Einfluss der Führung des Trocknungsprozesses auf den Trocknungsverlauf und die Produkteigenschaften empfindlicher biologischer Güter

Die Konvektionstrocknung ist eine der ältesten Methoden zur Konservierung von Lebensmitteln. Es ist bekannt, dass Agrarprodukte temperaturempfindlich sind. Bei Überhitzung erleiden sie chemische und physikalische Veränderungen, die ihre Qualität vermindern. In der industriellen Praxis wird die Konvektionstrocknung in der Regel auf Grundlage empirisch ermittelter Werte durchgeführt, welche die Produkttemperatur nicht berücksichtigen. Es ist deshalb nicht sichergestellt, ob der Prozess optimal oder auch nur gut betrieben wird. Inhalt dieser Arbeit ist ein Vergleich der klassischen einstufigen Konvektionstrocknung mit einer Prozessführungsstrategie bei der die Produkttemperatur als Regelgröße eingeführt wird. Anhand der Untersuchung des Trocknungsverhaltens von Äpfeln werden die beiden Verfahren analysiert, die erhaltenen Ergebnisse miteinander verglichen und daraus optimierte Trocknungsbedingungen abgeleitet. Die für dieses Projekt entwickelte Prozessanlage erlaubt die simultane Untersuchung sämtlicher wesentlicher Temperaturen, der Gewichtsveränderung und der optischen Qualitätskriterien. Gleichzeitig ist es möglich, entweder die Lufttemperatur oder die Temperatur des Produktes zur regeln, während die jeweils andere Größe als Messwert erfasst wird. Es kann weiterhin zwischen Durch- und Überströmung gewählt werden.

La ventilación no invasiva con presión positiva en la insuficiencia respiratoria aguda hipercápnica: diez años de experiencia clínica de una unidad de terapia semiintensiva respiratoria

Premisa: Si bien numerosos estudios prospectivos, controlados y aleatorizados han demostrado el éxito de la ventilación no invasiva con presión positiva (VNI) en casos seleccionados de insuficiencia respiratoria aguda (IRA) hipercápnica, en contexto con intensidad de cuidado diferente, los datos de práctica clínica relativos al uso de la VNI en escenarios reales son limitados.Objetivo: Reportar los resultados de nuestra experiencia clínica sobre la VNI en la IRA aplicada en la Unidad de Terapia Semiintensiva Respiratoria (UTSIR), de la Unidad Operativa de Neumología de Arezzo, entre 1996-2006, en términos de tolerabilidad, efectos sobre los gases arteriales, tasa de éxito y factores predictivos del fracaso.Métodos: Trescientos cincuenta de los 1.484 pacientes (23,6%) ingresados consecutivamente por IRA en nuestra Unidad Operativa de Neumología, durante el periodo de estudio, recibieronla VNI asociada a la terapia estándar, posterior al cumplimiento de criterios predefinidos, empleados de rutina.Resultados: Ocho pacientes (2,3%) no toleraron la VNI por incomodidad producida por la máscara, mientras los 342 restantes (M: 240; F: 102; edad: mediana [intercuartiles] 74,0 años [68,0-79,3]; enfermedad pulmonar obstructiva crónica (EPOC) [69,3%]) fueron ventilados por más de una hora. Los parámetros de ventilación (y su efecto sobre el pH) y de oxigenación mejoraron significativamente después de dos horas de VNI (media [desviación estándar] pH: 7,33 [0,07] contra 7,28 [7,25-7,31 ], p < 0,0001; PaCO2: 71,4 mmHg [15,3] contra 80,8 mmHg [16,6], p < 0,0001; PaO2/FiO2: 205 [61] contra 183 [150-222 ], p < 0,0001). La VNI evitó la intubación en 285/342 pacientes (83,3%), con una mortalidad hospitalaria del 14,0%. El fracaso de la VNI resultó ser predicho de modo independiente por el puntaje acute physiology and chronic health evaluation III (Apache III), por el índice de masa corporal y por el fracaso tardío de la VNI (mayor a 48 horas de ventilación), después de una respuesta positiva inicial.Conclusiones: Según nuestra experiencia clínica de diez años en una UTSIR, la VNI confirma ser bien tolerada, eficaz en el mejoramiento de los gases arteriales y útil en evitar la intubación en muchos episodios de IRA que no responden a la terapia estándar.

Osteomielitis esternal: utilidad de las pruebas de diagnóstico por imágenes con enfoque en medicina nuclear

Introducción: El diagnóstico de osteomielitis esternal post-esternotomía resulta difícil empleando síntomas clínicos o de laboratorio y las imágenes morfológicas orientan a sospecha más que al diagnóstico. Un diagnóstico precoz ofrece calidad de vida y el mejor tratamiento para reducir una mortalidad que oscila entre 14% y 47%. La gammagrafía con leucocitos marcados ofrece el mejor rendimiento diagnóstico para infecciones y se destaca como el patrón de oro diagnóstico. Objetivo: Identificar el desempeño y utilidad de la gammagrafía con leucocitos autólogos marcados con 99mTc-HMPAO en los estudios realizados para la evaluación de osteomielitis esternal. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo de prueba diagnóstica en la Fundación Cardioinfantil de Bogotá entre enero/2010 y mayo/2015 evaluando gammagrafías con leucocitos marcados ante la sospecha de osteomielitis posterior a esternotomía. Resultados: Se evaluaron 52 pacientes, en los que la gammagrafía con leucocitos mostró 23 pacientes (44,2%) con osteomielitis esternal, logrando una sensibilidad y especificidad del 88,46% y 100% respectivamente. El valor predictivo positivo fue de 100%, y el valor predictivo negativo fue de 89,66%. El impacto de una prueba negativa no modificó el manejo médico inicial en el 93% de los casos mientras que una prueba positiva lo modificó en el 83%. Conclusiones: La gammagrafía con leucocitos autólogos radiomarcados con 99mTc-HMPAO continúa siendo el patrón de oro de referencia no invasiva para el diagnóstico de osteomielitis, y en el caso de osteomielitis esternal se convierte en la prueba de elección pertinente en la selección de pacientes que ameritan una re-intervención quirúrgica.

Expression of beta-human chorionic gonadotropin (beta-hCG) in non-trophoblastic elements of transitional cell carcinoma of the bladder: possible relationship with the prognosis.

Transitional cell carcinoma (TCC) of the bladder is a neoplasm with variability in its clinical behavior. Although there are several studies correlating stage and ABO isoantigen expression with invasiveness, there is no single predictor factor to assess the potential invasiveness, especially in the low grade, non-invasive TCC. In the present study we evaluated the correlation of histological grade plus stage and the expression of beta human chorionic gonadotropin (beta-hCG), in 100 cases of TCC, with the clinical behavior. These features were correlated with tumor progression in patients with at least two years of follow up. We observed more aggressiveness in G4 group (high grade and invasive) (93% had tumor progression) when compared to G1 group (low grade and superficial) (11% had tumor progression). However in 25.5% of the TCC cases (groups G2: low grade and invasive and G3: high grade and superficial) the clinical behavior was intermediate, showing some limitation in using grading and staging only, as a predictive factor. There was an expression of beta-hCG in 21.4% of the cases in up to 25% of the tumor cells without any trophoblastic morphology. These beta-hCG producing TCC had a strong correlation with aggressiveness: 39.1% and 12.8% of the TCC expressed beta-hCG with and without tumor progression, respectively.

Comparação entre limiar anaeróbio determinado por variáveis ventilatórias e pela resposta do lactato sanguíneo em ciclistas

Many investigations have shown that the coincidence between the ventilatory thresholds and those thresholds using the lactate response does not happen all of the time, suggesting that there is no relationship between the cause-effect between these phenomena. Thus, the present study had as main purpose to compare and correlate the Oxygen consumption (V̇O 2), the power (W), and the heart rate (HR) values attained using protocols to determine the Ventilatory Threshold (VT) and the Individual Anaerobic Threshold (IAT). The sampling was constituted by eight State and National level cyclists (age: 27.88 ± 8.77 years; body mass: 65.19 ± 4.40 kg; height: 169.31 ± 5,77 cm). The IAT was determined starting from a three minutes 50 W warm up with progressive increases of 50 W.3min -1 up to achieving the voluntary exhaustion, when the blood was collected in the last 20 seconds of each phase, and during the recovering period. In order to determine the VT, it was used the same protocol used to determine the IAT, but without performing the blood collection. The VT was identified through the changes in the pulmonary ventilation, as well as of the ventilatory equivalent of the O 2 and CO 2. The t-Student test showed no significant statistical difference in any of the attained variables. The associations found were high and significant. The V̇O 2 (ml.kg -1.min. -1), P (W), and HR (bpm) corresponding to the VT and IAT, as well as the associations between variables were respectively: 48.00 ± 3.82 vs. 48.08 ± 3.71 (r = 0.90); 256.25 ± 32.04 vs. 246.88 ± 33.91 (r = 0.84); 173.75 ± 9.18 vs. 171.25 ± 12.02 (r = 0.97). According to the results attained, it can be concluded that the IAT and the VT produce similar V̇O 2, W, and HR values, favoring the adoption of the VT because it is a non-invasive method to determine the anaerobic threshold in cyclists.

A simple protocol for a low invasive DNA accessing in Stenella longirostris (Cetacea: Delphinidae)

The most significant studies about the spinner dolphin (Stenella longirostris) in the Southwestern Atlantic Ocean were conducted in Fernando de Noronha Archipelago, off Northeastern Brazil. The continuity of these studies depends upon the development of non-invasive methods. In this work, we present results from the skin swabbing sampling procedure for this species. We tested the performance of this method for nuclear and mitochondrial DNA analysis, unknown for this population. A total of skin 161 samples were collected during two expeditions. After the contacts the most of the dolphins remained close to the boat. Microsatellites markers and cytochrome b region primers were evaluated and the respective fragments were successfully amplified. Thus, skin swabbing may be considered an efficient strategy to obtain tissue samples for spinner dolphin genetic analysis in Fernando de Noronha Archipelago.

Pulmonary function in obese vs non-obese cats

Obesity is a risk factor in the development of several respiratory diseases. Lung volumes tend to be decreased, especially expiratory reserve volume, increasing expiratory flow limitation during tidal breathing. Barometric whole-body plethysmography is a non-invasive pulmonary function test that allows a dynamic study of breathing patterns. The objective of this study was to compare pulmonary function variables between obese and non-obese cats through the use of barometric whole-body plethysmography. Nine normal-weight and six obese cats were placed in the plethysmograph chamber, and different respiratory variables were measured. There was a significant decrease in tidal volume per kilogram (P=0.003), minute volume per kilogram (P=0.001) and peak inspiratory and expiratory flows per kilogram (P=0.001) in obese cats compared with non-obese cats. Obesity failed to demonstrate a significant increase in bronchoconstriction index variable enhanced pause (Penh), as previously reported in humans and dogs. The results show that feline obesity impairs pulmonary function in cats, although a significant increase in bronchoconstriction indexes was not observed. Non-invasive barometric whole-body plethysmography can help characterise mechanical dysfunction of the airways in obese cats.

Estudo randonizado duplo-cego da capacidade funcional e da prática de atividade física em indivíduos com diagnóstico polissonográfico de SAOS antes e após uso de CPAP

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação do desempenho de dois monitores oscilométricos portáteis na estimativa da pressão arterial direta em gatos anestesiados com isofluorano

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Longterm peripheral baroreflex and chemoreflex function after bilateral eversion carotid endarterectomy

Introduction The “eversion” technique for carotid endarterectomy (e-CEA), that involves the transection of the internal carotid artery at the carotid bulb and its eversion over the atherosclerotic plaque, has been associated with an increased risk of postoperative hypertension possibly due to a direct iatrogenic damage to the carotid sinus fibers. The aim of this study is to assess the long-term effect of the e-CEA on arterial baroreflex and peripheral chemoreflex function in humans. Methods A retrospective review was conducted on a prospectively compiled computerized database of 3128 CEAs performed on 2617 patients at our Center between January 2001 and March 2006. During this period, a total of 292 patients who had bilateral carotid stenosis ≥70% at the time of the first admission underwent staged bilateral CEAs. Of these, 93 patients had staged bilateral e-CEAs, 126 staged bilateral s- CEAs and 73 had different procedures on each carotid. CEAs were performed with either the eversion or the standard technique with routine Dacron patching in all cases. The study inclusion criteria were bilateral CEA with the same technique on both sides and an uneventful postoperative course after both procedures. We decided to enroll patients submitted to bilateral e-CEA to eliminate the background noise from contralateral carotid sinus fibers. Exclusion criteria were: age >70 years, diabetes mellitus, chronic pulmonary disease, symptomatic ischemic cardiac disease or medical therapy with b-blockers, cardiac arrhythmia, permanent neurologic deficits or an abnormal preoperative cerebral CT scan, carotid restenosis and previous neck or chest surgery or irradiation. Young and aged-matched healthy subjects were also recruited as controls. Patients were assessed by the 4 standard cardiovascular reflex tests, including Lying-to-standing, Orthostatic hypotension, Deep breathing, and Valsalva Maneuver. Indirect autonomic parameters were assessed with a non-invasive approach based on spectral analysis of EKG RR interval, systolic arterial pressure, and respiration variability, performed with an ad hoc software. From the analysis of these parameters the software provides the estimates of spontaneous baroreflex sensitivity (BRS). The ventilatory response to hypoxia was assessed in patients and controls by means of classic rebreathing tests. Results A total of 29 patients (16 males, age 62.4±8.0 years) were enrolled. Overall, 13 patients had undergone bilateral e-CEA (44.8%) and 16 bilateral s-CEA (55.2%) with a mean interval between the procedures of 62±56 days. No patient showed signs or symptoms of autonomic dysfunction, including labile hypertension, tachycardia, palpitations, headache, inappropriate diaphoresis, pallor or flushing. The results of standard cardiovascular autonomic tests showed no evidence of autonomic dysfunction in any of the enrolled patients. At spectral analysis, a residual baroreflex performance was shown in both patient groups, though reduced, as expected, compared to young controls. Notably, baroreflex function was better maintained in e-CEA, compared to standard CEA. (BRS at rest: young controls 19.93 ± 2.45 msec/mmHg; age-matched controls 7.75 ± 1.24; e-CEA 13.85 ± 5.14; s-CEA 4.93 ± 1.15; ANOVA P=0.001; BRS at stand: young controls 7.83 ± 0.66; age-matched controls 3.71 ± 0.35; e-CEA 7.04 ± 1.99; s-CEA 3.57 ± 1.20; ANOVA P=0.001). In all subjects ventilation (VÝ E) and oximetry data fitted a linear regression model with r values > 0.8. Oneway analysis of variance showed a significantly higher slope both for ΔVE/ΔSaO2 in controls compared with both patient groups which were not different from each other (-1.37 ± 0.33 compared with -0.33±0.08 and -0.29 ±0.13 l/min/%SaO2, p<0.05, Fig.). Similar results were observed for and ΔVE/ΔPetO2 (-0.20 ± 0.1 versus -0.01 ± 0.0 and -0.07 ± 0.02 l/min/mmHg, p<0.05). A regression model using treatment, age, baseline FiCO2 and minimum SaO2 achieved showed only treatment as a significant factor in explaining the variance in minute ventilation (R2= 25%). Conclusions Overall, we demonstrated that bilateral e-CEA does not imply a carotid sinus denervation. As a result of some expected degree of iatrogenic damage, such performance was lower than that of controls. Interestingly though, baroreflex performance appeared better maintained in e-CEA than in s-CEA. This may be related to the changes in the elastic properties of the carotid sinus vascular wall, as the patch is more rigid than the endarterectomized carotid wall that remains in the e-CEA. These data confirmed the safety of CEA irrespective of the surgical technique and have relevant clinical implication in the assessment of the frequent hemodynamic disturbances associated with carotid angioplasty stenting.

Sistemi "brain-to-computer" invasivi e non invasivi: Il futuro dell' "assistive technology"

Un confronto fra metodiche invasive e non invasive per interfacce brain-to-computer (BCI), al corrente stato dell'arte. Un approfondimento sulle applicazioni mediche, in particolare l'uso nelle tecnologie per l'assistenza di pazienti con malattie degenerative del sistema motorio.

Studio del metodo "systolic volume balance" per la stima non invasiva della portata media cardiaca

La portata media cardiaca, (cardiac output “CO”) è un parametro essenziale per una buona gestione dei pazienti o per il monitoraggio degli stessi durante la loro permanenza nell’unità di terapia intensiva. La stesura di questo elaborato prende spunto sull’articolo di Theodore G. Papaioannou, Orestis Vardoulis, and Nikos Stergiopulos dal titolo “ The “systolic volume balance” method for the non invasive estimation of cardiac output based on pressure wave analysis” pubblicato sulla rivista American Journal of Physiology-Heart and Circulatory Physiology nel Marzo 2012. Nel sopracitato articolo si propone un metodo per il monitoraggio potenzialmente non invasivo della portata media cardiaca, basato su principi fisici ed emodinamici, che usa l’analisi della forma d’onda di pressione e un metodo non invasivo di calibrazione e trova la sua espressione ultima nell’equazione Qsvb=(C*PPao)/(T-(Psm,aorta*ts)/Pm). Questa formula è stata validata dagli autori, con buoni risultati, solo su un modello distribuito della circolazione sistemica e non è ancora stato validato in vivo. Questo elaborato si pone come obiettivo quello di un’analisi critica di questa formula per la stima della portata media cardiaca Qsvb. La formula proposta nell'articolo verrà verificata nel caso in cui la circolazione sistemica sia approssimata con modelli di tipo windkessel. Dallo studio svolto emerge il fatto che la formula porta risultati con errori trascurabili solo se si approssima la circolazione sistemica con il modello windkessel classico a due elementi (WK2) e la portata aortica con un’onda rettangolare. Approssimando la circolazione sistemica con il modello windkessel a tre elementi (WK3), o descrivendo la portata aortica con un’onda triangolare si ottengono risultati con errori non più trascurabili che variano dal 7%-9% nel caso del WK2 con portata aortica approssimata con onda triangolare ad errori più ampi del 20% nei i casi del WK3 per entrambe le approssimazioni della portata aortica.

Comparison of non-calibrated pulse-contour analysis with continuous thermodilution for cardiac output assessment in patients with induced hypothermia after cardiac arrest

Induced mild hypothermia after cardiac arrest interferes with clinical assessment of the cardiovascular status of patients. In this situation, non-invasive cardiac output measurement could be useful. Unfortunately, arterial pulse contour is altered by temperature, and the performance of devices using arterial blood pressure contour analysis to derive cardiac output may be insufficient.

Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Switzerland: sampling only invasive isolates does not allow a representative description of the local diversity of clones

We conducted a molecular study of MRSA isolated in Swiss hospitals, including the first five consecutive isolates recovered from blood cultures and the first ten isolates recovered from other sites in newly identified carriers. Among 73 MRSA isolates, 44 different double locus sequence typing (DLST) types and 32 spa types were observed. Most isolates belonged to the NewYork/Japan, the UK-EMRSA-15, the South German and the Berlin clones. In a country with a low to moderate MRSA incidence, inclusion of non-invasive isolates allowed a more accurate description of the diversity.

Liver breath tests non-invasively predict higher stages of non-alcoholic steatohepatitis

Effectively assessing subtle hepatic metabolic functions by novel non-invasive tests might be of clinical utility in scoring NAFLD (non-alcoholic fatty liver disease) and in identifying altered metabolic pathways. The present study was conducted on 39 (20 lean and 19 obese) hypertransaminasemic patients with histologically proven NAFLD {ranging from simple steatosis to severe steatohepatitis [NASH (non-alcoholic steatohepatitis)] and fibrosis} and 28 (20 lean and eight overweight) healthy controls, who underwent stable isotope breath testing ([(13)C]methacetin and [(13)C]ketoisocaproate) for microsomal and mitochondrial liver function in relation to histology, serum hyaluronate, as a marker of liver fibrosis, and body size. Compared with healthy subjects and patients with simple steatosis, NASH patients had enhanced methacetin demethylation (P=0.001), but decreased (P=0.001) and delayed (P=0.006) ketoisocaproate decarboxylation, which was inversely related (P=0.001) to the degree of histological fibrosis (r=-0.701), serum hyaluronate (r=-0.644) and body size (r=-0.485). Ketoisocaproate decarboxylation was impaired further in obese patients with NASH, but not in patients with simple steatosis and in overweight controls. NASH and insulin resistance were independently associated with an abnormal ketoisocaproate breath test (P=0.001). The cut-off value of 9.6% cumulative expired (13)CO(2) for ketoisocaproate at 60 min was associated with the highest prediction (positive predictive value, 0.90; negative predictive value, 0.73) for NASH, yielding an overall sensitivity of 68% and specificity of 94%. In conclusion, both microsomal and mitochondrial functions are disturbed in NASH. Therefore stable isotope breath tests may usefully contribute to a better and non-invasive characterization of patients with NAFLD.