RESUMO
AIMS: To evaluate the feasibility of a transthoracic echocardiogram using an apical-subcostal protocol in invasive mechanical ventilation (IMV) and prone position. METHODS: Prospective study of adults who required a prone position during IMV. A pillow was placed only under the left hemithorax in the prone position to elevate and ease the apical and subcostal windows. A critical care cardiologist (prone group) acquired and evaluated the images using the apical-subcostal protocol. Besides, we used ambulatory echocardiograms performed as a comparative group (supine group). RESULTS: 86 patients were included, 43 in the prone and 43 in the supine. In the prone group, the indication to perform an echocardiogram was hemodynamic monitoring. All patients were ventilated with protective parameters, and the mean end-expiratory pressure was 10.6 cmH2O. The protocol was performed entirely in 42 of 43 patients in the prone group because one patient did not have any acoustic window. In the 43 patients in the prone group analyzed and compared to the supine group, global biventricular function was assessed in 97.7% (p = 1.0), severe heart valve disease in 88.4% (p = 0.055), ruled out of the presence of pulmonary hypertension in 76.7% (p = 0.80), pericardial effusion in 93% (p = 0.12), and volume status by inferior vena cava in 93% (p = 0.48). Comparing prone versus supine position, a statistical difference was found when evaluating the left ventricle apical 2-chamber view (65.1 versus 100%, p < 0.01) and its segmental function (53.4 versus 100%, p < 0.01). CONCLUSION: The echocardiogram using an apical-subcostal protocol is feasible in patients in the IMV and prone position.
Assuntos
Ecocardiografia , Estudos de Viabilidade , Unidades de Terapia Intensiva , Respiração Artificial , Humanos , Masculino , Decúbito Ventral , Feminino , Estudos Prospectivos , Respiração Artificial/métodos , Ecocardiografia/métodos , Pessoa de Meia-Idade , Posicionamento do Paciente/métodos , IdosoRESUMO
Biocircularity could play a key role in the circular economy, particularly in applications where organic recycling (composting) has the potential to become a preferred waste management option, such as food packaging. The development of fully biobased and biodegradable composites could help reduce plastic waste and valorize agro-based residues. In this study, extruded films made of composites of polyhydroxybutyrate-co-valerate (PHBV) and lignocellulosic fibers, namely almond shell (AS) and Oryzite® (OR), a polymer hybrid composite precursor, have been investigated. Scanning electron microscopy (SEM) analysis revealed a weak fiber-matrix interfacial interaction, although OR composites present a better distribution of the fiber and a virtually lower presence of "pull-out". Thermogravimetric analysis showed that the presence of fibers reduced the onset and maximum degradation temperatures of PHBV, with a greater reduction observed with higher fiber content. The addition of fibers also affected the melting behavior and crystallinity of PHBV, particularly with OR addition, showing a decrease in crystallinity, melting, and crystallization temperatures as fiber content increased. The mechanical behavior of composites varied with fiber type and concentration. While the incorporation of AS results in a reduction in all mechanical parameters, the addition of OR leads to a slight improvement in elongation at break. The addition of fibers improved the thermoformability of PHBV. In the case of AS, the improvement in the processing window was achieved at lower fiber contents, while in the case of OR, the improvement was observed at a fiber content of 20%. Biodisintegration tests showed that the presence of fibers promoted the degradation of the composites, with higher fiber concentrations leading to faster degradation. Indeed, the time of complete biodisintegration was reduced by approximately 30% in the composites with 20% and 30% AS.
RESUMO
La infección odontogénica es una infección polimicrobiana y mixta (aerobios/anaerobios). Comprende diversos cuadros clínicos, cuya importancia deriva de su frecuencia y gravedad potencial. Es el tipo de infección más frecuente en la cavidad bucal y su tratamiento supone hasta el 10% del total de prescripciones de antibióticos. La celulitis facial es una inflamación difusa de los tejidos blandos que no está circunscrita o limitada a una región y tiende a diseminarse. El objetivo de esta revisión es actualizar las consideraciones para la atención del niño con celulitis facial de origen dental y el manejo multidisciplinario entre el odontólogo y el pediatra.
An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria). It comprises various clinical conditions, whose importance varies depending on their frequency and potential severity. It is the most common type of oral infection and its treatment involves up to 10% of all antibiotic prescriptions. Facial cellulitis is a diffuse inflammation of soft tissue that is not confined or limited to a specific region and tends to spread. The objective of this review is to update the aspects considered in the care of children with facial cellulitis of odontogenic origin and the multidisciplinary management between dentists and pediatricians.
Assuntos
Humanos , Criança , Atenção , Criança , Infecção Focal Dentária , CeluliteRESUMO
An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria). It comprises various clinical conditions, whose importance varies depending on their frequency and potential severity. It is the most common type of oral infection and its treatment involves up to 10% of all antibiotic prescriptions. Facial cellulitis is a diffuse inflammation of soft tissue that is not confined or limited to a specific region and tends to spread. The objective of this review is to update the aspects considered in the care of children with facial cellulitis of odontogenic origin and the multidisciplinary management between dentists and pediatricians.
La infección odontogénica es una infección polimicrobiana y mixta (aerobios/anaerobios). Comprende diversos cuadros clínicos, cuya importancia deriva de su frecuencia y gravedad potencial. Es el tipo de infección más frecuente en la cavidad bucal y su tratamiento supone hasta el 10% del total de prescripciones de antibióticos. La celulitis facial es una inflamación difusa de los tejidos blandos que no está circunscrita o limitada a una región y tiende a diseminarse. El objetivo de esta revisión es actualizar las consideraciones para la atención del niño con celulitis facial de origen dental y el manejo multidisciplinario entre el odontólogo y el pediatra.
