ABSTRACT
Ankylosing spondylitis (AS) is a common form of axial spondyloarthritis, characterized by inflammatory back pain, radiographic sacroiliitis, excess spinal bone formation, and a high prevalence of HLA-B27. Commonly, AS patients require spinal surgery for kyphotic deformities, spinal trauma, and spinal infections. For preoperative management, proper interruption considering each specific half-lives of disease-modifying antirheumatic drugs are necessary to avoid complications, such as infections. When feasible, bone quality assessment before surgery is mandatory. For intraoperative measurements, airway management should be carefully evaluated, especially in patients with severe cervical deformities. Cardiac, renal, and pulmonary assessment should be made considering specific pathologic characteristics involved in AS patients, such as pulmonary restrictive disease and chronic anti-inflammatory drugs use. Multimodal neurophysiological intraoperative monitoring is recommended once these patients had a high risk for neurological deterioration. At the postoperative period, early oral intake, early mobilization, and aggressive pain control may decrease complications and enhance recovery. AS presents several unique challenges that require specific attention around spine surgery. This includes handling preoperative and postoperative pharmacotherapeutics, intraoperative airway management, and the mitigation of postoperative complications. In this paper, we provide a literature review of optimal strategies for the perioperative management for patients with AS.
Subject(s)
Kyphosis , Spondylitis, Ankylosing , Humans , Spondylitis, Ankylosing/surgery , Spondylitis, Ankylosing/complications , Magnetic Resonance Imaging , Spine , Pain , Kyphosis/complicationsABSTRACT
Objective: To analyze the body heat dissipation by thermography during indoor running treadmill with different airflowconditions.Materials and method: Nine male participants (23.0±2.5 years old) underwent three 45-minute moderate-intensity runningsessions (60-70% reserve heart rate) on a treadmill. At each session, a different experimental condition was applied in a cros-sover design: without airflow (NF), and with low (LF) and high airflow (HF) generated by a fun. Thermograms were obtainedwith a thermal camera before exercise, during (every 10 minutes), and after exercise. Skin temperature (Tsk) was measuredon regions of interest of the upper body: pectoral, brachial biceps, and upper back. A repeated measures ANOVA was usedto compare Tsk over time and between conditions, considering p<0.05 as statistically significant.Results: In pectoral and brachial biceps, LF and HF conditions provided greater reductions in Tsk at all moments when com-pared to the NF (p<0.05). There was a higher reduction in Tsk to the HF vs LF in biceps at 30, 40, and 45 min during exercise(p<0.05). In the upper back, Tsk remained below baseline at all moments during exercise only in the HF condition (p<0.05).In NF and LF conditions, Tsk returned to baseline at 30 min during exercise (p>0.05).Conclusion: The frontal wind flow enhances body heat dissipation during moderate-intensity running in the pectoral, brachialbiceps, and upper back, with a direct relationship of flow speed and Tsk reduction during exercise.(AU)
Objetivo: Analizar el disipación del calor corporal mediante termografía en ejercicio de carrera en tapiz con diferentescondiciones de flujo de aire.Material y método: Nueve hombres (23,0±2,5 años) se sometieron a tres sesiones de 45 minutos de carrera de intensidadmoderada (60-70% frecuencia cardíaca de reserva) en tapiz, bajo tres condiciones diferentes en un diseño cruzado: sin flujo deaire (NF) y con flujo de aire bajo (LF) y alto (HF) generado por un ventilador. Los termogramas se obtuvieron con una cámaratérmica antes del ejercicio, durante y después del ejercicio, midiéndose la temperatura de la piel (Tp) en las regiones de interésdel pectorales, bíceps braquiales y parte superior de la espalda. Se utilizó un ANOVA de medidas repetidas para comparar Tpen función del tiempo y entre condiciones, considerando p<0,05 como estadísticamente significativo.Resultados: En los pectorales y bíceps braquiales, las condiciones LF y HF redujeron en todo momento la Tp comparadas conNF (p<0,05). La reducción de Tp fue mayor con HF que con LF en bíceps a los 30, 40 y 45 min (p<0,05). En la espalda superior,la Tp se mantuvo siempre por debajo de la línea base durante el ejercicio solo en la condición HF (p<0,05). En condicionesde NF y LF la Tp volvió a valores de referencia a los 30 min de ejercicio (p>0,05).Conclusiones: El flujo de viento frontal mejora la disipación del calor corporal en pectorales, bíceps braquiales y parte superiorde la espalda durante la carrera de intensidad moderada, con una relación directa de la velocidad del flujo y la reducción dela Tp durante el ejercicio.(AU)
Subject(s)
Humans , Male , Adult , 51570 , Cool-Down Exercise , Body Temperature , Thermography , Running , Sports Medicine , Breathing ExercisesABSTRACT
Cyclic lipopeptides (CLPs) are non-ribosomal biosurfactants produced by Bacillus species that exhibit outstanding interfacial activity. The synthesis of CLPs is under genetic and environmental influence, and representatives from different families are generally co-produced, generating isoforms that differ in chemical structure and biological activities. This study to evaluate the effect of low and high NaCl concentrations on the composition and surface activity of CLPs produced by Bacillus strains TIM27, TIM49, TIM68, and ICA13 towards microbial enhanced oil recovery (MEOR). The strains were evaluated in mineral medium containing NaCl 2.7, 66, or 100 g L-1 and growth, surface tension and emulsification activity were monitored. Based on the analysis of 16S rDNA, gyrB and rpoB sequences TIM27 and TIM49 were assigned to Bacillus subtilis, TIM68 to Bacillus vallismortis, and ICA13 to Bacillus amyloliquefaciens. All strains tolerated up to 100-g L-1 NaCl, but only TIM49 and TIM68 were able to reduce surface tension at this concentration. TIM49 also showed emulsification activity at concentrations up to 66-g L-1 NaCl. ESI-MS analysis showed that the strains produced a mixture of CLPs, which presented distinct CLP profiles at low and high NaCl concentrations. High NaCl concentration favored the synthesis of surfactins and/or fengycins that correlated with the surface activities of TIM49 and TIM68, whereas low concentration favored the synthesis of iturins. Taken together, these findings suggest that the determination of CLP signatures under the expected condition of oil reservoirs can be useful in the guidance for choosing well-suited strains to MEOR.
