Effect of intrabronchial platelet rich plasma on the exercise-induced pulmonary hemorrhage endoscopic score in thoroughbred racehorses using furosemide: a preliminary study / [Efeito da instilação intrabronquial de plasma rico em plaquetas no escore endoscópico da hemorragia pulmonar induzida por exercício em cavalos Puro-Sangue Inglês de corrida e usuários de furosemida: um estudo preliminar]

The high prevalence of exercise-induced pulmonary hemorrhage (EIPH) in athletic horses constitutes to be a challenge to the racing industry and a source of major concern to animal welfare. Both experimental and clinical evidence indicate that the use of autologous platelet-rich plasma (PRP) is a promising effector of repair in a variety of pulmonary conditions. The present study evaluated the effect of intrabronchial instillation of PRP on EIPH endoscopic scores from 37 Thoroughbred racehorses. Inclusion criteria were for animals to be EIPH-positive in, at least, two consecutive post-exercise endoscopic exams and to receive 250mg of furosemide IV four hours before racing. Animals were randomly assigned into 3 groups: placebo, control, and PRP instillation. All 37 Thoroughbred racehorses included had EIPH endoscopic scores pre- and post- treatment compared by statistical analysis. The bleeding score from the group receiving PRP was significantly lower than in the control and placebo groups. No adverse effects were observed in any animal during or after the experiment. It was possible to conclude that the intrabronchial instillation of autologous PRP was effective in reducing EIPH scores in racehorses receiving furosemide and that this bioproduct can be considered as a promising coadjuvant in controlling EIPH in athletic horses.(AU)

A alta prevalência de hemorragia pulmonar induzida por exercício (HPIE) em cavalos atletas é um desafio de longa data para a indústria de corridas, além de figurar como grande preocupação sobre o bem-estar animal. As evidências experimentais e clínicas indicam que o uso do plasma rico em plaquetas (PRP) de fonte autógena é promissor na terapêutica de diversas lesões pulmonares. O presente estudo objetivou avaliar as mudanças após corrida no escore endoscópico de HPIE de 37 cavalos Puro-Sangue Inglês que receberam instilação intrabronquial de PRP autólogo. Os animais selecionados eram HPIE-positivos em, ao menos, dois exames endoscópicos consecutivos e recebiam 250mg de furosemida IV administrado quatro horas antes de cada corrida. Na comparação dos escores endoscópicos pré e pós-tratamento, verificou-se que o escore de HPIE do grupo tratado com PRP foi significantemente menor que o dos grupos controle e placebo. Nenhum efeito adverso foi observado nos animais durante ou após o experimento. Concluiu-se que a instilação intrabronquial de PRP autólogo foi efetiva na redução do escore de HPIE de cavalos de corrida usuários de furosemida e que este bioproduto pode ser considerado uma alternativa promissora no controle de HPIE em cavalos atletas.(AU)

Aspiración intrabronquial de cuerpo extraño en el niño / Intrabronchial foreign body aspiration in children / Aspiração intrabrônquica de corpo estranho em crianças

RESUMEN La aspiración de cuerpos extraños por vías respiratorias no es una rareza y constituye un problema urgente y grave en la población pediátrica. Se realizó esta investigación con el objetivo de conocer el comportamiento clínico epidemiológico de la aspiración intrabronquial de cuerpos extraños en niños menores de 5 años en el Hospital Hermanos Cordové y elaborar un procedimiento que favorezca la calidad atencional a este grupo de pacientes. Se realizó un estudio descriptivo, retrospectivo y transversal, con una línea analítica, en menores de 5 años de edad egresados del Hospital Pediátrico Provincial Docente Hermanos Cordové, de Manzanillo, con diagnóstico de aspiración intrabronquial de cuerpos extraños en el periodo de enero de 2017 a diciembre de 2018. Los factores de riesgos que condicionan la aparición de la aspiración de cuerpos extraños incluyen la edad menor de tres años, del sexo masculino y de procedencia rural. Los cuerpos extraños orgánicos necesitaron de menor tiempo para su diagnóstico y no fue posible establecer una secuencia típica del comportamiento clínico. Se elaboró un procedimiento de actuación ante el accidente para los diagnósticos y conducta a seguir ante la aspiración intrabronquial de cuerpos extraños en niños.

ABSTRACT Aspiration of foreign bodies through the respiratory tract is not a rarity and constitutes an urgent and serious problem in the pediatric population. This research was carried out with the aim of knowing the epidemiological clinical behavior of intrabronchial aspiration of foreign bodies in children under 5 years of age at Hospital Hermanos Cordové and to develop a procedure that favors the quality of care for this group of patients. A descriptive, retrospective and cross-sectional study was carried out, with an analytical line, in children under 5 years of age graduated from the Hermanos Cordové Provincial Pediatric Teaching Hospital, in Manzanillo, with a diagnosis of intrabronchial aspiration of foreign bodies in the period from January 2017 to December 2018. The risk factors that determine the appearance of foreign body aspiration include the age of less than three years old, male and of rural origin. Organic foreign bodies needed less time to diagnose and it was not possible to establish a typical sequence of clinical behavior. An accident response procedure was prepared for diagnoses and behavior to be followed when faced with intrabronchial aspiration of foreign bodies in children.

RESUMO A aspiração de corpos estranhos pelo trato respiratório não é uma raridade e constitui um problema urgente e grave na população pediátrica. Esta pesquisa foi realizada com o objetivo de conhecer o comportamento epidemiológico clínico da aspiração intrabrônquica de corpos estranhos em crianças menores de 5 anos no Hospital Hermanos Cordové e desenvolver um procedimento que favoreça a qualidade da assistência a esse grupo de pacientes. Foi realizado um estudo descritivo, retrospectivo e transversal, com uma linha analítica, em crianças menores de 5 anos de idade, graduadas no Hospital Pediátrico Provincial de Hermanos Cordové, em Manzanillo, com diagnóstico de aspiração intrabrônquica de corpos estranhos no período de janeiro de 2017 a Dezembro de 2018. Os fatores de risco que determinam a aparência da aspiração de corpo estranho incluem a idade de menos de três anos, do sexo masculino e de origem rural. Corpos estranhos orgânicos precisavam de menos tempo para diagnosticar e não foi possível estabelecer uma sequência típica de comportamento clínico. Um procedimento de resposta a acidentes foi preparado para diagnósticos e comportamentos a serem seguidos quando confrontados com aspiração intrabrônquica de corpos estranhos em crianças.

Análisis numérico de una prótesis endobronquial utilizada para el tratamiento de cáncer pulmonar / Numerical analysis of intrabronchial prosthesis used for the treatment of lung cancer

En México, la mortalidad debido a enfermedades bronco-respiratorias se ubica en el sexto lugar según datos estadísticos dados por el Instituto Nacional de Enfermedades Respiratorias (INER). Esto genera la necesidad de incrementar la eficiencia en la aplicación de los tratamientos usados para este tipo de patología. Algunos de los métodos utilizados con mayor frecuencia para el tratamiento de estas dolencias hacen uso de micro dispositivos, también conocidos como válvulas endobronquiales. Este es un sistema alternativo que evita cirugías invasivas y logra prolongar e incrementar la calidad de vida de los pacientes. En este trabajo se presenta el análisis del desempeño de la válvula IBV®. Para el desarrollo del estudio numérico se determinaron las dimensiones y propiedades mecánicas del modelo a partir de catálogos del fabricante. Se desarrolló un modelo para el cual se consideraron las propiedades del Nitinol® y Silastic®. Asimismo, se propusieron dos condiciones de operación para la válvula, una anclada en el bronquio y la otra en la condición en la que se encuentra plegada dentro del broncoscopio. Se utilizó el Método del elemento finito (MEF) para simular las condiciones de trabajo de la válvula. Los resultados encontrados muestran el funcionamiento estructural y el nivel de los esfuerzos generados en el implante durante el ciclo de respiración forzada del individuo. Además, se proporcionan las bases para generar un nuevo dispositivo que pueda emular el funcionamiento de este tipo de implantes y aumente la eficiencia del tratamiento de dicha patología.

In Mexico, the mortality rate due to bronchial respiratory sickness is placed in the sixth position, according to statistics from the National Institute of Breathing Sickness (INER), so it is convenient to increment the efficiency of treatments for those pathologies. The intrabronchial valve is a recommended alternative method; being it main objective to avoid invasive surgery and increase the time and quality of patient´s life. Within this work a biomechanical analysis of an IBV® valve is carried out. Regarding the numerical analysis, the dimensions and mechanical properties of the valve were proposed based on catalogues published by the manufacturer as more reliable information was not available in the open literature. As a result, a new model was developed in which both materials Nitinol® and Silastic® are considered as the main valve materials. The proposed working conditions assume that the valve is implanted in folded form at the bronchus and then anchored when it is unfolded. Finite Element Method (FEM) was used to simulate the proposed working conditions. Results obtained show the structural performance and the level of stress generated in the implant during the breathing cycle. In addition, it provides the knowledge to generate a new device that could emulate the performance of these implants and develop a more efficient treatment this disease.

Spectrum of intrabronchial mass lesions and role of flexible bronchoscopy in their diagnosis: A series of 74 cases.

Background. Variety of benign and malignant lesions of respiratory system presents as intrabronchial mass lesions. Present study was carried out to study the spectrum of intrabronchial lesions and role of flexible flexible bronchoscopy in their diagnosis. Methods. Retrospective study of case-records of patients with intrabronchial mass lesions diagnosed by flexible bronchoscopy, bronchial washings and bronchial biopsy between January 2004 and June 2006. Results. Out of the 696 flexible bronchoscopies done during the study period, intrabronchial mass lesions were evident in 74 patients (10.6%) (age range 21-86 years; 60 males). Fifty (68%) lesions were malignant, eighteen (24%) lesions were benign while six (8%) lesions were inconclusive. Diagnostic yield was about 92%; repeat bronchoscopy for inconclusive results improved the diagnostic yield. Conclusions. Though malignant lesions are common, benign lesions remain important causes of intrabronchial mass lesions. Bronchoscopy with adequate sampling is an essential diagnostic modality for confirming the diagnosis of such lesions.

Two cases of intrabronchial neurilemmoma / 결핵

Neurilemmoma is rare benign tumor originating from the Schwann cell of the nerve sheath. Intrabronchial neurilemmoma are extremely rare and only few cases have been reported previously in Korea. Neurilemmoma at all ages but are most common in persons between the ages of 20 and 50 years. It affects the head, neck, flexor regions of the extremities. Neurilemmoma was confirmed histologically because of the presence of Verocay bodies, Antoni A or B tissue pattern and of S-100 protein. We report two cases of intrabronchial neurilemmoma with chronic coughing and nonspecific radiologic findings.

Study on formation of biofilm in bronchi of old patients during application of mechanic air / 医疗卫生装备

Objective To investigate the status of biological membrane(biofilm) formation in the bronchi of old patients treated with mechanical air,and clarify its correlations and risk factors.Methods The retaining time in 25 bronchi from 22 cases of old patients and the results of bacterial culture were analyzed.Results Bacteria culture-positive samples are 22 cases isolated from 25 endotrached tube,accounting for 88%.Negative samples are 3 cases,accounting for 12%.Conclusion The density of bacteria is corresponding to the time of tubing in the bronchi.With the extension of tubing time,the quantity of bacteria is greatly increased.