Evaluation and Performance of a Positive Airway Pressure Device (CPAP-AirFlife™): A Randomized Crossover Non-Inferiority Clinical Study in Normal Subjects.

Background and Objectives: During the COVID-19, the demand for non-invasive ventilatory support equipment significantly increased. In response, a novel non-invasive ventilatory support model called CPAP-AirFlife™ was developed utilizing existing technologies. This model offers technological advantages, including an aerosol-controlled helmet suitable for high-risk environments such as ambulances. Additionally, it is cost-effective and does not require medical air, making it accessible for implementation in low-level hospitals, particularly in rural areas. This study aimed to assess the efficacy of CPAP-AirFlife™ by conducting a non-inferiority comparison with conventional ventilation equipment used in the Intensive Care Unit. Materials and Methods: A clinical study was conducted on normal subjects in a randomized and sequential manner. Parameters such as hemoglobin oxygen saturation by pulse oximetry, exhaled PCO2 levels, vital signs, and individual tolerance were compared between the CPAP-AirFlife™ and conventional equipment. The study population was described in terms of demographic characteristics and included in the analysis. Results: It was shown that the CPAP-AirFlife™ was not inferior to conventional equipment in terms of efficacy or tolerability. Hemoglobin oxygen saturation levels, exhaled PCO2 levels, vital signs, and individual tolerance did not significantly differ between the two models. Conclusions: The findings suggest that CPAP-AirFlife™ is a practical and cost-effective alternative for non-invasive ventilatory support. Its technological advantages, including the aerosol-controlled helmet, make it suitable for high-risk environments. The device's accessibility and affordability make it a promising solution for implementation in low-level hospitals, particularly in rural areas. This study supports using CPAP-AirFlife™ as a practical option for non-invasive ventilatory support, providing a valuable contribution to respiratory care during the COVID-19 pandemic and beyond.

Cov-caldas: A new COVID-19 chest X-Ray dataset from state of Caldas-Colombia.

The emergence of COVID-19 as a global pandemic forced researchers worldwide in various disciplines to investigate and propose efficient strategies and/or technologies to prevent COVID-19 from further spreading. One of the main challenges to be overcome is the fast and efficient detection of COVID-19 using deep learning approaches and medical images such as Chest Computed Tomography (CT) and Chest X-ray images. In order to contribute to this challenge, a new dataset was collected in collaboration with "S.E.S Hospital Universitario de Caldas" ( https://hospitaldecaldas.com/ ) from Colombia and organized following the Medical Imaging Data Structure (MIDS) format. The dataset contains 7,307 chest X-ray images divided into 3,077 and 4,230 COVID-19 positive and negative images. Images were subjected to a selection and anonymization process to allow the scientific community to use them freely. Finally, different convolutional neural networks were used to perform technical validation. This dataset contributes to the scientific community by tackling significant limitations regarding data quality and availability for the detection of COVID-19.

A New Medical Device to Provide Independent Ventilation to Two Subjects Using a Single Ventilator: Evaluation in Lung-Healthy Pigs.

BACKGROUND: The global crisis situation caused by SARS-CoV-2 has created an explosive demand for ventilators, which cannot be met even in developed countries. Designing a simple and inexpensive device with the ability to increase the number of patients that can be connected to existing ventilators would have a major impact on the number of lives that could be saved. We conducted a study to determine whether two pigs with significant differences in size and weight could be ventilated simultaneously using a single ventilator connected to a new medical device called DuplicARⓇ. METHODS: Six pigs (median weight 12 kg, range 9-25 kg) were connected in pairs to a single ventilator using the new device for 6 hours. Both the ventilator and the device were manipulated throughout the experiment according to the needs of each animal. Tidal volume and positive end-expiratory pressure were individually controlled with the device. Primary and secondary outcome variables were defined to assess ventilation and hemodynamics in all animals throughout the experiment. RESULTS: Median difference in weight between the animals of each pair was 67% (range: 11-108). All animals could be successfully oxygenated and ventilated for 6 hours through manipulation of the ventilator and the DuplicARⓇ device, despite significant discrepancies in body size and weight. Mean PaCO2 in arterial blood was 42.1 ± 4.4 mmHg, mean PaO2 was 162.8 ± 46.8 mmHg, and mean oxygen saturation was 98 ± 1.3%. End-tidal CO2 values showed no statistically significant difference among subjects of each pair. Mean difference in arterial PaCO2 measured at the same time in both animals of each pair was 4.8 ± 3 mmHg, reflecting the ability of the device to ventilate each animal according to its particular requirements. Independent management of PEEP was achieved by manipulation of the device controllers. CONCLUSION: It is possible to ventilate two lung-healthy animals with a single ventilator according to each one's needs through manipulation of both the ventilator and the DuplicARⓇ device. This gives this device the potential to expand local ventilators surge capacity during disasters or pandemics until emergency supplies can be delivered from central stockpiles.

Mesenchymal Stem Cell Therapy Facilitates Donor Lung Preservation by Reducing Oxidative Damage during Ischemia.

Lung transplantation is a lifesaving therapy for people living with severe, life-threatening lung disease. The high mortality rate among patients awaiting transplantation is mainly due to the low percentage of lungs that are deemed acceptable for implantation. Thus, the current shortage of lung donors may be significantly reduced by implementing different therapeutic strategies which facilitate both organ preservation and recovery. Here, we studied whether the anti-inflammatory effect of human umbilical cord-derived mesenchymal stem cells (HUCPVCs) increases lung availability by improving organ preservation. We developed a lung preservation rat model that mimics the different stages by which donor organs must undergo before implantation. The therapeutic schema was as follows: cardiac arrest, warm ischemia (2 h at room temperature), cold ischemia (1.5 h at 4°C, with Perfadex), and normothermic lung perfusion with ventilation (Steen solution, 1 h). After 1 h of warm ischemia, HUCPVCs (1 × 106 cells) or vehicle was infused via the pulmonary artery. Physiologic data (pressure-volume curves) were acquired right after the cardiac arrest and at the end of the perfusion. Interestingly, although lung edema did not change among groups, lung compliance dropped to 34% in the HUCPVC-treated group, while the vehicle group showed a stronger reduction (69%, p < 0.0001). Histologic assessment demonstrated less overall inflammation in the HUCPVC-treated lungs. In addition, MPO activity, a neutrophil marker, was reduced by 41% compared with vehicle (p < 0.01). MSC therapy significantly decreased tissue oxidative damage by controlling reactive oxygen species production. Accordingly, catalase and superoxide dismutase enzyme activities remained at baseline levels. In conclusion, these results demonstrate that the anti-inflammatory effect of MSCs protects donor lungs against ischemic injury and postulates MSC therapy as a novel tool for organ preservation.

Sobre el derecho a la imperfecció / On the right to imperfectio

Debemos reclamar el derecho a laimperfección, igual que clamamos por el derecho a declinar, recordando que nos hemos originado de un leño torcido. Tenemos el derecho a morir, a llegar a ser nada. También tenemos derecho a que esa nada senos aparezca cada dia. Un poco de ocio, una fracción de desorden, un tanto de confusión, una dosis de irresponsabilidad, unos fragmentos de intrascendencia, algo de odio, de rencor, de envidia que no dañen a nadie y no nos lesionen demasiado, son parte del Derecho a la Imperfección o mas bien a lo que debería llamarse el derecho a la perfección que cabe en el ser humano. Y para solaz de los que quieran ingresar en esta corriente, en esta manera de ver la existencia del hombre, un pensador de la dimensión de Karl Popper hace ya un buen tiempo le dio este camino a la ciencia misma, a la ciencia moderna, a la ciencia a la que nos queremos aproximar, señalando dos grandes principios que caminan sobre el sendero del Derecho a la Imperfección. El primero de ellos señala que la ciencia se desempeña sobre el duo ensayo-error y quedebemos ensayar mucho y errar mucho para luego ensayar mas y errar menos. El segundo gran principio de Popper es la de falsación: si una teoría tolera muchos argumentos que tratan de demostrar que es falsa, tal vez tiene mucho de verdad. No es que sea verdadera, lo que es propio de la excelencia. No. Dice que es posiblemente verdadera, que es lo adecuado a la imperfección.

La teoría del cazador. Aproximación antropológica a las repercusiones de la alimentación humana / The hunter theory. Anthropologic approach to the repercussions of human feed

Debe el hombre moderno, para mejorar su cantidad y su calidad de vida, comportarse como un cazador-recolector que mantiene una actividad física permanente y sólo consume lo absolutamente necesario para sus necesidades metabólicas, sin poner en riesgo a otros miembros de su especie

Los caminos a las cavidades inviolables: anotaciones para una historia de la cirugía torácica no cardíaca

"Los hechos relacionados con la cirigía son: el paciente, el operador, los ayudantes, los instrumentos, la luz, donde y de qué manera, cuántas cosas y cómo, donde el cuerpo y los instrumentos, el tiempo, la manera, el lugar" Hipócrates, año 400 a.C

Manual de autocuidado en enfermedad pulmonar obstructiva cronica / Self care manual for patients with pulmonary chronic obstructive disease

Manual informativo para los pacientes con EPOC que tiene como objetivo estimular la formacion de grupos de rehabilitacion pulmonar concientes del papel del propio paciente y su familiar en la recuperacion y rehabilitacion de la enfermedad..