807 resultados para inhaled corticosteroids


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Chronic respiratory illnesses are a significant cause of morbidity and mortality, and acute changes in respiratory function often lead to hospitalization. Air pollution is known to exacerbate asthma, but the molecular mechanisms of this are poorly understood. The current studies were aimed at clarifying the roles of nerve subtypes and purinergic receptors in respiratory reflex responses following exposure to irritants. In C57Bl/6J female mice, inspired adenosine produced sensory irritation, shown to be mediated mostly by A-delta fibers. Secondly, the response to inhaled acetic acid was discovered to be dually influenced by C and A-delta fibers, as indicated by the observed effects of capsaicin pretreatment, which selectively destroys TRPV1-expressing fibers (mostly C fibers) and pretreatment with theophylline, a nonselective adenosine receptor antagonist. The responses to both adenosine and acetic acid were enhanced in the ovalbumin-allergic airway disease model, although the particular pathway altered is still unknown.

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A growing number of studies show strong associations between stress and altered immune function. In vivo studies of chronic and acute stress have demonstrated that cognitive stressors are strongly correlated with high circulating levels of catecholamines (CT) and corticosteroids (CS) that are associated with changes in type-1/type-2 cytokine expression. Although individual pharmacologic doses of CS and CT can inhibit the expression of T-helper 1 (Th1, type-1 like) and promote the production of T-helper 2 (Th2, type-2 like) cytokines in antigen-specific and mitogen stimulated human leukocyte cultures in vitro, little attention has been focused on the effects of combination physiologic-stress doses of CT and CS that may be more physiologically relevant. In addition, both in-vivo and in-vitro studies suggest that the differential expression of the B7 family of costimulatory molecules CD80 and CD86 may promote the expression of type-1 or type-2 cytokines, respectively. Furthermore, corticosteroids can influence the expression of β2-adrenergic receptors in various human tissues. We therefore investigated the combined effects of physiologic-stress doses of in vitro CT and CS upon the type-1/type-2 cytokine balance and expression of B7 costimulatory molecules of human peripheral blood mononuclear cells (PBMC) as a model to study the immunomodulatory effects of physiologic stress. Results demonstrated a significant decrease in type-1 cytokine expression and a significant increase in type-2 cytokine production in our CS+CT incubated cultures when compared to either CT or CS agents alone. In addition, we demonstrated the differential expression of CD80/CD86 in favor of CD86 at the cellular and population level as determined by flow cytometry in lipopolysaccharide stimulated human Monocytes. Furthermore, we developed flow cytometry based assays to detect total β2AR in human CD4+ T-lymphocytes that demonstrated decreased expression of β2AR in mitogen stimulated CD4+ T-lymphocytes in the presence of physiologic stress levels of CS and CT as single in vitro agents, however, when both CS and CT were combined, significantly higher expression of β2AR was observed. In summary, our in vitro data suggest that both CS and CT work cooperatively to shift immunity towards type-2 responses. ^

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Steroid binding proteins are an obvious choice in the search for genetic factors in plasma that might predispose to upper body obesity, a risk factor for non-insulin dependent diabetes and cardiovascular disease. The two steroid binding proteins studied by isoelectric focusing were sex hormone binding globulin (SHBG), the transport protein for sex hormones and corticosteroid binding globulin (CBG), the transport protein for corticosteroids. Auto-radiography and immunoblotting on polyacrylamide gels were used to detect polymorphism in SHBG. Immunoblotting on agarose gels was used to visualize corticosteroid binding globulin. SHBG showed similar structural variation in American Caucasians, American Blacks and Canadian Indians. Two alleles (1, 2) were hypothesized with highly polymorphic frequencies in all three ethnic groups. CBG was not found to be polymorphic, but two variants were found in Caucasian male twins and in a Black individual. The finding of a good assay and a polymorphic system for SHBG are the first steps for additional studies into disease associations. ^

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Background. Inhibition of tumor necrosis factor (TNF) is associated with progression of latent tuberculosis infection (LTBI) to active disease. LTBI screening prior to starting TNF inhibitor therapy is recommended. Blood tests, collectively known as interferon-gamma release assays (IGRAs), offer a means other than the tuberculin skin test (TST) of screening for LTBI. However, in the setting of immune compromise, anergy may limit the clinical utility of IGRAs. ^ Methods. A cross-sectional study was conducted in children and young adults ≤ 21 years of age who were cared for at Texas Children's Hospital in Houston, TX, during 2011 and who were candidates for, or were receiving, tumor necrosis factor (TNF)-inhibitor therapy. All subjects answered a risk factor questionnaire and were tested for LTBI by two commercially available IGRAs (QuantiFERON-Gold In-Tube assay and the T-SPOT.TB assay), along with the TST. T-cell phenotypes were evaluated through flow cytometry, both at baseline and after antigen stimulation. ^ Results. Twenty-eight subjects were enrolled. All were TST negative and none were IGRA positive. Results were negative for the 27 subjects who were tested with QuantiFERON-Gold In-Tube. However, 26% of subjects demonstrated anergy in the T-SPOT.T. Patients with T-SPOT. TB anergy had lower quantitative IFN-γ responses to mitogen in the QFT assay—the mean IFN-γ level to mitogen in patients without T-SPOT.TB anergy was 9.84 IU/ml compared to 6.91 IU/ml in patients with T-SPOT.TB anergy (P = 0.046). Age and use of TNF inhibitors, corticosteroids, or methotrexate use were not significantly associated with T-SPOT.TB anergy. Antigen stimulation revealed depressed expression of intracellular IFN-γ in subjects with T-SPOT. TB anergy. ^ Conclusions. The frequency of anergy in this population is higher than would be expected from studies in adults. There appears to be inappropriate IFN-γ responses to antigen in subjects with T-SPOT. TB anergy. This immune defect was detected by the T-SPOT. TB assay but not by the QuantiFERON-Gold In-Tube assay. Further data are needed to clarify the utility of IGRAs in this population.^

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Objetivos: Analizar características clínicas y morbimortalidad de las bacteriemias por Pseudomonas aeruginosa comparadas con Klebsiella spp en pacientes hospitalizados en un Servicio de Clínica Médica de adultos. Material y métodos: Estudio protocolizado, descriptivo, observacional de 15 años de duración. Criterio de inclusión: 2 o más hemocultivos positivos para el germen. Los datos fueron procesados en EPI Info 6.04. El criterio de significación se estableció para un error alfa menor del 5%. Resultados: Se detectaron en el período de estudio 282 bacteriemias por bacilos gram negativos de las cuales 19 fueron por Pseudomonas aeruginosa (6.7%) y 76 por Klebsiella (26.9%). No se encontraron diferencias significativas entre ambas en cuanto a edad media [53.9 años (DS±17.9 ) vs 58.7 años (DS±15.2)], sexo (femenino: 26.3 vs 38.2%) ni complicaciones (77.8 vs 77.3%). La presencia de neutropenia (52.6 vs 9.2%)(p<0.0001), comorbilidad mayor (94.7 vs 68.4%)(p<0.05), neoplasias (47.4 vs 22.4%)(p<0.05), uso de corticoides (21.1 vs 3.9%)(p<0.05), e inmunosupresores (31.6 vs 7.9%)(p<0.01), trombocitopenia (77.7 vs 49.3%) (p<0.05) y leucopenia (52.6 vs 21.3%)(p<0.01) fueron más frecuentes en las bacteriemias por P. aeruginosa. Resultó más frecuente la hipoalbuminemia (88.5 vs 37.5%)(p<0.001) en las bacteriemias por Klebsiella spp. No se encontraron diferencias significativas en cuanto a puerta de entrada conocida (78.9 vs 77.6%), anemia (84.2 vs 71.2%), complicaciones infecciosas (84.2 vs 73.7%), descompensación de comórbidas (55.6 vs 51.3%) y encefalopatía (36.8 vs 57.9%)(pNS). La mortalidad precoz (dentro de los 7 días) fue significativamente mayor en el grupo de las bacteriemias por P.aeruginosa (57.1 vs 12%) (p<0.01), sin diferencias en la mortalidad global (36.8 vs 32.9%) (pNS). Conclusiones: Las bacteriemias por P.aeruginosa comparadas con las producidas por Klebsiella spp. se asociaron significativamente a mayor frecuencia de neoplasias, leucopenia, trombocitopenia y neutropenia, comorbilidad mayor, uso de corticoides e inmunosupresores, y a mortalidad precoz.

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Saharan dust incursions and particulates emitted from human activities degrade air quality throughout West Africa, especially in the rapidly expanding urban centers in the region. Particulate matter (PM) that can be inhaled is strongly associated with increased incidence of and mortality from cardiovascular and respiratory diseases and cancer. Air samples collected in the capital of a Saharan-Sahelian country (Bamako, Mali) between September 2012 - July 2013 were found to contain inhalable PM concentrations that exceeded World Health Organization (WHO) and US Environmental Protection Agency (USEPA) PM2.5 and PM10 24-h limits 58 - 98% of days and European Union (EU) PM10 24-h limit 98% of days. Mean concentrations were 1.2-to-4.5 fold greater than existing limits. Inhalable PM was enriched in transition metals, known to produce reactive oxygen species and initiate the inflammatory reaction, and other potentially bioactive and biotoxic metals/metalloids. Eroded mineral dust composed the bulk of inhalable PM, whereas most enriched metals/metalloids were likely emitted from oil combustion, biomass burning, refuse incineration, vehicle traffic, and mining activities. Human exposure to inhalable PM and associated metals/metalloids over 24-h was estimated. The findings indicate that inhalable PM in the Sahara-Sahel region may present a threat to human health, especially in urban areas with greater inhalable PM and transition metal exposure.

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PURPOSE To report acute/subacute vision loss and paracentral scotomata in patients with idiopathic multifocal choroiditis/punctate inner choroidopathy due to large zones of acute photoreceptor attenuation surrounding the chorioretinal lesions. METHODS Multimodal imaging case series. RESULTS Six women and 2 men were included (mean age, 31.5 ± 5.8 years). Vision ranged from 20/20-1 to hand motion (mean, 20/364). Spectral domain optical coherence tomography demonstrated extensive attenuation of the external limiting membrane, ellipsoid and interdigitation zones, adjacent to the visible multifocal choroiditis/punctate inner choroidopathy lesions. The corresponding areas were hyperautofluorescent on fundus autofluorescence and were associated with corresponding visual field defects. Full-field electroretinogram (available in three cases) showed markedly decreased cone/rod response, and multifocal electroretinogram revealed reduced amplitudes and increased implicit times in two cases. Three patients received no treatment, the remaining were treated with oral corticosteroids (n = 4), oral acyclovir/valacyclovir (n = 2), intravitreal/posterior subtenon triamcinolone acetate (n = 3), and anti-vascular endothelial growth factor (n = 2). Visual recovery occurred in only three cases of whom two were treated. Varying morphological recovery was found in six cases, associated with decrease in hyperautofluorescence on fundus autofluorescence. CONCLUSION Multifocal choroiditis/punctate inner choroidopathy can present with transient or permanent central photoreceptor attenuation/loss. This presentation is likely a variant of multifocal choroiditis/punctate inner choroidopathy with chorioretinal atrophy. Associated changes are best evaluated using multimodal imaging.

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Prevalence of vitamin B12 deficiency is very common in elderly people and can reach values as high as 40.5% of the population. It can be the result of the interaction among several factors. Vitamin B12 deficiencies have been associated with neurological, cognitive deterioration, haematological abnormalities and cardiovascular diseases that have an important influence on the health of the elderly and their quality of life. It is necessary to approach the problems arisen from the lack of data relative to them. The main objective of this thesis was to analyse the evolution of vitamin B12 status and related parameters, lipid and haematological profiles and their relationship to health risk factors, and to functional and cognitive status over one year and to determine the effect of an oral supplementation of 500 μg of cyanocobalamin for a short period of 28 days. An additional objective was to analyze the possible effects of medicine intakes on vitamin B status. Three studies were performed: a) a one year longitudinal follow-up with four measure points; b) an intervention study providing an oral liquid supplement of 500 μg of cyanocobalamin for a 28 days period; and c) analysis of the possible effect of medication intake on vitamin B status using the ATC classification of medicines. The participants for these studies were recruited from nursing homes for the elderly in the Region of Madrid. Sixty elders (mean age 84 _ 7y, 19 men and 41 women) were recruited for Study I and 64 elders (mean age 82 _ 7y, 24 men and 40 women) for Study II. For Study III, baseline data from the initially recruited participants of the first two studies were used. An informed consent was obtained from all participants or their mentors. The studies were approved by the Ethical Committee of the University of Granada. Blood samples were obtained at each examination date and were analyzed for serum cobalamin, holoTC, serum and RBC folate and total homocysteine according to laboratory standard procedures. The haematological parameters analyzed were haematocrit, haemoglobin and MCV. For the lipid profile TG, total cholesterol, LDL- and HDLcholesterol were analyzed. Anthropometric measures (BMI, skinfolds [triceps and subscapular], waist girth and waist to hip ratio), functional tests (hand grip, arm and leg strength tests, static balance) and MMSE were obtained or administered by trained personal. The vitamin B12 supplement of Study II was administered with breakfast and the medication intake was taken from the residents’ anamnesis. Data were analyzed by parametric and non-parametric statistics depending on the obtained data. Comparisons were done using the appropriate ANOVAs or non-parametric tests. Pearsons’ partial correlations with the variable “time” as control were used to define the association of the analyzed parameters. XIII The results showed that: A) Over one year, in relationship to vitamin B status, serum cobalamin decreased, serum folate and mean corpuscular volumen increased significantly and total homocysteine concentrations were stable. Regarding blood lipid profile, triglycerides increased and HDL-cholesterol decreased significantly. Regarding selected anthropometric measurements, waist circumference increased significantly. No significant changes were observed for the rest of parameters. B) Prevalence of hyperhomocysteinemia was high in the elderly studied, ranging from 60% to 90 % over the year depending on the cut-off used for the classification. LDL-cholesterol values were high, especially among women, and showed a tendency to increase over the year. Results of the balance test showed a deficiency and a tendency to decrease; this indicates that the population studied is at high risk for falls. Lower extremity muscular function was deficient and showed a tendency to decrease. A highly significant relationship was observed between the skinfold of the triceps and blood lipid profile. C) Low cobalamin concentrations correlated significantly with low MMSE scores in the elderly studied. No correlations were observed between vitamin B12 status and functional parameters. D) Regarding vitamin B12 status, holo-transcobalamin seems to be more sensitive for diagnosis; 5-10% of the elderly had a deficiency using serum cobalamin as a criterion, and 45-52% had a deficiency when using serum holotranscobalamin as a criterion. E) 500 μg of cyanocobalamin administered orally during 28 days significantly improved vitamin B12 status and significantly decreased total homocysteine concentrations in institutionalized elderly. No effect of the intervention was observed on functional and cognitive parameters. F) The relative change (%) of improvement of vitamin B12 status was higher when using serum holo-transcobalamin as a criterion than serum cobalamin. G) Antiaenemic drug intake normalized cobalamin, urologic drugs and corticosteroids serum folate, and psychoanaleptics holo-transcobalamin levels. Drugs treating pulmonary obstruction increased total homocysteine concentration significantly. H) The daily mean drug intake was 5.1. Fiftynine percent of the elderly took medication belonging to 5 or more different ATC groups. The most prevalent were psycholeptic (53%), antiacid (53%) and antithrombotic (47%) drugs.

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El trabajo de investigación desarrollado que ha dado lugar a la realización de esta Tesis, aborda la protección de los edificios frente a la entrada de gas radón y su acumulación en los espacios habitados. Dicho gas (isótopo del radón Rn-222) es un elemento radiactivo que se genera, principalmente, en terrenos con altos contenidos de radio (terrenos graníticos por ejemplo). Su alto grado de movilidad permite que penetre en los edificios a través de los materiales de cerramiento del mismo (porosidad de los materiales, fisuras, grietas y juntas) y se acumule en su interior, donde puede ser inhalado en altas concentraciones. La Organización Mundial de la Salud, califica al radón como agente cancerígeno de grado 1. Según este Organismo, el radón es la segunda causa de contracción de cáncer pulmonar detrás del tabaco. Como respuesta a esta alarma, distintos estados ya han elaborado normativas en las que se proponen soluciones para que los niveles de concentración de radón no superen los valores recomendados por los organismos internacionales responsables de la protección radiológica. En España aún no existe normativa de protección frente a este agente cancerígeno causante de numerosas muertes, y es por tal motivo evidente la necesidad de aportar documentación técnica que ayude a las administraciones nacionales y locales a desarrollar dicha normativa para ajustarse a las recomendaciones europeas e internacionales sobre los niveles que no se deben superar y que, por otro lado, ya han contemplado una gran cantidad de países. Como principal aportación de este trabajo se muestran los resultados de reducción de concentración de gas radón de distintas soluciones constructivas enfocadas a frenar la entrada de gas radón al interior de los edificios haciendo uso de técnicas y materiales habituales en el ámbito de la construcción en España. Para ello, se han estudiado las efectividades de dichas soluciones, en lo referente a su capacidad para frenar la inmisión de radón, en un prototipo de vivienda construido al efecto en un terreno con altas concentraciones de radón. Las soluciones propuestas y ensayadas han sido el resultado de una labor de optimización de los sistemas estudiados en la bibliografía con el fin de adaptar las técnicas a los sistemas constructivos habituales en España y en concreto a la situación real del prototipo de vivienda construido en un lugar con contenidos de radón en terreno muy elevados. El trabajo incluye un capítulo inicial con los conceptos básicos necesarios para entender la problemática que supone habitar en espacios con altos contenidos de radón. ABSTRACT The research developed, which has led to the completion of this thesis, deal with the protection of buildings against entry of radon gas and its accumulation in the ocupated spaces. This gas (radon isotope Rn-222) is a radioactive element generated, mainly, in areas with high levels of radio (granitic terrain for example). Its high mobility allows entering in buildings through the enclosure materials of it (porosity of materials, cracks, crevices and joints) and accumulates inside, where it can be inhaled in high concentrations. The World Health Organization describes radon gas as a carcinogen agent in level 1. According to this Agency, radon is the second leading cause of lung cancer behind tobacco. In response to this alarm, some states have developed regulations that propose solutions to reduce radon concentration levels for not exceeding the values recommended by international agencies responsible in radiation protection. In Spain there is still no legislation to protect against this carcinogen element that cause numerous deaths, and for that reason it is evident the need to provide technical documentation to help the national and local governments to develop legislation for reaching the European and international levels recommendations. As the main contribution of this work are the results of reducing radon concentration using different constructive solutions aimed to stop radon entry in buildings, with techniques and materials common in Spain. To do this, effectiveness of such solutions, have been studied in terms of its ability to stop radon entry in a housing prototype built for this purpose in an area with high radon levels. The solutions proposed and tested have been the result of a process of optimization of systems studied in the literature in order to adapt the techniques to Spanish building material and, specifically, to the actual situation of housing prototype built in a place with high contents of radon in soil. The work includes an initial chapter with the basic concepts needed to understand the problem of living in areas with high levels of radon.

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Colombia is one the largest per capita mercury polluters as a consequence of its artisanal gold mining operations, which are steadily increasing following the rising price of this metal. Compared to gravimetric separation methods and cyanidation, the concentration of gold using Hg amalgams presents several advantages: the process is less time-consuming and minimizes gold losses, and Hg is easily transported and inexpensive relative to the selling price of gold. Very often, mercury amalgamation is carried out on site by unprotected workers. During this operation large amounts of mercury are discharged to the environment and eventually reach the fresh water bodies in the vicinity where it is subjected to methylation. Additionally, as gold is released from the amalgam by heating on open charcoal furnaces in small workshops, mercury vapors are emitted and inhaled by the artisanal smelters and the general population

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Radon gas (Rn) is a natural radioactive gas present in some soils and able to penetrate buildings through the building envelope in contact with the soil. Radon can accumulate within buildings and consequently be inhaled by their occupants. Because it is a radioactive gas, its disintegration process produces alpha particles that, in contact with the lung epithelia, can produce alterations potentially giving rise to cancer. Many international organizations related to health protection, such as WHO, confirm this causality. One way to avoid the accumulation of radon in buildings is to use the building envelope as a radon barrier. The extent to which concrete provides such a barrier is described by its radon diffusion coefficient (DRn), a parameter closely related to porosity (ɛ) and tortuosity factor (τ). The measurement of the radon diffusion coefficient presents challenges, due to the absence of standard procedures, the requirement to establish adequate airtightness in testing apparatus (referred to here as the diffusion cell), and due to the fact that measurement has to be carried out in an environment certified for use of radon calibrated sources. In addition to this calibrated radon sources are costly. The measurement of the diffusion coefficient for non-radioactive gas is less complex, but nevertheless retains a degree of difficulty due to the need to provide reliably airtight apparatus for all tests. Other parameters that can characterize and describe the process of gas transport through concrete include the permeability coefficient (K) and the electrical resistivity (ρe), both of which can be measured relatively easily with standardized procedure. The use of these parameters would simplify the characterization of concrete behaviour as a radon barrier. Although earlier studies exist, describing correlation among these parameters, there is, as has been observed in the literature, little common ground between the various research efforts. For precisely this reason, prior to any attempt to measure radon diffusion, it was deemed necessary to carry out further research in this area, as a foundation to the current work, to explore potential relationships among the following parameters: porosity-tortuosity, oxygen diffusion coefficient, permeability coefficient and resistivity. Permeability coefficient measurement (m2) presents a more straightforward challenge than diffusion coefficient measurement. Some authors identify a relationship between both coefficients, including Gaber (1988), who proposes: k= a•Dn Equation 1 Where: a=A/(8ΠD020), A = sample cross-section, D020 = diffusion coefficient in air (m2/s). Other studies (Klink et al. 1999, Gaber and Schlattner 1997, Gräf and Grube et al. 1986), experimentally relate both coefficients of different types of concrete confirming that this relationship exists, as represented by the simplified expression: k≈Dn Equation 2 In each particular study a different value for n was established, varying from 1.3 to 2.5, but this requires determination of a value for n in a more general way because these proposed models cannot estimate diffusion coefficient. If diffusion coefficient has to be measured to be able to establish n, these relationships are not interesting. The measurement of electric resistivity is easier than diffusion coefficient measurement. Correlation between the parameters can be established via Einstein´s law that relates movement of electrical charges to media conductivity according to the expression: D_e=k/ρ Equation 3 Where: De = diffusion coefficient (cm2/s), K = constant, ρ = electric resistivity (Ω•cm). The tortuosity factor is used to represent the uneven geometry of concrete pores, which are described as being not straight, but tortuous. This factor was first introduced in the literature to relate global porosity with fluid transport in a porous media, and can be formulated in a number of different ways. For example, it can take the form of equation 4 (Mason y Malinauskas), which combines molecular and Knudsen diffusion using the tortuosity factor: D=ε^τ (3/2r √(πM/8RT+1/D_0 ))^(-1) Equation 4 Where: r = medium radius obtained from MIP (µm), M = gas molecular mass, R = ideal gases constant, T = temperature (K), D0 = coefficient diffusion in the air (m2/s). Few studies provide any insight as to how to obtain the tortuosity factor. The work of Andrade (2012) is exceptional in this sense, as it outlines how the tortuosity factor can be deduced from pore size distribution (from MIP) from the equation: ∅_th=∅_0•ε^(-τ). Equation 5 Where: Øth = threshold diameter (µm), Ø0 = minimum diameter (µm), ɛ = global porosity, τ = tortuosity factor. Alternatively, the following equation may be used to obtain the tortuosity factor: DO2=D0*ɛτ Equation 6 Where: DO2 = oxygen diffusion coefficient obtained experimentally (m2/s), DO20 = oxygen diffusion coefficient in the air (m2/s). This equation has been inferred from Archie´s law ρ_e=〖a•ρ〗_0•ɛ^(-m) and from the Einstein law mentioned above, using the values of oxygen diffusion coefficient obtained experimentally. The principal objective of the current study was to establish correlations between the different parameters that characterize gas transport through concrete. The achievement of this goal will facilitate the assessment of the useful life of concrete, as well as open the door to the pro-active planning for the use of concrete as a radon barrier. Two further objectives were formulated within the current study: 1.- To develop a method for measurement of gas coefficient diffusion in concrete. 2.- To model an analytic estimation of radon diffusion coefficient from parameters related to concrete porosity and tortuosity factor. In order to assess the possible correlations, parameters have been measured using the standardized procedures or purpose-built in the laboratory for the study of equations 1, 2 y 3. To measure the gas diffusion coefficient, a diffusion cell was designed and manufactured, with the design evolving over several cycles of research, leading ultimately to a unit that is reliably air tight. The analytic estimation of the radon diffusion coefficient DRn in concrete is based on concrete global porosity (ɛ), whose values may be experimentally obtained from a mercury intrusion porosimetry test (MIP), and from its tortuosity factor (τ), derived using the relations expressed in equations 5 y 6. The conclusions of the study are: Several models based on regressions, for concrete with a relative humidity of 50%, have been proposed to obtain the diffusion coefficient following the equations K=Dn, K=a*Dn y D=n/ρe. The final of these three relations is the one with the determination coefficient closest to a value of 1: D=(19,997*LNɛ+59,354)/ρe Equation 7 The values of the obtained oxygen diffusion coefficient adjust quite well to those experimentally measured. The proposed method for the measurement of the gas coefficient diffusion is considered to be adequate. The values obtained for the oxygen diffusion coefficient are within the range of those proposed by the literature (10-7 a 10-8 m2/s), and are consistent with the other studied parameters. Tortuosity factors obtained using pore distribution and the expression Ø=Ø0*ɛ-τ are inferior to those from resistivity ρ=ρ0*ɛ-τ. The closest relationship to it is the one with porosity of pore diameter 1 µm (τ=2,07), being 7,21% inferior. Tortuosity factors obtained from the expression DO2=D0*ɛτ are similar to those from resistivity: for global tortuosity τ=2,26 and for the rest of porosities τ=0,7. Estimated radon diffusion coefficients are within the range of those consulted in literature (10-8 a 10-10 m2/s).ABSTRACT El gas radón (Rn) es un gas natural radioactivo presente en algunos terrenos que puede penetrar en los edificios a través de los cerramientos en contacto con el mismo. En los espacios interiores se puede acumular y ser inhalado por las personas. Al ser un gas radioactivo, en su proceso de desintegración emite partículas alfa que, al entrar en contacto con el epitelio pulmonar, pueden producir alteraciones del mismo causando cáncer. Muchos organismos internacionales relacionados con la protección de la salud, como es la OMS, confirman esta causalidad. Una de las formas de evitar que el radón penetre en los edificios es utilizando las propiedades de barrera frente al radón de su propia envolvente en contacto con el terreno. La principal característica del hormigón que confiere la propiedad de barrera frente al radón cuando conforma esta envolvente es su permeabilidad que se puede caracterizar mediante su coeficiente de difusión (DRn). El coeficiente de difusión de un gas en el hormigón es un parámetro que está muy relacionado con su porosidad (ɛ) y su tortuosidad (τ). La medida del coeficiente de difusión del radón resulta bastante complicada debido a que el procedimiento no está normalizado, a que es necesario asegurar una estanquidad a la celda de medida de la difusión y a que la medida tiene que ser realizada en un laboratorio cualificado para el uso de fuentes de radón calibradas, que además son muy caras. La medida del coeficiente de difusión de gases no radioactivos es menos compleja, pero sigue teniendo un alto grado de dificultad puesto que tampoco está normalizada, y se sigue teniendo el problema de lograr una estanqueidad adecuada de la celda de difusión. Otros parámetros que pueden caracterizar el proceso son el coeficiente de permeabilidad (K) y la resistividad eléctrica (ρe), que son más fáciles de determinar mediante ensayos que sí están normalizados. El uso de estos parámetros facilitaría la caracterización del hormigón como barrera frente al radón, pero aunque existen algunos estudios que proponen correlaciones entre estos parámetros, en general existe divergencias entre los investigadores, como se ha podido comprobar en la revisión bibliográfica realizada. Por ello, antes de tratar de medir la difusión del radón se ha considerado necesario realizar más estudios que puedan clarificar las posibles relaciones entre los parámetros: porosidad-tortuosidad, coeficiente de difusión del oxígeno, coeficiente de permeabilidad y resistividad. La medida del coeficiente de permeabilidad (m2) es más sencilla que el de difusión. Hay autores que relacionan el coeficiente de permeabilidad con el de difusión. Gaber (1988) propone la siguiente relación: k= a•Dn Ecuación 1 En donde: a=A/(8ΠD020), A = sección de la muestra, D020 = coeficiente de difusión en el aire (m2/s). Otros estudios (Klink et al. 1999, Gaber y Schlattner 1997, Gräf y Grube et al. 1986) relacionan de forma experimental los coeficientes de difusión de radón y de permeabilidad de distintos hormigones confirmando que existe una relación entre ambos parámetros, utilizando la expresión simplificada: k≈Dn Ecuación 2 En cada estudio concreto se han encontrado distintos valores para n que van desde 1,3 a 2,5 lo que lleva a la necesidad de determinar n porque no hay métodos que eviten la determinación del coeficiente de difusión. Si se mide la difusión ya deja de ser de interés la medida indirecta a través de la permeabilidad. La medida de la resistividad eléctrica es muchísimo más sencilla que la de la difusión. La relación entre ambos parámetros se puede establecer a través de una de las leyes de Einstein que relaciona el movimiento de cargas eléctricas con la conductividad del medio según la siguiente expresión: D_e=k/ρ_e Ecuación 3 En donde: De = coeficiente de difusión (cm2/s), K = constante, ρe = resistividad eléctrica (Ω•cm). El factor de tortuosidad es un factor de forma que representa la irregular geometría de los poros del hormigón, al no ser rectos sino tener una forma tortuosa. Este factor se introduce en la literatura para relacionar la porosidad total con el transporte de un fluido en un medio poroso y se puede formular de distintas formas. Por ejemplo se destaca la ecuación 4 (Mason y Malinauskas) que combina la difusión molecular y la de Knudsen utilizando el factor de tortuosidad: D=ε^τ (3/2r √(πM/8RT+1/D_0 ))^(-1) Ecuación 4 En donde: r = radio medio obtenido del MIP (µm), M = peso molecular del gas, R = constante de los gases ideales, T = temperatura (K), D0 = coeficiente de difusión de un gas en el aire (m2/s). No hay muchos estudios que proporcionen una forma de obtener este factor de tortuosidad. Destaca el estudio de Andrade (2012) en el que deduce el factor de tortuosidad de la distribución del tamaño de poros (curva de porosidad por intrusión de mercurio) a partir de la ecuación: ∅_th=∅_0•ε^(-τ) Ecuación 5 En donde: Øth = diámetro umbral (µm), Ø0 = diámetro mínimo (µm), ɛ = porosidad global, τ = factor de tortuosidad. Por otro lado, se podría utilizar también para obtener el factor de tortuosidad la relación: DO2=D0*-τ Ecuación 6 En donde: DO2 = coeficiente de difusión del oxígeno experimental (m2/s), DO20 = coeficiente de difusión del oxígeno en el aire (m2/s). Esta ecuación está inferida de la ley de Archie ρ_e=〖a•ρ〗_0•ɛ^(-m) y la de Einstein mencionada anteriormente, utilizando valores del coeficiente de difusión del oxígeno DO2 obtenidos experimentalmente. El objetivo fundamental de la tesis es encontrar correlaciones entre los distintos parámetros que caracterizan el transporte de gases a través del hormigón. La consecución de este objetivo facilitará la evaluación de la vida útil del hormigón así como otras posibilidades, como la evaluación del hormigón como elemento que pueda ser utilizado en la construcción de nuevos edificios como barrera frente al gas radón presente en el terreno. Se plantean también los siguientes objetivos parciales en la tesis: 1.- Elaborar una metodología para la medida del coeficiente de difusión de los gases en el hormigón. 2.- Plantear una estimación analítica del coeficiente de difusión del radón a partir de parámetros relacionados con su porosidad y su factor de tortuosidad. Para el estudio de las correlaciones posibles, se han medido los parámetros con los procedimientos normalizados o puestos a punto en el propio Instituto, y se han estudiado las reflejadas en las ecuaciones 1, 2 y 3. Para la medida del coeficiente de difusión de gases se ha fabricado una celda que ha exigido una gran variedad de detalles experimentales con el fin de hacerla estanca. Para la estimación analítica del coeficiente de difusión del radón DRn en el hormigón se ha partido de su porosidad global (ɛ), que se obtiene experimentalmente del ensayo de porosimetría por intrusión de mercurio (MIP), y de su factor de tortuosidad (τ), que se ha obtenido a partir de las relaciones reflejadas en las ecuaciones 5 y 6. Las principales conclusiones obtenidas son las siguientes: Se proponen modelos basados en regresiones, para un acondicionamiento con humedad relativa de 50%, para obtener el coeficiente de difusión del oxígeno según las relaciones: K=Dn, K=a*Dn y D=n/ρe. La propuesta para esta última relación es la que tiene un mejor ajuste con R2=0,999: D=(19,997*LNɛ+59,354)/ρe Ecuación 7 Los valores del coeficiente de difusión del oxígeno así estimados se ajustan a los obtenidos experimentalmente. Se considera adecuado el método propuesto de medida del coeficiente de difusión para gases. Los resultados obtenidos para el coeficiente de difusión del oxígeno se encuentran dentro del rango de los consultados en la literatura (10-7 a 10-8 m2/s) y son coherentes con el resto de parámetros estudiados. Los resultados de los factores de tortuosidad obtenidos de la relación Ø=Ø0*ɛ-τ son inferiores a la de la resistividad (ρ=ρ0*ɛ-τ). La relación que más se ajusta a ésta, siendo un 7,21% inferior, es la de la porosidad correspondiente al diámetro 1 µm con τ=2,07. Los resultados de los factores de tortuosidad obtenidos de la relación DO2=D0*ɛτ son similares a la de la resistividad: para la porosidad global τ=2,26 y para el resto de porosidades τ=0,7. Los coeficientes de difusión de radón estimados mediante estos factores de tortuosidad están dentro del rango de los consultados en la literatura (10-8 a 10-10 m2/s).

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Recent neuroimaging and neurological data implicate cerebellum in nonmotor sensory, cognitive, vegetative, and affective functions. The present study assessed cerebellar responses when the urge to breathe is stimulated by inhaled CO2. Ventilation changes follow arterial blood partial pressure CO2 changes sensed by the medullary ventral respiratory group (VRG) and hypothalamus, entraining changes in midbrain, pons, thalamus, limbic, paralimbic, and insular regions. Nearly all these areas are known to connect anatomically with the cerebellum. Using positron emission tomography, we measured regional brain blood flow during acute CO2-induced breathlessness in humans. Separable physiological and subjective effects (air hunger) were assessed by comparisons with various respiratory control conditions. The conjoint physiological effects of hypercapnia and the consequent air hunger produced strong bilateral, near-midline activations of the cerebellum in anterior quadrangular, central, and lingula lobules, and in many areas of posterior quadrangular, tonsil, biventer, declive, and inferior semilunar lobules. The primal emotion of air hunger, dissociated from hypercapnia, activated midline regions of the central lobule. The distributed activity across the cerebellum is similar to that for thirst, hunger, and their satiation. Four possible interpretations of cerebellar function(s) here are that: it subserves implicit intentions to access air; it provides predictive internal models about the consequences of CO2 inhalation; it modulates emotional responses; and that while some cerebellar regions monitor sensory acquisition in the VRG (CO2 concentration), others influence VRG to adjust respiratory rate to optimize partial pressure CO2, and others still monitor and optimize the acquisition of other sensory data in service of air hunger aroused vigilance.

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To investigate the contribution of interleukin-4 (IL-4) to airway inflammation in vivo and to explore directly its relationship to airway reactivity, we created transgenic mice in which the murine cDNA for IL-4 was regulated by the rat Clara cell 10 protein promoter. Expression was detected only in the lung and not in thymus, heart, liver, spleen, kidney, or uterus. The expression of IL-4 elicited hypertrophy of epithelial cells of the trachea, bronchi, and bronchioles. Hypertrophy is due, at least in part, to the accumulation of mucus glycoprotein. Histologic examination of parenchyma revealed multinucleated macrophages and occasional islands of cells consisting largely of eosinophils or lymphocytes. Analysis of lung lavage fluid revealed the presence of a leukocytic infiltrate consisting of lymphocytes, neutrophils and eosinophils. Mice expressing IL-4 had greater baseline airway resistance but did not demonstrate hyperreactivity to methacholine. Thus, the expression of IL-4 selectively within the lung elicits an inflammatory response characterized by epithelial cell hypertrophy, and the accumulation of macrophages, lymphocytes, eosinophils, and neutrophils without resulting in an alteration in airway reactivity to inhaled methacholine.

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A murine model for antigen-induced bronchial hyperreactivity (BHR) and airway eosinophilia, two hallmarks of asthma, was developed using ovalbumin-immunized mice, which produce large amounts of IgE (named BP2, "Bons Producteurs 2," for High Line of Selection 2). A single intranasal ovalbumin challenge failed to modify the bronchial responses, despite the intense eosinophil recruitment into the bronchoalveolar lavage fluid and airways. When mice were challenged twice a day for 2 days or once a day for 10 days, BHR in response to i.v. 5-hydroxytryptamine or to inhaled methacholine was induced in BP2 mice but not in BALB/c mice. Histological examination showed that eosinophils reached the respiratory epithelium after multiple ovalbumin challenges in BP2 mice but remained in the bronchial submucosa in BALB/c mice. Total IgE titers in serum were augmented significantly with immunization in both strains, but much more so in BP2 mice. Interleukin 5 (IL-5) titers in serum and bronchoalveolar lavage fluid of BP2 mice were augmented by the antigenic provocation, and a specific anti-IL5 neutralizing antibody suppressed altogether airway eosinophilia and BHR, indicating a participation of IL-5 in its development. Our results indicate that the recruitment of eosinophils to the airways alone does not induce BHR in mice and that the selective effect on BP2 mice is related to their increased IgE titers associated with antigen-driven eosinophil migration to the epithelium, following formation and secretion of IL-5.