Interface Healing Between Adjacent Tracks in Fused Filament Fabrication Using In-Process Laser Heating.

Fused filament fabrication is one of the most desired thermal plastic additive manufacturing processes because of its ability to fabricate complex objects with high accessibility. However, due to the extrusion track-based direct write process mechanism, parts built using this method exhibit anisotropic mechanical properties. In this work, an in-process laser heating method is introduced to heal interface adhesion between adjacent deposited tracks by increasing the interface temperature to promote polymer reptation and enhance bonding strength of the interface of adjacent tracks. With the use of laser heating induced interface healing, the measured flexural strength between adjacent tracks in the same layer increased and exceeded that of the control sample tested along the track direction. The effect of laser on interface healing was also verified by investigating the load-displacement curve and morphology analysis of the fractured surface.

Experiencias de las brigadas del Contingente Henry Reeve en Ciudad de México, 2021 / Experiences of the Henry Reeve Contingent ́s Brigades in Mexico City, 2021

Durante el enfrentamiento a la pandemia de COVID-19, más de 40 países recibieron la ayuda solidaria de Cuba a través de las brigadas del Contingente Henry Reeve, ejemplo de esto fue su participación en México entre diciembre 2020 y abril de 2021. Con el objetivo de exponer las experiencias de las brigadas médicas cubanas del Contingente Henry Reeve durante el enfrentamiento de la epidemia de la COVID-19 en la Ciudad de México desde diciembre de 2020 hasta abril de 2021, se relatan algunos desafíos enfrentados por el equipo de cooperación médica internacional cubano durante tres meses de intensa labor que gracias, además, a la estrecha colaboración de las autoridades sanitarias y sociales, la Secretaría de Defensa, y la Secretaría de Marina mexicanas les permitió aumentar sus conocimientos sobre bioseguridad y de enfrentamiento a situaciones de graves epidemias en hospitales de campaña. Así alcanzó una eficiente respuesta con 1700 vidas salvadas. La labor desempeñada por las brigadas sanitarias cubanas junto al personal de salud mexicano permitió brindar atención de calidad a los enfermos de COVID-19 y fortalecer los lazos de hermandad entre ambos pueblos(AU)

During the confrontation to the COVID-19 pandemic, more than 40 countries received solidarity aid from Cuba through the brigades of the Henry Reeve Contingent, and an example of this was their presence in Mexico from December 2020 to April 2021. With the objective of showing the experiences of the Cuban medical brigades of the Henry Reeve Contingent during the confrontation of COVID-19 epidemic in Mexico City from December 2020 to April 2021, some challenges faced by the Cuban international medical cooperation team during 3 months of intense work are reported thanks to, in addition, the close collaboration of the health and social authorities, the Ministry of Defense, and the Mexican Ministry of the Navy, that allowed health workers to increase their knowledge about biosecurity and dealing with situations of serious epidemics in field hospitals. Thus, the efforts reached an efficient response with 1700 lives saved. The work carried out by the Cuban health brigades together with Mexican health personnel allowed to provide quality care to those sick with COVID-19 and strengthen the bonds of brotherhood between both peoples(AU)

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services.

BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

Complications and hospital admission in the following 90 days after lung cryobiopsy performed in interstitial lung disease.

Transbronchial lung cryobiopsy (TBLC) is an emerging technique for the diagnosis of interstitial lung disease (ILD), but its risk benefit ratio has been questioned. The objectives of this research were to describe any adverse events that occur within 90 days following TBLC and to identify clinical predictors that could help to detect the population at risk. METHODS: We conducted an ambispective study including all patients with suspected ILD who underwent TBLC. Data were collected concerning the safety profile of this procedure and compared to various clinical variables. RESULTS: Overall, 257 TBLCs were analysed. Complications were observed in 15.2% of patients; nonetheless, only 5.4% of all patients required hospital admission on the day of the procedure. In the 30 and 90 days following the TBLC, rates of readmission were 1.3% and 3.5% and of mortality were 0.38%, and 0.78% respectively. Two models were built to predict early admission (AUC 0.72; 95% CI 0.59-0.84) and overall admission (AUC 0.76; 95% CI 0.67-0.85). CONCLUSIONS: Within 90 days after TBLC, 8.9% of patients suffered a complication serious enough to warrant hospital admission. Modified MRC dyspnoea score ≥2, FVC<50%, and a Charlson Comorbidity Index score ≥2 were factors that predicted early and overall admission.

Effect of Ultrasonic Vibration on Interlayer Adhesion in Fused Filament Fabrication 3D Printed ABS.

One of the fundamental issues in the Fused Filament Fabrication (FFF) additive manufacturing process lies in the mechanical property anisotropy where the strength of the FFF-3D printed part in the build-direction can be significantly lower than that in other directions. The physical phenomenon that governs this issue is the coupled effect of macroscopic thermal mechanical issues associated with the thermal history of the interface, and the microscopic effect of the polymer microstructure and mass transfer across interfaces. In this study it was found that the use of 34.4 kHz ultrasonic vibrations during FFF-3D printing results in an increase of up to 10% in the interlayer adhesion in Acrylonitrile Butadiene Styrene (ABS), comparing the printing in identical thermal conditions to that in conventional FFF printing. This increase in the interlayer adhesion strength is attributed to the increase in polymer reptation due to ultrasonic vibration-induced relaxation of the polymer chains from secondary interactions in the interface regions.

Usefulness of an angioplasty balloon as selective bronchial blockade device after transbronchial cryobiopsy.

BACKGROUND AND OBJECTIVE: Transbronchial cryobiopsy (TBCB) is a technique in which frozen samples of lung are obtained using a probe inserted through a bronchoscope. We performed a retrospective study to assess the performance of the TBCB procedure complemented by segmental bronchial blockade using an angioplasty balloon, in terms of diagnostic yield and safety in diffuse parenchymal lung disease (DPLD). METHODS: Data from 100 patients with suspected DPLD (clinical and radiological findings), who underwent TBCB in our institution to establish a definitive diagnosis, were reviewed. In our institution, TBCB is monitored with fluoroscopy and performed under general anaesthesia by a multidisciplinary team (an anaesthesiologist, a pulmonologist and an interventional radiologist). In each patient, four samples were collected using a 2.4-mm distal diameter cryoprobe. To control bleeding, the biopsied segmental bronchus was blocked with a 6-mm diameter angioplasty balloon, inserted over a 0.035-inch angled hydrophilic guidewire. After the cryoextraction, the balloon was inflated for 3 min intervals until bleeding stopped. RESULTS: Overall, 98% of samples had diagnostic value. In 85% of cases, DPLD was confirmed, while in 7%, cancer was diagnosed. Complications were observed in 16% of the patients: 13 patients developed moderate haemorrhage, and 3 developed pneumothorax. CONCLUSION: Transbronchial cryobiopsy had a high diagnostic yield for DPLD. Performing the procedure under fluoroscopy guidance and using angioplasty balloon for selective bronchial blockade achieved a low rate of iatrogenic complications directly associated with the technique.

Histiocitosis X, diagnóstico por criobiopsia: a propósito de un caso / Histiocytosis X diagnosis by cryobiopsy: a case report

La Histiocitosis de células de Langerhans (HPCL) es una enfermedad de etiología incierta, que puede manifestarse como enfermedad sistémica o enfermedad localizada. Su forma de presentación limitada a pulmón, se denomina Histiocitosis X. Su incidencia es desconocida, siendo >90% de los casos fumadores, entre 20-40 años, y más frecuente en mujeres. El tabaco juega un papel fundamental en el desarrollo de la enfermedad, sin estar claro el mecanismo fisiopatológico. La presentación clínica de la enfermedad pulmonar es variable, desde síntomas larvados de tos, disnea dolor torácico, sudoración o pérdida de peso, a neumotórax en un 15%. El diagnóstico se basa en Pruebas de imagen (TACAR), Pruebas respiratorias, Histológicas e munohistoquímicas. Su confirmación histológica se realiza mediante biopsia transbronquial, en nuestro caso criobiopsia pulmonar, aumentando así el rendimiento diagnóstico y evitando complicaciones. El abandono del tabaco, evita la progresión de la enfermedad e incluso logra su regresión (AU)

Pulmonary Langerhans cell histiocytosis(PLCH) is a disease of uncertain etiology, which manifest itself either as a Systemic or a localized disease. When confined to the lungs, it is known as Histiocytosis X. Although the exact incidence rate in unknown, more than 90% of cases are smokers of between 20 and 40 years old, most commonly women. Smoking plays a major role in the development of the disease, though the physiopathological mechanisms remain unclear. The clinical presentation of the disease varies from a non-specific cough, dyspnea, thoracic pain, weight loss, and pneumothorax. The diagnosis is based on high-resolution CT, respiratory, histological and immunohistochemistry tests. Histological confirmation is achieved via transbronchial biopsy, in our case lung criobiopsy, which increases the diagnostic yield and avoids complications. Smoking cessationprevents progression of the disease and can even lead to its regression (AU)

Sarcoid intermediate uveitis following etanercept treatment: a case report and review of the literature.

PURPOSE: To describe a case of sarcoid uveitis subsequent to anti-TNFα therapy and review previously reported cases. METHODS: Review of the clinical records of the authors' patient and of the literature using the PubMed database. RESULTS: A 30-year-old woman presented with intermediate uveitis with snowballs in both eyes. She was on treatment with etanercept due to psoriatic arthritis. An ultrasound-guided biopsy of a mediastinal adenopathy showed non-necrotizing granulomas compatible with sarcoidosis. The clinical picture resolved after etanercept was withdrawn and treatment with immunosuppressants. In a literature search the authors identified six other cases of sarcoid uveitis induced by anti-TNFα therapy. The types of uveitis were anterior uveitis, posterior uveitis, or panuveitis. Management consisted of withdrawal of anti-TNFα therapy and administration of immunosuppressive agents in 5 cases. CONCLUSIONS: Sarcoid uveitis induced by TNFα antagonists is a rare complication. Appropriate management consists of withdrawing the TNFα antagonist and giving immunosuppressants.

Complicaciones y evaluación terapéutica de la meningoencefalitis bacteriana / Complications and therapeutic assessment of the bacterial meningoencephalitis

Se realizó un estudio descriptivo, longitudinal y prospectivo a los pacientes con el diagnóstico de meningoencefalitis bacteriana en el Hospital General Docente Abel Santamaría de Pinar del Río, durante 2 años. Se pesquisaron las complicaciones, los exámenes paraclínicos, el tratamiento y respuesta al mismo. Se aplicaron las pruebas para la comparación de proporciones de un mismo grupo, test para la comparación de proporciones de grupos independientes y técnicas estadísticas descriptivas para la estimación porcentual de parámetros. Se encontraron el mayor número de casos en el grupo de edades entre 30 y 59 años, seguido del grupo entre 60 y 79 años. Las convulsiones y el edema cerebral fueron las complicaciones neurológicas más frecuentes mientras que la neumonía fue la complicación sistémica más frecuente. La tinción de Gram del líquido cefalorraquídeo identificó diplococos Gram positivos mayoritariamente y su cultivo constató que el Streptococcus pneumoniae fue el germen más periódico. Las cefalosporinas de tercera generación siguen siendo los medicamentos de elección para iniciar tratamiento empírico de las meningoencefalitis bacteriana extrahospitalarias.

A descriptive, longitudinal and prospective study was conducted with patients suffering from bacterial meningoencephalitis at "Abel Santamaria Cuadrado" University Hospital, Pinar del Rio during two years. Complications, paraclinical examinations, treatment and response were screened and tests were applied to assess the comparison of proportions to the same group, independent groups and descriptive statistical techniques to estimate the percentage of the parameters. The majority of the cases were found in the age-bracket between 30-59 years old, followed by the group of ages from 60 to 79. The seizures and brain edema were the most usual neurological complications while pneumonia was the most frequent systemic complication. Finding in the stain of the spinal fluid a Gram-positive diplococcus and in the culture a Streptococcus pneumoniae was verified as the most periodic germen. Cephalosporin of third generation is still the elective medications to start the empiric treatment of the extrahospital bacterial meningoencephalitis.

Complicaciones y evaluación terapéutica de la meningoencefalitis bacteriana / Complications and therapeutic assessment of the bacterial meningoencephalitis

Se realizó un estudio descriptivo, longitudinal y prospectivo a los pacientes con el diagnóstico de meningoencefalitis bacteriana en el Hospital General Docente Abel Santamaría de Pinar del Río, durante 2 años. Se pesquisaron las complicaciones, los exámenes paraclínicos, el tratamiento y respuesta al mismo. Se aplicaron las pruebas para la comparación de proporciones de un mismo grupo, test para la comparación de proporciones de grupos independientes y técnicas estadísticas descriptivas para la estimación porcentual de parámetros. Se encontraron el mayor número de casos en el grupo de edades entre 30 y 59 años, seguido del grupo entre 60 y 79 años. Las convulsiones y el edema cerebral fueron las complicaciones neurológicas más frecuentes mientras que la neumonía fue la complicación sistémica más frecuente. La tinción de Gram del líquido cefalorraquídeo identificó diplococos Gram positivos mayoritariamente y su cultivo constató que el Streptococcus pneumoniae fue el germen más periódico. Las cefalosporinas de tercera generación siguen siendo los medicamentos de elección para iniciar tratamiento empírico de las meningoencefalitis bacteriana extrahospitalarias...(AU)

A descriptive, longitudinal and prospective study was conducted with patients suffering from bacterial meningoencephalitis at Abel Santamaria Cuadrado University Hospital, Pinar del Rio during two years. Complications, paraclinical examinations, treatment and response were screened and tests were applied to assess the comparison of proportions to the same group, independent groups and descriptive statistical techniques to estimate the percentage of the parameters. The majority of the cases were found in the age-bracket between 30-59 years old, followed by the group of ages from 60 to 79. The seizures and brain edema were the most usual neurological complications while pneumonia was the most frequent systemic complication. Finding in the stain of the spinal fluid a Gram-positive diplococcus and in the culture a Streptococcus pneumoniae was verified as the most periodic germen. Cephalosporin of third generation is still the elective medications to start the empiric treatment of the extrahospital bacterial meningoencephalitis...(AU)

Impact of hospitalisations for exacerbations of COPD on health-related quality of life.

Exacerbations of chronic obstructive pulmonary disease (COPD) impair health-related quality of life (HRQoL). It is unknown whether exacerbations requiring hospitalisation have an impact on HRQoL. 611 ambulatory COPD patients were prospectively identified. The average age (SD) was 65.5 (8.6), FEV(1) (SD) was 52% (14%) of the predicted value. All patients completed the Saint George's Respiratory Questionnaire (SGRQ) and the Medical Outcomes Study Short Form (SF-36) questionnaire at the beginning of the study. After five years of follow-up, the 391 survivors again completed these HRQoL instruments. No changes in HRQoL were observed among patients not hospitalised for COPD exacerbations. Those hospitalised during follow-up experienced significant declines in HRQoL. The largest changes were observed among patients with >or=3 hospitalisations, with a 13.6 unit increase in the total SGRQ and a 10.5 unit decrease in the physical component summary scale of the SF-36. Similar changes were observed among patients with FEV(1)>or=50% at baseline. In the multivariate analysis, after adjustment by FEV(1%), age, comorbidities, and HRQoL in the respective HRQoL domain at baseline, hospitalisations were an independent predictor of the change in HRQoL. Hospitalisations for exacerbations of COPD have an independent and negative impact on the evolution of HRQoL, regardless of COPD severity.

Predictors of mortality in patients with stable COPD.

OBJECTIVES: To determine which easily available clinical factors are associated with mortality in patients with stable COPD and if health-related quality of life (HRQoL) provides additional information. DESIGN: Five-year prospective cohort study. SETTING: Five outpatient clinics of a teaching hospital. PARTICIPANTS: Six hundred stable COPD patients recruited consecutively. MEASUREMENTS: The variables were age, FEV(1%), dyspnea, previous hospital admissions and emergency department visits for COPD, pack-years of smoking, comorbidities, body mass index, and HRQoL measured by Saint George's Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire (CRQ), and Short-Form 36 (SF-36). Logistic and Cox regression models were used to assess the influence of these variables on mortality and survival. RESULTS: FEV(1%)(OR: 0.62, 95% CI 0.5 to 0.75), dyspnea (OR 1.92, 95% CI 1.2 to 3), age (OR 2.41, 95% CI 1.6 to 3.6), previous hospitalization due to COPD exacerbations (OR 1.53, 1.2 to 2) and lifetime pack-years (OR 1.15, 95% CI 1.1 to 1.2) were independently related to respiratory mortality. Similarly, these factors were independently related to all-cause mortality with dyspnea having the strongest association (OR 1.54, 95% CI 1.1 to 2.2). HRQoL was an independent predictor of respiratory and all-cause mortality only when dyspnea was excluded from the models, except scores on the SGRQ were associated with all-cause mortality with dyspnea in the model. CONCLUSIONS: Among patients with stable COPD, FEV(1%) was the main predictor of respiratory mortality and dyspnea of all-cause mortality. In general, HRQoL was not related to mortality when dyspnea was taken into account, and CRQ and SGRQ behaved in similar ways regarding mortality.

Desarrollo tecnológico y estudio de estabilidad del citrato de fentanilo 0, 05 mg/mL / Technological development and stability study of fentanyl citrate 0.05 mg/mL

El citrato de fentanilo es un potente analgésico opiácico, análogo sintético de la morfina, que se emplea ampliamente como anestésico narcótico en cirugía durante la premedicación y mantenimiento de la anestesia, y el período posoperatorio. Se desarrolló una formulación de citrato de fentanilo para administración por vía parenteral. Se obtuvo un medicamento que cumple con todos los requisitos de calidad exigidos y tiene un tiempo de vida útil de 2 años, a temperatura ambiente, que mantiene invariables sus características físicas, químicas y microbiológicas

Desarrollo tecnológico y estudio de estabilidad del citrato de fentanilo 0, 05 mg/mL / Technological development and stability study of fentanyl citrate 0.05 mg/mL

El citrato de fentanilo es un potente analgésico opiácico, análogo sintético de la morfina, que se emplea ampliamente como anestésico narcótico en cirugía durante la premedicación y mantenimiento de la anestesia, y el período posoperatorio. Se desarrolló una formulación de citrato de fentanilo para administración por vía parenteral. Se obtuvo un medicamento que cumple con todos los requisitos de calidad exigidos y tiene un tiempo de vida útil de 2 años, a temperatura ambiente, que mantiene invariables sus características físicas, químicas y microbiológicas(AU)

Desarrollo tecnológico de lidocaína al 2 por ciento -epinefrina 1: 50 000 cartuchos dentales / Technological development of lidocaine to 2 percent-epinephine on dental cases

Se diseñó una formulación anestésica para uso estomatológico compuesta por lidocaína 2 por ciento y epinefrina 1:50 000 envasada en cartuchos. Se desarrollaron y validaron 2 técnicas analíticas por cromatografía líquida de alta resolución (CLAR) para estudiar la estabilidad de la formulación y determinar su fecha de vencimiento. Se comprobó la calidad microbiológica de la preparación, y se logró un producto que cumple satisfactoriamente con todas las especificaciones establecidas para preparaciones estériles. La tecnología obtenida fue fácilmente escalable, lo cual ha dado la posibilidad de producir los cartuchos dentales con buenos resultados(AU)