernova. We propose that other similar events have been observed but have been misclassified as peculiar thermonuclear supernovae (sometimes labelled SN 2002cx-like events). This discovery could link these faint supernovae to some long-duration gamma-ray bursts, because extremely faint, hydrogen-stripped core-collapse supernovae have been proposed to produce such long gamma-ray bursts, the afterglows of which do not show evidence of associated supernovae.
Resumo:
Background: Pulmonary exacerbations (PEx) are responsible for much of the morbidity and mortality associated with cystic fibrosis (CF). However, there is a paucity of data on outcomes in CF PEx and factors influencing outcomes.
Methods: We reviewed all PEx in patients infected with Pseudomonas aeruginosa treated with parenteral antibiotics over 4 years at our center. Treatment failures were categorized a priori as those PEx requiring antibiotic regimen change, prolongation of therapy > 20 days because of failure to respond, an early recurrent event within < 45 days, or failure to recover lung function to > 90% of baseline FEV1.
Results: A total of 101 patients were followed for 452 PEx. Treatment failures were observed in 125 (28%) of PEx; antibiotic regimen change was observed in 27 (6%), prolongation of therapy in 29 (6%), early recurrent events in 63 (14%), and failure to recover lung function to > 90% of baseline FEV1 in 66 (15%). Demographic factors associated with one or more treatment failures per year included advanced airways disease, use of enteric feeds, CF-related diabetes, and CF liver disease but did not include female sex or F508del homozygosity. Increased treatment failure risk was associated with lower admission FEV1 and increased markers of inflammation. At therapeutic completion, increased inflammatory markers correlated with treatment failure. Failure rates decreased with increasing number of active antimicrobial agents used based on in vitro susceptibility (zero, 28/65 [43%]; one, 38/140 [27%]; two, 59/245 [24%]; three, 0/2 [0%]; P = .02).
Conclusions: One-fourth of PEx fail to respond adequately to initial management. Patient demographic and episode-specific clinical information can be used to identify individuals at increased risk of initial management failure.
Resumo:
We present a new, detailed analysis of late-time mid-infrared observations of the Type II-P supernova (SN) 2003gd. At about 16 months after the explosion, the mid-IR flux is consistent with emission from 4 x 10(-5) M. of newly condensed dust in the ejecta. At 22 months emission from pointlike sources close to the SN position was detected at 8 and 24 mu m. By 42 months the 24 mu m flux had faded. Considerations of luminosity and source size rule out the ejecta of SN 2003gd as the main origin of the emission at 22 months. A possible alternative explanation for the emission at this later epoch is an IR echo from preexisting circumstellar or interstellar dust. We conclude that, contrary to the claim of Sugerman and coworkers, the mid-IR emission from SN 2003gd does not support the presence of 0.02 M. of newly formed dust in the ejecta. There is, as yet, no direct evidence that core-collapse supernovae are major dust factories.
Resumo:
We present an extensive set of photometric and spectroscopic data for SN 2009jf, a nearby Type Ib supernova (SN), spanning from ˜20 d before B-band maximum to 1 yr after maximum. We show that SN 2009jf is a slowly evolving and energetic stripped-envelope SN and is likely from a massive progenitor (25-30 Msun). The large progenitor's mass allows us to explain the complete hydrogen plus helium stripping without invoking the presence of a binary companion. The SN occurred close to a young cluster, in a crowded environment with ongoing star formation. The spectroscopic similarity with the He-poor Type Ic SN 2007gr suggests a common progenitor for some SNe Ib and Ic. The nebular spectra of SN 2009jf are consistent with an asymmetric explosion, with an off-centre dense core. We also find evidence that He-rich Ib SNe have a rise time longer than other stripped-envelope SNe, however confirmation of this result and further observations are needed. This paper is based on observations with several telescopes, including NTT(184.D-1151), VLT-UT1(085.D-0750,386.D-0126), NOT, WHT, TNG, PROMPT, Ekar, Calar Alto and Liverpool Telescope.