Complicaciones de traqueotomías asociadas a intubaciones prolongadas. Revisión sistemática / Tracheostomy complications associated with prolonged intubation. Systematic review / Complicações da traqueostomia associadas à entubação prolongada. Revisão sistemática

Objetivo: Determinar las complicaciones detalladas de traqueotomías asociadas a intuba-ciones prolongadas en el adulto. Metodología: Revisión sistemática de los 5 años anteriores con base en los lineamientos PRISMA. Se recurrió a las bases de datos Scopus, Web of Sci-ence, Taylor and Francis y el Portal Regional de la Biblioteca Virtual en Salud. Además, se seleccionó la información a través de palabras clave, tales como: traqueotomía, intubación prolongada, UCI, adulto, complicaciones. Las publicaciones estaban en idioma español e inglés. La información se catalogó según criterios de inclusión y exclusión. Análisis: 24 artículos fueron elegidos. El momento de la traqueotomía (TQ) por intubación prolongada sigue siendo incierto. La TQ temprana demostró mayores beneficios que la TQ tardía. La TQ percutánea demostró menores tasas de estancia en la UCI y en los hospitales, con menos com-plicaciones. La hemorragia y la desaturación fueron complicaciones registradas asociadas a TQ tardía. Conclusión: La TQ percutánea fue la que se eligió en la mayoría de casos por ser eficaz, rápida y segura; además, disminuye la estancia hospitalaria y en la UCI, con menos complicaciones. Se debe precisar que en la mayoría de las publicaciones, al menos uno de estos beneficios no alcanzó significancia estadística. La complicación con mayor frecuencia fue la hemorragia en el sitio de punción

Objective: To determine the detailed complications of tracheotomies associated with pro-longed intubation in adults. Methodology: Systematic review of the previous 5 years based on PRISMA guidelines. The databases Scopus, Web of Science, Taylor and Francis and the Regional Portal of the Virtual Health Library were used to select information through key-words tracheotomy, prolonged intubation, ICU, adult, complications; the publications were in Spanish and English. The information was catalogued according to inclusion and exclusion criteria. Analysis: 24 articles were selected. The timing of tracheostomy (TQ) for prolonged intubation remains uncertain. Early TQ showed greater benefits than late TQ. Percutane-ous TQ demonstrated lower rates of ICU stay, hospital stay, and complications. Hemorrhage and desaturation were mostly reported complications associated with late TQ. Conclusion: Percutaneous TQ was the TQ of choice in most cases because it is effective, fast and safe, decreases hospital stay, ICU and complication rate, most publications at least one of these benefits did not reach statistical significance. The most frequent complication was bleeding at the puncture site

Objetivo: Determinar as complicações detalhadas da traqueostomia associadas à entubação prolongada em adultos. Metodologia: Revisão sistemática dos 5 anos anteriores com base nas diretrizes do PRISMA. As bases de dados Scopus, Web of Science, Taylor e Francis e o Portal Regional da Biblioteca Virtual em Saúde foram usadas para selecionar informações usando palavras-chave traqueostomia, intubação prolongada, UTI, adulto, complicações; as publicações foram em espanhol e inglês. As informações foram catalogadas de acordo com critérios de inclusão e exclusão. Análise: 24 artigos foram selecionados. O momento da traqueostomia (TQ) para entubação prolongada permanece incerto. O TQ precoce demon-strou maior benefício do que o TQ tardio. A TQ percutânea demonstrou taxas mais baixas de internação na UTI, internação hospitalar e complicações. A hemorragia e a dessaturação foram as complicações mais comumente relatadas associadas à TQ tardia. Conclusão: O TQ percutâneo foi o TQ de escolha na maioria dos casos, pois é eficaz, rápido e seguro, diminui a permanência hospitalar, a UTI e a taxa de complicações, a maioria das publicações pelo menos um desses benefícios não alcançou significância estatística. A complicação mais fre-qüente era o sangramento no local da punção

Spray-drying encapsulation of microwave-assisted extracted polyphenols from Moringa oleifera: Influence of tragacanth, locust bean, and carboxymethyl-cellulose formulations.

In this work, polyphenols from Moringa oleifera (Mor) leaves were extracted by microwave-assisted extraction (MAE) and encapsulated by spray-drying (SD). Particularly, we explored the influence of tragacanth gum (TG), locust bean gum (LBG), and carboxymethyl-cellulose (CMC) as wall-materials on the physicochemical behavior of encapsulated Mor. Single or combined wall-material treatments (100:00 and 50:50 ratios, and total solid content 1%) were tested. The results showed the wall-material had a significant effect on the process yield (55.7-68.3%), encapsulation efficiency (24.28-35.74%), color (yellow or pale-yellow), total phenolic content (25.17-27.49 mg GAE g-1 of particles), total flavonoid content (23.20-26.87 mg QE g-1 of particles), antioxidant activity (DPPH• = 5.96-6.95 mg GAE g-1; ABTS•+ = 5.61-6.18 mg TE g-1 of particles), and particle size distribution (D50 = 112-1946 nm) of the encapsulated Mor. On the other hand, SEM analysis showed smooth and spherical particles, while TGA and DSC analyses confirmed the encapsulation of bioactive compounds based on the changes in thermal peaks. Finally, XRD analysis showed that the particles have an amorphous behavior. The encapsulated Mor produced with individual TG or CMC demonstrated better properties than those obtained from mixed gums. Thus, TG or CMC might be feasible wall materials for manufacturing encapsulated Mor that conserve the phenolic content and antioxidant activity.

A Study on exfoliation of Expanded Graphite Stacks in Candelilla Wax.

A novel, green route for pre-exfoliation of graphite based on a biodegradable polymer and high-power ultrasound is presented. Candelilla wax (CW), derived from the leaves of the candelilla plant, has been used for the first time as a natural non aqueous medium to induce the pre-exfoliation of expanded graphite (EG) under ultrasonic irradiation in an economical way. The proposed method uses also D-limonene as a natural organic solvent for reducing viscosity and increasing the affinity between the polar groups of EG and candelilla wax, thus improving the intercalation/exfoliation of EG. The quality of dispersion of the nanofiller in the natural wax matrix has been evaluated using multiple techniques. The addition of EG to wax and use of ultrasonic treatment leads to a reduced crystallinity, probably due to restrictions of the molecular movements, improved thermal stability of wax, and to an increased shear thinning exponent, which are all indicative of a high degree of EG dispersion. The ultrasonic dynamic mechanical results suggest a reduction in the cluster size and a better filler dispersion in the wax matrix promoted by polar or chemical reactions between the CW fractions and the graphite stacks, which was observed by XPS analysis. The results were compared to those obtained with paraffin, a synthetic wax, and confirmed the dispersion improvement obtained by using natural wax as a pre-exfoliating medium.