Correlation between climate change and epistaxis in Yueqing of Zhejiang province / 中国基层医药

Objective:To correlate climate change with epistaxis in Yueqing of Zhejiang province and to provide evidence for the diagnosis and treatment of epistaxis.Methods:A total of 1 800 patients with epistaxis, who received treatment in Yueqing People's Hospital between October 2018 and October 2019, were included in this study. The data of these patients were input into the Microsoft Excel software. They were summarized and sorted as per admission time. Climate change was correlated with epistaxis.Results:Daily average temperatures were negatively correlated with epistaxis ( r = -0.65, P = 0.003). A non-linear, inverted-U-shaped relationship was observed between daily relative humidity and epistaxis. When the daily relative humidity was < 65%, daily relative humidity was positively correlated with epistaxis ( r = -0.54, P = 0.007).When the daily relative humidity was > 65%, daily relative humidity was negatively correlated with epistaxis ( r = -0.68, P = 0.002). There was a nearly linear positive correlation between diurnal temperature range and epistaxis ( r = 0.52, P = 0.009). There was a linear and positive correlation between daily average atmospheric pressure and epistaxis ( r = 0.60, P = 0.004). The risk of epistaxis increased by 1.48% (95% CI: -2.15 to -0.81) when the temperature decreased by 1 ℃. When daily relative humidity was < 65%, the effects of humidity change on the risk of epistaxis were not statistically significant ( P > 0.05). When the relative humidity of the day was > 65%, the risk of epistaxis decreased by 1.82% (95% CI: -2.71 to -0.93) for every unit of humidity rise. The risk of epistaxis increased by 2.86% (95% CI: 0.54 - 5.18) for every 1 ℃ increase in temperature. The risk of epistaxis increased by 1.18% (95% CI: 0.50 - 1.87) for every 1 Pa increase in air pressure. Conclusion:Temperature change is negatively correlated with epistaxis. Atmospheric pressure and diurnal temperature range are positively correlated with epistaxis. Temperature change, atmospheric pressure, and diurnal temperature have temporary effects on epistaxis. High humidity has an obvious long-term protective effect against epistaxis.

Evaluación microbiológica del caudal de impulsión y extracción mecánica en habitaciones hospitalarias de aislados infecciosos e inmunodeprimidos / Microbiological evaluation of the discharge flow and mechanical extraction in hospital rooms of infectious and immunosuppressed isolates

Por las particularidades de los hospitales, su entorno contiene un gran número de microorganismos proporcionando condiciones muy favorables para la reproducción y la propagación de microorganismos patógenos. Por otro lado, como un sitio importante del uso de antibióticos, las infecciones asociadas a hospitales y la resistencia a los antimicrobianos promueven mutuamente la formación de un círculo vicioso. Existen fuertes evidencias de que la transmisión por aire y aerosoles de los microorganismos patógenos están muy extendidos en los entornos hospitalarios. En ese sentido, las partículas transportadas por el aire se caracterizan por su baja densidad, invisibilidad y susceptibilidad a la turbulencia. El asentamiento de partículas infecciosas en el aire sobre la herida de un paciente puede causar infecciones en cirugía o en caso más graves, infectar a pacientes con sistemas inmunológicos comprometidos, o puede conducir, si las condiciones de ventilación no son apropiadas, a la diseminación de bacterias y hongos (bioaerosoles) desde pacientes infecciosos a toda la comunidad hospitalaria. Para mejorar el estado de estas infecciones asociadas a los hospitales, los sistemas tradicionales se han centrado en estrategias para eliminar patógenos presentes en pacientes, superficies clínicas y trabajadores de la salud, que ha impulsado la implementación de varios protocolos de control y desinfección de infecciones que también han tenido éxito en la reducción de la incidencia de este tipo de infecciones hospitalarias. Dentro de estos procedimientos, está el uso de sistema de ventilación con presión de aire positiva o negativa El objetivo de este trabajo es determinar la capacidad de control microbiano de los sistemas de ventilación en dos centros de asistencia médica del Perú en habitaciones con pacientes inmunosuprimidos (VIH/Sida) aislados o en habitaciones de pacientes infecciosos(AU)

Due to the particularities of hospitals, their environment contains a large number of microorganisms, providing very favorable conditions for the reproduction and spread of pathogenic microorganisms. On the other hand, as an important site of antibiotic use, hospital-associated infections and antimicrobial resistance mutually promote the formation of a vicious circle. There is strong evidence that airborne and aerosol transmission of pathogenic microorganisms is widespread in hospital settings. In that sense, airborne particles are characterized by their low density, invisibility, and susceptibility to turbulence. The settling of airborne infectious particles on a patient's wound can cause infections in surgery or, in more serious cases, infect patients with compromised immune systems, or can lead, if ventilation conditions are not appropriate, to the spread of pathogens. bacteria and fungi (bioaerosols) from infectious patients to the entire hospital community. To improve the status of these hospital-associated infections, traditional systems have focused on strategies to eliminate pathogens present in patients, clinical surfaces, and healthcare workers, which has prompted the implementation of various infection control and disinfection protocols that they have also been successful in reducing the incidence of this type of hospital infection. Within these procedures, there is the use of a ventilation system with positive or negative air pressure. The objective of this work is to determine the microbial control capacity of the ventilation systems in two medical care centers in Peru in rooms with immunosuppressed patients (HIV/AIDS) isolated or in infectious patient rooms(AU)

Effect of optimal time of intermittent pneumatic compression on deep venous thrombosis of critical patients in respiratory department / 中国实用护理杂志

Objective:To investigate the effect of optimal time of intermittent pneumatic compression(IPC) on deep venous thrombosis (DVT) of critical patients in respiratory department.Methods:Totally, 105 critical patients in Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital, Nanjing University Medical School from July 2018 to October 2019 were divided into experimental group 1, group 2 and group 3 by random digits table method, with 35 cases in each group. The experimental group 1 received IPC treatment with 30 min every time, twice a day; and group 2 received 40 min every time, twice a day; and group 3 received 1 hour every time, twice a day. The incidence of DVT and deep tissue injury was observed among three groups, meanwhile, the coagulation function index among three groups was compared before and after IPC treatment.Results:There was no significant difference in the incidence of DVT among the three groups ( P>0.05), however, the deep tissue injury rate were 22.9% (8/35) in the experimental group 3, significantly higher than 2.9% (1/35) in the experimental group 1 and 5.7% (2/35) in experimental group 2, the difference was statistically significant ( χ2 values were 6.248, 4.200, P<0.05). After 2 weeks of treatment, the levels of fbgrinogen and D-Dimer were (5.32±1.82) g/L, (0.71±0.38) mg/L and (4.15±1.82) g/L, (0.39±0.13) mg/L and (3.75±1.46), (0.33± 0.14) mg/L in the experimental group 1, experimental group 2, experimental group 3, respectively; the fbgrinogen and D-Dimer was significantly decreased in the experimental group 2 and experimental group 3 compared to the experimental group 1 ( t values were 2.131-3.977, P<0.05), however, there was no significant difference between experimental group 2 and experimental group 3 ( P>0.05). Conclusions:IPC can be extend to 40 min every time, twice a day, which can significantly improve coagulation function and do not increase the incidence of skin pressure injury of critical patients in respiratory department. It is worth being applied in clinic.

The study of the effect of C-PAP therapy in type-II diabetic patients with obesity and obstructive sleep apnea

Type II diabetes mellitus (T2DM) is closely associated with Obstructive sleep apnea (OSA) and obesity. Type 2 diabetes and OSA may be pathophysiologically independent conditions although the joint association with obesity or visceral adiposity. There is a consistent relationship between obesity and OSA, which has been reported in 60-90% of OSA patients. The prevalence of obesity increases with a parallel increase in the prevalence of OSA. Continuous positive airway pressure (CPAP) therapy is an effective choice of treatment for OSA, an overnight test, or titration some patients may reduce apnea events by minimizes airway collapse by CPAP. Several studies showed that the effect of drug treatment with 3 months of C-PAP in patients with type 2 diabetes. In the present study, we include 300 patients in different groups, out of the 100 patients undergoing treatment of CPAP therapy minimum for three months. Blood sugar, HbA1c, and lipid profile were measured and an overnight sleep study was done. The obtained data shows the significant effect of therapy on physiological and biochemical parameters. AHI and BMI were highly significant in group II and Group III when compared to group I. FBS, HbA1C, and Lipid profile parameters also gave significance results (p-value <0.001) in group II and group III when compared with healthy subjects (group I).

Analysis of effect by different air pressure treatment time on prevention of deep venous thrombosis of the lower extremity in severe chronic bedridden patients / 中国实用护理杂志

Objective@#To explore the effect of different air pressure treatment time on preventing deep vein thrombosis in severe chronic bedridden patients.@*Methods@#This is a prospectie, randomized and controlled study. A total of 120 patients with severe chronic bedridden were randomly divided into normal group and experimental group 1, group 2, with 40 cases in each group. The normal group received 30 min every time, and group 1 received 1h,and group 2 received 2h. To observe the incidence of DVT within 15 days, the blood flow velocity of deep femoral vein before and after the first treatment, and the incidence of deep tissue injury.@*Results@#There was no significant difference in the incidence of DVT among the three groups (P> 0.05), but the incidence of DVT in test group 1 was 5.0% (2/40), 2.5% (1/40) and 12.5% (5/40) compared with the conventional group. Compared with before treatment, the blood flow velocity of deep femoral vein in the three groups increased significantly after treatment (t=1.475、t=2.881、t=4.027, all P < 0.05), but after treatment, the blood flow velocity of deep femoral vein in the conventional group (20.41±1.37) ml/s, the experimental group 1 and the experimental group 2 were (22.39±2.22) ml/s and (22.51±1.73) ml/s, respectively, which were significantly faster than that of the conventional group. There were significant differences (t= 3.086、t= 3.662, all P < 0.05).(3) The incidence of deep tissue injury in experimental group 2 was 20.0% (8/40), which was 2.5% (1/40) and 5.0% (2/40) higher than that in conventional group and experimental group 1 respectively (χ2=6.135、χ2=4.114, all P<0.05).@*Conlousion@#On the basis of conventional barometric therapy, it can be extended to 1 h/time, 3 times/d, which can significantly increase the blood flow velocity of deep femoral vein, reduce the incidence of DVT, and do not increase the incidence of skin pressure injury in patients with chronic bed-rest. It is worth popularizing and applying in clinic.

Analysis of effect by different air pressure treatment time on prevention of deep venous thrombosis of the lower extremity in severe chronic bedridden patients / 中国实用护理杂志

Objective To explore the effect of different air pressure treatment time on preventing deep vein thrombosis in severe chronic bedridden patients. Methods This is a prospectie, randomized and controlled study. A total of 120 patients with severe chronic bedridden were randomly divided into normal group and experimental group 1, group 2, with 40 cases in each group. The normal group received 30 min every time, and group 1 received 1h,and group 2 received 2h. To observe the incidence of DVT within 15 days, the blood flow velocity of deep femoral vein before and after the first treatment, and the incidence of deep tissue injury. Results There was no significant difference in the incidence of DVT among the three groups (P>0.05), but the incidence of DVT in test group 1 was 5.0% (2/40), 2.5% (1/40) and 12.5% (5/40) compared with the conventional group. Compared with before treatment, the blood flow velocity of deep femoral vein in the three groups increased significantly after treatment (t=1.475、t=2.881、t=4.027, all P<0.05), but after treatment, the blood flow velocity of deep femoral vein in the conventional group (20.41±1.37) ml/s, the experimental group 1 and the experimental group 2 were (22.39±2.22) ml/s and (22.51 ± 1.73) ml/s, respectively, which were significantly faster than that of the conventional group. There were significant differences (t = 3.086、t = 3.662, all P < 0.05).(3) The incidence of deep tissue injury in experimental group 2 was 20.0% (8/40), which was 2.5% (1/40) and 5.0% (2/40) higher than that in conventional group and experimental group 1 respectively ( χ2=6.135、χ2=4.114,all P<0.05). Conlousion On the basis of conventional barometric therapy, it can be extended to 1 h/time, 3 times/d, which can significantly increase the blood flow velocity of deep femoral vein, reduce the incidence of DVT, and do not increase the incidence of skin pressure injury in patients with chronic bed-rest. It is worth popularizing and applying in clinic.

Relationship between climatic factors and cerebral hemorrhagic disease / 中华老年心脑血管病杂志

Objective To study the relationship between climatic factors and cerebral hemorrhagic disease.Methods A total of 1125 cerebral hemorrhage patients were included in this study.The relationship between the onset time of cerebral hemorrhage and daily climatice factors (including temperature,humidity,atmospheric pressure,wind direction and rainfall volume) was analyzed and the onset time of cerebral hemorrhage in each patient was analyzed according to the X2 test for goodness of fit.Results The number of male cerebral hemorrhagy patients was greater than that of female cerebral hemorrhage patients.The mean age of femalc cerebral hemorrhage patients was older than that of male cerebral hemorrhage patients (P＜0.01).The incidence of cerebral hemorrhage accounted for 11％ in January in a greatest number of such patients,accounted for 5.0％ in September in a smallest number of such paticnts,and was the highest at h 4-8 AM and at h 16-20 FM in ≤45 years old cerebral hemorrhage patients.Univariate correlation analysis showed that cerebral hemorrhage was negatively related with daily mean temperature,daily mean maximal and minimal temperature (r=-0.157,r =-0.163,r=-0.156,P＜0.05),positively related with daily mean atmospheric pressure (r=0.157,P＜0.05).Multivariate linear stepwise analysis showed that cerebral hemorrhage was related with daily mean temperature,maximal and minimal temperature,and daily mean atmospheric pressure (P＜0.05,P＜0.01).Conclusion The incidence of cerebral hemorrhage differs in seasons and months,is higher in winter and lower in summer,and is thus related with temperature,atmospheric pressure and wind direction.

Design and manufacture of hypobaric cabin simulator for experimental animals / 医疗卫生装备

Objective To design and manufacture a hypobaric cabin simulator for experimental animals.Methods The simulator was composed of a fully transparent working chamber,an electrical chamber,a pressure control component and a program control component,which had its body made of polymethyl methacrylate plastics,the hatch made of metal plate and support by reinforced metal bar.The air inside chamber was exhausted by the diaphragm vacuum pump,the air inflow was controlled by proportional valve,and the inner pressure and the speed of rise and decline were exactly controlled by the balance of inflow and exhaust.Results The new type of hypobaric cabin simulator had the characteristics of accurate pressure control,low fluctuation range and controllable up and down time,low noise as well as adaptable air exchange rate.Conclusion The new type of hypobaric cabin simulator matches the national standard for experimental animals,and can be used in making the animal model of high altitude diseases.

Negative pressure of the environmental air in the cleaning area of the materials and sterilization center: a systematic review / Pressão negativa do ar ambiente em área de limpeza do centro de material e esterilização: revisão sistemática / Presión ambiental negativa de aire en el área de limpieza del centro de materiales y esterilización: revisión sistemática

ABSTRACT Objective: to analyze the scientific evidence on aerosols generated during cleaning activities of health products in the Central Service Department (CSD) and the impact of the negative pressure of the ambient air in the cleaning area to control the dispersion of aerosols to adjacent areas. Method: for this literature systematic review the following searches were done: search guidelines, manuals or national and international technical standards given by experts; search in the portal and databases PubMed, Scopus, CINAHL and Web of Science; and a manual search of scientific articles. Results: the five technical documents reviewed recommend that the CSD cleaning area should have a negative differential ambient air pressure, but scientific articles on the impact of this intervention were not found. The four articles included talked about aerosols formed after the use of a ultrasonic cleaner (an increased in the contamination especially during use) and pressurized water jet (formation of smaller aerosols 5μm). In a study, the aerosols formed from contaminated the hot tap water with Legionella pneumophila were evaluated. Conclusions: there is evidence of aerosol formation during cleanup activities in CSD. Studies on occupational diseases of respiratory origin of workers who work in CSD should be performed.

RESUMO Objetivo: analisar as evidências científicas sobre aerossóis gerados durante atividades de limpeza dos produtos para saúde no Centro de Material e Esterilização (CME) e o impacto da pressão negativa do ar ambiente na área de limpeza para controle da dispersão de aerossóis para áreas adjacentes. Método: para essa revisão sistemática de literatura foram realizadas: busca de diretrizes, manuais ou normas técnicas nacionais e internacionais indicadas por especialistas; busca no portal e bases de dados PUBMED, SCOPUS, Cinahl e Web of Science; e busca manual de artigos científicos. Resultados: Os cinco documentos técnicos analisados preconizam que na área de limpeza do CME haja diferencial negativo de pressão do ar ambiente, porém não foram encontrados artigos científicos sobre o impacto dessa intervenção. Os quatro artigos incluídos trataram dos aerossóis formados após uso de lavadora ultrassônica (aumento da contaminação principalmente durante o uso) e do jato de água pressurizado (formação de aerossóis menores que 5µm). Em um estudo foram avaliados aerossóis formados a partir de torneira de água quente contaminada com Legionella pneumophila. Conclusões: há evidências sobre formação de aerossóis durante atividades de limpeza em CME. Estudos sobre doenças ocupacionais de origem respiratória dos trabalhadores que atuam em CME devem ser realizados.

RESUMEN Objetivo: examinar la evidencia científica sobre los aerosoles generados durante las actividades de limpieza de productos de salud en el Centro de Materiales y Esterilización (CME) y el impacto de la presión negativa del aire ambiente en la zona de limpieza para controlar la dispersión de aerosoles a las zonas adyacentes. Método: para esta revisión sistemática de literatura se llevaron a cabo: búsqueda de directrices, manuales o normas técnicas nacionales e internacionales impartidas por expertos; búsqueda en las bases de datos PUBMED, SCOPUS, Cinahl y Web of Science; y búsqueda manual de artículos científicos. Resultados: Los cinco documentos técnicos analizados recomiendan que el área de limpieza del CME tenga un diferencial negativo de presión en el aire ambiente, aunque no se han encontrado artículos científicos sobre el impacto de esta intervención. Los cuatro artículos incluidos fueron sobre los aerosoles formados después del uso de la lavadora ultrasónica (aumento de la contaminación, especialmente durante el uso) y chorro de agua a presión (formación de aerosoles menores a 5µm). De esta forma, en un solo estudio se evaluaron los aerosoles formados a partir de un grifo de agua caliente contaminada con Legionella pneumophila. Conclusiones: hay evidencia de formación de aerosoles durante las actividades de limpieza en CME. Sin embargo, es necesario realizar estudios sobre las enfermedades profesionales de origen respiratorio de los trabajadores que trabajan en CME.

Influence of artificial CO2 cavity on MMP-2 and VCAM-1, ICAM-1 expression in MDA-MB-231 cell / 中华内分泌外科杂志

Objective To investigate the influence of in vitro artificial CO 2 cavity on matrix metallopro-teinase 2(MMP-2), adhesion molecule vascular cell adhesion molecule 1(VCAM-1), and intercellular adhesion molecule 1(ICAM-1)expression in MDA-MB-231 cell.Methods An in vitro artificial CO2 cavity model was es-tablished.MDA-MB-231 cells were exposed to CO2 under the pressure of 7 mmHg for 1, 2 and 4 hours, respective-ly.MMP-2 concentration was measured by enzyme linked immunosorbent assay (ELISA).VCAM-1 and ICAM-1 ex-pression were measured by flow cytometry 0, 24, 48 and 72 hours after CO2-insufflation.Hypoxia group was ex-posed to 0 mmHg helium for 1 h, and the control group was exposed to 37℃incubator only .Results Compared with that in the control group , MMP-2 expression in the 1, 2 and 4 hours treatment group was significantly elevat-ed at 0 hour(F=15.045, P<0.05), and the MMP-2 expression in the 2 hours CO2 treatment group was signifi-cantly elevated after 24 hours compared with that in the control group and 1, and 4 hours CO2 treatment group (F=5.976, P<0.05).The VCAM-1 expression was significantly elevated at 0 hour and after 24 hours in the 1, 2 and 4 hours CO2 treatment group compared with that in the control group ( F1 =18.321, F2 =20.443, P<0.05), and significantly declined after 72 hours in the 4 hours CO2 treatment group compared with that in 1, and 2 hours CO2 treatment group(F=15.045,P<0.05).ICAM-1 expression was significantly elevated at 0 hour in hypoxia group and 1, 2, 4 hours CO2 treatment group compared with that in the control group , Meanwhile it was higher in 2 hours CO2 treatment group than in 1 hours and 4 hours CO2 treatment group(F=73.765, P<0.05). ICAM-1 expression was significantly elevated after 24 hours in 2 and 4 hours CO2 treatment group compared with that in the control group and 1 hour CO2 treatment group(F=46.322, P<0.05), and it was significantly elevat-ed after 48 hours in 2 hours CO2 treatment group compared with that in the control group and 1, and 4 hours CO2 treatment group(F=22.315, P<0.05).Conclusion The expression of MMP-2, adhesion molecule VCAM-1, and ICAM-1 in MDA-MB-231 cells is elevated after exposure to artificial 7 mmHg CO2 cavity, and CO2 cavity of mastoscopy may modulate the metastasis capacity of breast tumor cells .

Nasalance in Cochlear Implantees

OBJECTIVES: Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing. METHODS: Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated. RESULTS: Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers. CONCLUSION: The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees.

14-2 Inverse association between air pressure and rheumatoid arthritis synovitis / 日本温泉気候物理医学会雑誌

  Rheumatoid arthritis (RA) is a bone destructive autoimmune disease. Many patients with RA recognize fluctuations of their joint synovitis according to changes of air pressure, but the correlations between them have never been addressed in large-scale association studies. To address this point we recruited large-scale assessments of RA activity in a Japanese population, and performed an association analysis. Here, a total of 23,064 assessments of RA activity from 2,131 patients were obtained from the KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) database. Detailed correlations between air pressure and joint swelling or tenderness were analyzed separately for each of the 326 patients with more than 20 assessments to regulate intra-patient correlations. Association studies were also performed for seven consecutive days to identify the strongest correlations. Standardized multiple linear regression analysis was performed to evaluate independent influences from other meteorological factors. As a result, components of composite measures for RA disease activity revealed suggestive negative associations with air pressure. The 326 patients displayed significant negative mean correlations between air pressure and swellings or the sum of swellings and tenderness (p=0.00068 and 0.00011, respectively). Among the seven consecutive days, the most significant mean negative correlations were observed for air pressure three days before evaluations of RA synovitis (p=1.7x10-7, 0.00027, and 8.3x10-8, for swellings, tenderness and the sum of them, respectively). Standardized multiple linear regression analysis revealed these associations were independent from humidity and temperature. Our findings suggest that air pressure is inversely associated with synovitis in patients with RA.

14-2Inverse association between air pressure and rheumatoid arthritis synovitis / 日本温泉気候物理医学会雑誌

  Rheumatoid arthritis (RA) is a bone destructive autoimmune disease. Many patients with RA recognize fluctuations of their joint synovitis according to changes of air pressure, but the correlations between them have never been addressed in large-scale association studies. To address this point we recruited large-scale assessments of RA activity in a Japanese population, and performed an association analysis. Here, a total of 23,064 assessments of RA activity from 2,131 patients were obtained from the KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) database. Detailed correlations between air pressure and joint swelling or tenderness were analyzed separately for each of the 326 patients with more than 20 assessments to regulate intra-patient correlations. Association studies were also performed for seven consecutive days to identify the strongest correlations. Standardized multiple linear regression analysis was performed to evaluate independent influences from other meteorological factors. As a result, components of composite measures for RA disease activity revealed suggestive negative associations with air pressure. The 326 patients displayed significant negative mean correlations between air pressure and swellings or the sum of swellings and tenderness (p=0.00068 and 0.00011, respectively). Among the seven consecutive days, the most significant mean negative correlations were observed for air pressure three days before evaluations of RA synovitis (p=1.7x10^-7, 0.00027, and 8.3x10^-8, for swellings, tenderness and the sum of them, respectively). Standardized multiple linear regression analysis revealed these associations were independent from humidity and temperature. Our findings suggest that air pressure is inversely associated with synovitis in patients with RA.

Análise das medidas aerodinâmicas no português brasileiro por meio do método multiparamétrico de avaliação vocal objetiva assistida (EVA) / Analysis of aerodynamic measures in Brazilian portuguese through multiparameter assessment method vocal objective assist (EVA)

OBJETIVO: definir medidas aerodinâmicas em falantes do português brasileiro, sem queixas vocais, obtidas pelo programa EVA. MÉTODO: participaram do estudo 20 homens e 20 mulheres, que tiveram suas vozes analisadas. RESULTADOS: os valores médios referentes à pressão subglótica para vozes femininas e masculinas foram, respectivamente: Pressão subglótica= 5,84 hPa e 6,7 hPa, média da intensidade= 79,21 dB e 81,7 dB, média do fluxo oral= 0,09 dm³/s e 0,16 dm³/s, eficiência glótica= 13,87 dB/hPa e 12,78 dB/hPa, eficiência laríngea= 188,08 dB/(hPa.dm³/s) e 97,11 dB/(hPa.dm³/s), resistência laríngea= 96,26 hPa/(dm³/s) e 52,64 hPa/(dm³/s), média da frequência fundamental (F0)= 208,28 Hz e 136,56 Hz e pico da pressão do fluxo oral= 0,093 e 0,098. Houve diferença estatisticamente significante em relação ao gênero para as medidas de média de intensidade, eficiência laríngea, resistência laríngea e média da frequência fundamental. Os valores médios referentes ao fluxo oral para vozes femininas e masculinas foram respectivamente: Pressão subglótica= 6,05 hPa e 6,6 hPa, média da intensidade= 65,50 dB e 66,3 dB, média do fluxo oral= 0,10 dm³/s e 0,13 dm³/s, eficiência glótica= 11,12 dB/hPa e 11,77 dB/hPa, eficiência laríngea= 144,83 dB/(hPa.dm³/s) e 97,89 dB/(hPa.dm³/s), resistência laríngea= 78,98 hPa/(dm³/s) e 61,81 hPa/(dm³/s), média da F0= 222,52 Hz e 139,20 Hz e pico da pressão do fluxo oral= 0,047 e 0,053. CONCLUSÃO: o EVA é um programa ainda novo no Brasil, e a análise de medidas aerodinâmicas, em falantes do português brasileiro, permite a obtenção de valores de referência, possibilitando assim comparações com estudos futuros.

PURPOSE: to define aerodynamic measures in Brazilian Portuguese speakers without voice complaints, obtained by the EVA program. METHOD: the study included 20 men and 20 women who had their voices analyzed. RESULTS: the mean values with subglottic pressure for female and male voices were: Subglottic pressure = 5.84 hPa and 6.7 hPa; average intensity = 79.21dB and 81.7dB; oral mean flow = 0.09 dm3/s and 0.16 dm3/s; glottic efficiency = 13.87dB/hPa and 12.78 dB/hPa; laryngeal efficiency = 188.08 dB/(hPa.dm3/s) and 97.11dB/(hPa.dm3/s); laryngeal resistance = 96.26 hPa/(dm3/s) and 52.64 hPa/(dm3/s); mean fundamental frequency (F0) = 208.28 Hz and 136.56 Hz and peak mouth pressure flow = 0.093 and 0.098. There was a statistically significant difference in relation to gender for the measures of average intensity, efficiency, larynx, laryngeal resistance and mean fundamental frequency. The average flow for the oral female and male voices were: subglottic pressure = 6.05 hPa and 6.6 hPa; average intensity = 65.50 dB and 66.3 dB; oral mean flow = 0, 10 dm3/s and 0.13 dm3/s; glottic efficiency = 11.12 dB/hPa and 11.77 dB/hPa; laryngeal efficiency = 144.83 dB/( hPa.dm3/s) and 97.89 dB/( hPa.dm3/s); laryngeal resistance = 78.98 hPa/(dm3/s) and 61.81 hPa/( dm3/s); average F0 = 222.52 Hz and 139.20 Hz and peak pressure oral flow = 0.047 and 0.053. CONCLUSION: EVA is a new program in Brazil, and analysing the aerodynamic measures in Brazilian Portuguese speakers, allows us to obtain reference values, thus allowing comparisons with future studies.

Renal Function Evaluation with Color Doppler Ultrasound Before and After Ultrasonic Pneumatic Ballistic Lithotripsy Under Percutaneous Nephrolithotomy / 中国医学影像学杂志

Purpose To evaluate renal function recovery state with color Doppler ultrasound before and after ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy. Materials and Methods 79 patients with 81 kidneys with upper urinary tract stones underwent ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy, renal parenchymal thickness, renal collecting system separation degree and renal arterial resistance index (RI) were measured with color Doppler ultrasound before and after the operation, subjects were divided into renal dysfunction group (both preoperative and postoperative GFR 20 ml/min), renal function significantly impaired group (postoperative GFR less than preoperative GFR, the difference>20 ml/min) and no significant improvement group (both preoperative and postoperative GFR were >20 ml/min, the difference 4.27 cm, IRA RI and MRA RI>0.8 as diagnostic standard for kidney dysfunction; and the sensitivity and specificity were 87.4% and 85.7%respectively when taking IRA RI4.27 cm, IRA and MRA RI >0.8, and IRA RI <0.72 can be regarded as clinical reference standard for renal function prognosis of kidney dysfunction and hypo-functional before conducting ultrasonic pneumatic ballistic lithotripsy under percutaneous nephrolithotomy.

CPAP no tratamento da apneia obstrutiva do sono: indicações e implicações / CPAP in the treatment of obstructive sleep apnea: indications and implications

A apneia obstrutiva do sono (AOS) é altamente prevalente, porém de fácil diagnóstico e tratamento. Indivíduos com esta condição possuem características como ronco, pausas respiratórias presenciadas e sono excessivo. Sinais físicos, como obesidade, pescoço alargado, mandíbula e maxila pequena ou retrognata e uma via aérea estreitada, sugerem o diagnóstico da AOS. O médico especialista em sono confirma o diagnóstico de AOS por polissonografia (PSG). Após o diagnóstico, o paciente possui várias opções de tratamento, incluindo perda de peso e outras mudanças comportamentais, assim como CPAP (continuous positive airway pressure), cirurgias das vias aéreas e aparelhos intraorais. O paciente com AOS deve ser monitorado de perto durante o período de tratamento, pois a aderência ao regime de tratamento pode ser difícil e resultar em sonolência diurna residual.

The Effect of Cuff Pressure of Endotrachel Tube on Postoperative Sore Throat / 성인간호학회지

PURPOSE: The purpose of this study was to identify the effects of cuff pressure on postoperative sore throat. METHODS: Data were collected from January 4 through May 15, 2008. Among the 60 patients, 30 patients were randomly assigned to the control group and the rest to the experimental group. Initial cuff pressure of both groups was set at 20 cmH2O. The experimental group was maintained at 20 cmH2O throughout the anesthesia, while the control group was not regulated further. Sore throat was assessed at postoperative 1, 24 and 72 hours. Data were analyzed using Mann-Whitney U test and Spearman's rho coefficients. RESULTS: Cuff pressure in the control group increased from 20 to 43 cmH2O within 3 hours after induction. However, the experimental group showed that there was apparently a reduced rate of sore throat at postoperative 24 hours (p = .048), and 72 hours (p = .002) than in the control group. However, no outstanding differences between both groups at postoperative 1 hour (p = .081) were detected. The correlation between cuff pressure and sore throat was statistically significant (r(s) = .590, p < .001). CONCLUSION: We conclude that maintaining cuff pressure at 20 cmH2O could be an effective means to reduce sore throat in surgical patients with inhalation anesthesia.

Characteristics of oropharyngean air pressure, airflow in cleft palate patients

Development and Application of Air Pressure Slimming Unit / 医疗卫生装备

Objective To utilize air pressure for slimming. Methods The external counterpulsation was taken as the master, the non-motivity of which was utilized to develop special air pressure slimming unit based on the structure of human body and physiological characteristics. Results The air pressure slimming unit could work on the existing external counterpulsation with desirable results. Conclusion The air pressure slimming unit can be used not only on the existing external counterpulsation, but on other pneumatically operated equipment with control circuit. As aerobics, the working mode of air pressure slimming unit is a kind of long time and passive aerobic exercise with fixed position, frequency and mode. It is safe and the curative effect is reliable.