38 research outputs found
Nociceptin inhibits airway microvascular leakage induced by HCl intra-oesophageal instillation
No full textEl Mooc una herramienta tic para la resolución del conflicto
No full textCurrently, teachers face many challenges when exercising the profession, among which the new
Mooc regulatory framework is highlighted, which is defined as a tic tool for conflict resolution
and school coexistence. The results indicate as fundamental findings the need to update the
program plans, in the school context where the research was conducted; and as the discussion
groups are a strategy for teachers to make a reflective practice. And in this sense, conclusions are
highlighted for the strengthening of the pedagogical practice in relation to the resolution of
conflicts in the teaching of education, in institutions so as to be able to positively impact the
professional performance of the Teacher as a practice and strategy regarding coexistence of the
students.En la actualidad los docentes se enfrentan a muchos retos al momento de ejercer la profesión, entre
los cuales se destaca el nuevo marco normativo Mooc el cual se define como una herramienta
tic para la resolución de conflictos y convivencia escolar. Los resultados señalan como
hallazgos fundamentales la necesidad de actualizar los planes del programa, en el contexto escolar
donde se realizó la investigación; y como los grupos de discusión son una estrategia para que los
docentes hagan una práctica reflexiva. Y en este sentido se resaltan conclusiones para el
fortalecimiento de la práctica pedagógica en relación a la resolución de conflictos en la
enseñanza de la educación, en instituciones para así poder impactar positivamente el desempeño
profesional del Docente como una práctica y estrategia en cuanto a la convivencia del
alumnado.Rocha Acendra, Gissela JudithRodríguez Terán, Faisy Del Carme
Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients
No full textObjective: Use comparison with indirect calorimetry to confirm the ability of our previously described equation to predict resting energy expenditure in mechanically ventilated patients.Design: Prospective, validation study. Setting: Eighteen-bed, medical intensive care unit at a teaching hospital. Patients: All adult patients intubated >24 hrs were assessed for eligibility. Exclusion criteria were clinical situations that could contribute to erroneous calorimetric measurements. Interventions: Resting energy expenditure was calculated using the original Harris-Benedict equations and those corrected for usual stress factors, the Swinamer equation, the Fusco equation, the Ireton-Jones equation, and our equation: resting energy expenditure (kcal/day) = 8 × weight (kg) + 14 × height (cm) + 32 × minute ventilation (L/min) + 94 × temperature (°C) − 4834. Measurements and Main Results: Resting energy expenditure was measured by indirect calorimetry for the 45 included patients. Resting energy expenditure calculated with our predictive model correlated with the measured resting energy expenditure (r2 = .62, p < .0001), and Bland-Altman analysis showed a mean bias of −192 ± 277 kcal/day, with limits of agreement ranging from −735 to 351 kcal/day. Resting energy expenditure calculated with the Harris-Benedict equations was more weakly correlated with measured resting energy expenditure (r2 = .41, p < .0001), with Bland-Altman analysis showing a mean bias of 279 ± 346 kcal/day between them and the limits of agreement ranging from −399 to 957 kcal/day. Applying usual stress-correction factors to the Harris-Benedict equations generated wide variability, and the correlation with measured resting energy expenditure was poorer (r2 = .18, p < .0001), with Bland-Altman analysis showing a mean bias of −357 ± 750 kcal/day and limits of agreement ranging from −1827 to 1113 kcal/day. The use of the Swinamer, Fusco, or Ireton-Jones predictive methods yielded weaker correlation between calculated and measured resting energy expenditure (r2 = .41, p < .0001; r2 = .38, p < .0001; r2 = .39, p < .0001, respectively) than our equation, and Bland-Altman analysis showed no improvement in agreement and variability between methods. Conclusions: The Faisy equation, based on static (height), less stable (weight), and dynamic biometric variables (temperature and minute ventilation), provided precise and unbiased resting energy expenditure estimations in mechanically ventilated patients
Le système neurosensoriel et l’inflammation bronchique : interaction avec les agonistes des récepteurs β2-adrénergiques
No full textEffects of Acetazolamide on Weaning from Mechanical Ventilation in COPD Patients with Metabolic Alkalosis.
No full textHelium in the adult critical care setting.
No full textInternational audienceABSTRACT: Helium is a low-density inert gas whose physical properties are very different from those of nitrogen and oxygen. Such properties could be clinically useful in the adult critical care setting, especially in patients with upper to more distal airway obstruction requiring moderate to intermediate levels of FiO2. However, despite decades of utilization and reporting, it is still difficult to give any firm clinical recommendation in this setting. Numerous case reports are available in the context of upper airway obstruction of different origins, but there is a lack of controlled studies for this indication. One study reported a helium-induced beneficial effect on surrogates of work of breathing after extubation in non-COPD patients, possibly in relation to laryngeal consequences of tracheal intubation. Physiological benefits of helium-oxygen breathing have been demonstrated in the context of acute severe asthma, but there is a lack of large controlled studies demonstrating an effect on pertinent clinical endpoints, except for a study reported only as an abstract, which mentioned a reduction in the intubation rate in helium-treated patients. Finally, there are a number of physiological studies in the context of COLD-COPD patients demonstrating a beneficial effect, mainly by a reduction in the resistive inspiratory work of breathing but also by a reduction in hyperinflation. Reduction of hypercapnia was mainly observed in spontaneously breathing and noninvasively ventilated helium-treated patients but not in intubated patients during controlled ventilation, suggesting that the decrease in PaCO2 was mainly in relation to a diminution in CO2 production, related to the diminution in work of breathing and not an improved alveolar ventilation. Moreover, there is little evidence that helium-oxygen could improve parameters of heterogeneity in such patients. Two RCTs were unable to demonstrate a reduction in the intubation rate in such setting, but they were likely underpowered. An adequately powered international multicentric study is ongoing and will help to determinate the exact place of the helium-oxygen mixture in the future. The place of the mixture during the weaning period will deserve further evaluation
Energy expenditure in the critically ill performing early physical therapy
No full textPurpose: Resting energy expenditure (REE) determination is of high relevance to avoid both overfeeding and underfeeding. We conducted an observational study to determine the impact of early exercise on energy requirements to adjust caloric intake accordingly in critically ill patients. Methods: This was a prospective observational study conducted in an intensive care unit in 49 hemodynamically stable critically ill patients and 15 healthy volunteers. Indirect calorimetry (IC) was performed for 15 min at baseline during resting conditions, and then continuously recorded during 30 min of cycling at 0, 3, or 6 watts (W), followed by a 15-min resting period. REE determined by IC was compared with predictive formulas and correlated with several biomarkers. The energy cost of early exercise was compared between critically ill patients and healthy volunteers. Results: In patients, REE determined by IC was higher than predicted by Harris-Benedict (29 ± 31 %, p < 0.001) and Fleisch equations (23 ± 31 %, p < 0.001) but lower than predicted by the Faisy-Fagon equation for ventilated patients (16 ± 19 %, p < 0.05). Differences between Harris-Benedict predictions and IC determination were positively correlated with C-reactive protein (CRP) in patients with sepsis (r = 0.51, p = 0.003). During a similar exercise, VO 2 increase in patients was higher when compared with healthy volunteers at 3 W, close to significant at 6 W, and not present in the passive group. Conclusions: The critically ill have increased REE according to inflammation defined by CRP. Increased energy requirement for physical activity was only present for active exercise and seems to differ from that in the healthy population. For the exercise duration and intensity tested, nutritional adjustment is not indicated. © 2014 Springer-Verlag Berlin Heidelberg and ESICM
Gene-expression in complete human bronchi at basal state (H0) and after 15 hours of incubation (H15) with 0.1 µM fenoterol or Krebs–Henseleit solution (paired controls).
No full text<p>Data are expressed as relative expression (where ΔC<sub>t</sub> is the difference between the target gene C<sub>t</sub> and the mean C<sub>t</sub> of the reference genes). Values are means ± SEM (<i>n</i> = 8). No difference between fenoterol and paired controls were statistically significant.</p
Gene-expression in primary cultures of human airway epithelial cells incubated with or without (paired controls) 0.1 µM fenoterol for 15 hours.
No full text<p>Data are expressed as relative expression (where ΔC<sub>t</sub> is the difference between the target gene C<sub>t</sub> and the mean C<sub>t</sub> of the reference genes). Values are means ± SEM (<i>n</i> = 6). No difference between fenoterol and paired controls were statistically significant.</p
