Carbon dioxide conversion via reverse water-gas shift reaction: Reactor design.

The reverse water gas shift (RWGS) reaction converts carbon dioxide (CO2) and hydrogen (H2) to syngas, which is used to produce various high-added-value chemicals. This process has attracted great interest from researchers as a way of mitigating the potential environmental impacts of this greenhouse gas, with emphasis on global warming. This work aims to model and simulate an industrial catalytic reactor using kinetic data for the RWGS reaction. The simulation was carried out in Aspen Plus® v10. The thermodynamic analysis showed that the appropriate conditions for the reaction are feed molar ratio (H2/CO2) of 0.8:1, 750 °C, and 20 bar. The RWGS process proceeds in a multi-tubular fixed bed reactor with 36.26% CO2 conversion and 96.41% CO selectivity, at residence times in the order of 2.7 s. These results are at near-equilibrium CO2 conversion with higher CO selectivity.

A Meta-Analysis of Remote Ischemic Preconditioning in Lung Surgery and Its Potential Role in COVID-19.

Purpose: To determine the effects of remote ischemic preconditioning (RIPC) on pulmonary gas exchange in people undergoing pulmonary surgery and discuss a potential role of RIPC in COVID-19. Method: A search for studies examining the effects of RIPC after pulmonary surgery was performed. RevMan was used for statistical analyses examining measures of A-ado2, Pao2/Fio2, respiratory index (RI), a/A ratio and Paco2 obtained earlier after surgery (i.e., 6-8 hours) and later after surgery (i.e., 18-24 hours). Results: Four trials were included (N = 369 participants). Significant (p < 0.05) overall effects of RIPC were observed early after surgery on A-ado2 and RI (SMD -0.84 and SMD -1.23, respectively), and later after surgery on RI, Pao2/Fio2, and a/A ratio (SMD -0.39, 0.72, and 1.15, respectively) with the A-ado2 approaching significance (p = 0.05; SMD -0.45). Significant improvements in inflammatory markers and oxidative stress after RIPC were also observed. Conclusions: RIPC has the potential to improve pulmonary gas exchange, inflammatory markers, and oxidative stress in people with lung disease undergoing lung surgery and receiving mechanical ventilation. These potential improvements may be beneficial for people with COVID-19, but further investigation is warranted.

Objectif : déterminer les effets du préconditionnement ischémique à distance (PCID) sur les échanges gazeux pulmonaires chez les personnes qui subissent une opération pulmonaire et discuter du rôle potentiel du PCID sur la COVID-19. Méthodologie : les chercheurs ont procédé à une recherche sur les effets du PCID après une opération pulmonaire. Ils ont utilisé le logiciel RevMan pour effectuer les analyses statistiques des mesures du gradient artério-alvéolaire (A-ao2), du rapport entre la pression partielle d'oxygène et la fraction inspirée en oxygène (Pao2/Fio2), de l'indice respiratoire (IR), du gradient alvéolo-artériel (a-A) et de la pression partielle de dioxyde de carbone (Paco2) obtenus de six à huit heures après l'opération, puis de 18 à 24 heures après l'opération. Résultats : les chercheurs ont inclus quatre études (N = 369 participants). Ils ont observé des effets globaux importants (p < 0,05) du PCID peu après l'opération sur l'A-ao2 et l'IR (DMS = −0,84 et DMS = −1,23, respectivement), puis plus tard après l'opération sur l'IR, le Pao2/Fio2 et le gradient a-A (DMS = −0,39, 0,72 et 1,15, respectivement), et l'A-ao2 avoisine une valeur significative (p = 0,05; DMS = −0,45). Ils ont également observé des améliorations notables aux marqueurs inflammatoires et au stress oxydatif après le PCID. Conclusions : le PCID a le potentiel d'améliorer les échanges gazeux pulmonaires, les marqueurs inflammatoires et le stress oxydatif chez les personnes atteintes d'une maladie pulmonaire qui subissent une opération pulmonaire et reçoivent une ventilation mécanique. Ces améliorations potentielles peuvent être bénéfiques aux personnes atteintes de la COVID-19, mais d'autres recherches s'imposent.

Higher serum levels of systemic inflammatory markers are linked to greater inspiratory muscle dysfunction in COPD.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with an inflammatory response that becomes more pronounced in acute exacerbations. Considerable attention has recently focused on the value of several inflammatory mediators in predicting worsening of COPD-related symptoms. Whereas respiratory muscle dysfunction is also widely present in this population, little is known about how systemic inflammation relates to inspiratory muscle dysfunction in COPD. METHODS: Fifty-three males with mild-to-very severe airflow obstruction underwent blood sampling for 23 inflammatory markers, including acute-phase proteins, cytokines and adipokines. Inspiratory muscle performance was assessed via the test of incremental respiratory endurance, providing measures of maximal (MIP) and sustained maximal (SMIP) inspiratory pressures. RESULTS: The mean ± SD MIP and SMIP were 75.32 ± 19.62 cmH2 O and 406.15 ± 124.55 PTU. MIP negatively correlated with CRP, SAA and cystatin C (r-values from -0.333 to -0.378, P < 0.02), while SMIP was inversely related to SAA and cystatin C (r = -0.534 and r = -0.396, P = 0.00). Significant differences in CRP, SAA, cystatin C and PARC were also found between subjects with and without inspiratory muscle weakness. No additional significant relationships were observed between either MIP or SMIP and other inflammatory markers in the study. CONCLUSIONS: MIP and SMIP are markedly reduced with greater degrees of inflammation in COPD as expressed by higher levels of CRP, SAA and cystatin C. Future research is needed to further examine the above findings and determine the impact of systemic inflammation along with its underlying mechanisms on inspiratory muscle function in COPD.

Osteopathic manual therapy in heart failure patients: A randomized clinical trial.

BACKGROUND: Heart Failure (HF) patients usually present with increased arterial resistance and reduced blood pressure (BP) leading to an impaired functional capacity. Osteopathic Manual Therapy (OMT) focused on myofascial release techniques (MRT) and in the balancing of diaphragmatic tensions, has been shown to improve blood flow in individuals using the resistive index (RI). However, its effects in HF patients have not been examined. PURPOSE: To evaluate the acute response of selected osteopathic techniques on RI, heart rate (HR), and BP in patients with HF. METHODS: Randomized-controlled clinical trial of HF patients assigned to MRT (six different techniques with three aimed at the pelvis, two at the thorax, and one at the neck for 15 min) or Control group (subjects in supine position for 15 min without intervention). The RI of the femoral, brachial and carotid arteries was measured via doppler ultrasound while HR and BP were measured via sphygmomanometry before and after a single MRT or control intervention. RESULTS: Twenty-two HF patients equally distributed (50% male, mean age 53 years; range 32-69 years) (ejection fraction = 35.6%, VO2peak: 12.9 mL/kg-1 min-1) were evaluated. We found no intra or inter group differences in RI of the carotid (ΔMRT: 0.07% vs Δ Control:11.8%), brachial (ΔMRT:0.17% vs ΔControl: 2.9%), or femoral arteries (ΔMRT:1.65% vs ΔControl: 0.97%) (P > 0.05) and no difference in HR or BP (ΔMRT:0.6% vs ΔControl: 3%), (P > 0.05). CONCLUSION: A single MRT session did not significantly change the RI, HR, or BP of HF patients.

Inspiratory Muscle Performance of Former Smokers and Nonsmokers Using the Test of Incremental Respiratory Endurance.

BACKGROUND: Smoking has potential deleterious effects on respiratory muscle function. Smokers may present with reduced inspiratory muscle strength and endurance. We compared inspiratory muscle performance of nonsmokers with that of former smokers without overt respiratory problems via the Test of Incremental Respiratory Endurance. METHODS: This study was performed on 42 healthy subjects between the ages of 30 and 79 y (mean ± SD of 56.5 ± 14.4 y). Fourteen male and 7 female former smokers were matched to nonsmokers based on sex, age, height, and weight. Subjects completed a questionnaire about their health and current smoking status. Testing included the best of 3 or more consistent trials. The Test of Incremental Respiratory Endurance measurements included maximal inspiratory pressure measured from residual volume as well as sustained maximal inspiratory pressure and inspiratory duration measured from residual volume to total lung capacity during a maximal sustained inhalation. RESULTS: No significant difference in inspiratory performance of the entire group of former smokers compared with nonsmokers was found. However, separate sex analyses found a significant difference in sustained maximal inspiratory pressure between male former smokers and nonsmokers (518.7 ± 205.0 pressure time units vs 676.5 ± 255.2 pressure time units, P = .041). CONCLUSIONS: We found similar maximal inspiratory pressure between former smokers and nonsmokers via the Test of Incremental Respiratory Endurance, but the significant difference in sustained maximal inspiratory pressure between male former smokers and nonsmokers suggests that the sustained maximal inspiratory pressure may have greater discriminatory ability in assessing the effects of smoking on inspiratory muscle performance. Further investigation of the effects of smoking on inspiratory performance via the Test of Incremental Respiratory Endurance is warranted.

Symptomatic spinal cord metastasis of glioblastoma multiforme / Metástase espinhal sintomática de glioblastoma multiforme

Metástases espinhais sintomáticas de glioblastoma multiforme são raramente descritas na literatura. Relatamos o caso de um paciente de 27 anos que apresentou quadro de dor lombar e em membros inferiores bilateralmente nove meses após diagnóstico de GBM intracraniano. Exame de ressonância magnética da coluna lombar mostrou tumor em L1-L2 que foi removido com sucesso, e análise anatomopatológico foi consistente com metástase de GBM. Metástase espinhal deve ser investigada e incluída no diagnóstico diferencial de paciente com história prévia de GBM intracraniano e queixa de sintomas espinhais.

Symptomatic spinal cord metastasis from glioblastomamultiforme (GBM) has rarely been reported in the literature.We report the case of a 27-year-old man that presented withback and bilateral leg pain nine months after the primarydiagnosis of intracranial GBM. A magnetic resonance imaging(MRI) of the lumbar spine showed a L1-L2 tumor that wasremoved successfully and histopathological examination wasconsistent with GBM metastasis. Spinal metastasis shouldbe investigated and included in the differential diagnosis if apatient with a previous history of intracranial GBM presentswith spinal symptoms.

Metástase espinhal sintomática de glioblastoma multiforme / Syntomatic spinal cord metastasis of glioblastoma

Metastasis espinhais sintomáticas de glioblastoma multiformesão raramente descritas na literatura. Relatamos o casode um paciente de 27 anos que apresentou quadro de dor lombare em membros inferiores bilateralmente nove meses apósdiagnóstico de GBM intracraniano. Exame de ressonânciamagnética da coluna lombar mostrou tumor em L1-L2 quefoi removido com sucesso, e análise anatomopatológico foiconsistente com metástase de GBM. Metástase espinhal deveser investigada e incluída no diagnóstico diferencial de pacientecom história prévia de GBM.

Processos infecciosos e torcicolo, há algo com que se preocupar? / Infectious process and torticollis, is there something to worry about?

A subluxação rotatória atlantoaxial em associação com processos infecciosos da cabeça e do pescoço (Síndrome de Grisel)é uma doença rara e pobremente relatada e não reportada. A patogênese da síndrome é incerta e diversas teorias foram propostas para explicá-la. Este trabalho relata uma criança de 7anos de idade com s Síndrome de Grisel e a literatura sobre o tema é brevemente revisada.

Meningiomas induzidos por radiação: a importância seguimento contínuo após irradiação craniana / Radiation-induced meningiomas: the importance of continued follow up after cranial irradiation

O surgimento de tumores é uma complicação tardia após irradiação craniana, e destes a maior parte corresponde a meningiomas intracranianos. O período de latência entre a exposição à radiação e o diagnóstico de um meningioma induzido por radiação varia com o período inicial de exposição à radiação e a dose total recebida. Os autores relatam dois casos de meningiomas resultantes de altas doses de radiação recebidas para tratamento de um PNET. Ambos os pacientes foram submetidos à ressecção cirúrgica do tumor, e a análise imunohistoquímica revelou se tratar de meningioma típico.Estes casos ilustram a importância do seguimento contínuo após irradiação craniana na população pediátrica.

Association of increased CCL5 and CXCL7 chemokine expression with neutrophil activation in severe stable COPD.

BACKGROUND: Increased numbers of activated neutrophils have been reported in the bronchial mucosa of patients with stable chronic obstructive pulmonary disease (COPD), particularly in severe disease. OBJECTIVES: To investigate the expression of neutrophilic chemokines and adhesion molecules in bronchial biopsies from patients with stable COPD of different severity (GOLD stages I-IV) compared with age-matched control subjects, smokers with normal lung function and never smokers. METHODS: The expression of CCL5, CXCL1, 5, 6, 7 and 8, CXCR1, CXCR2, CD11b and CD44 was measured in the bronchial mucosa using immunohistochemistry, confocal immunofluorescence, real-time quantitative polymerase chain reaction (RT-QPCR) and Western blotting (WB). RESULTS: The numbers of CCL5+ epithelial cells and CCL5+ and CXCL7+ immunostained cells were increased in the bronchial submucosa of patients with stable severe COPD compared with control never smokers and smokers with normal lung function. This was also confirmed at the level of mRNA expression. The numbers of CCL5+ cells in the submucosa of patients with COPD were 2-15 times higher than any other chemokines. There was no correlation between the number of these cells and the number of neutrophils in the bronchial submucosa. Compared with control smokers, the percentage of neutrophils co-expressing CD11b and CD44 receptors was significantly increased in the submucosa of patients with COPD. CONCLUSION: The increased expression of CCL5 and CXCL7 in the bronchial mucosa of patients with stable COPD, together with an increased expression of extracellular matrix-binding receptors on neutrophils, may be involved in the pathogenesis of COPD.

T helper type 17-related cytokine expression is increased in the bronchial mucosa of stable chronic obstructive pulmonary disease patients.

There are increased numbers of activated T lymphocytes in the bronchial mucosa of stable chronic obstructive pulmonary disease (COPD) patients. T helper type 17 (Th17) cells release interleukin (IL)-17 as their effector cytokine under the control of IL-22 and IL-23. Furthermore, Th17 numbers are increased in some chronic inflammatory conditions. To investigate the expression of interleukin (IL)-17A, IL-17F, IL-21, IL-22 and IL-23 and of retinoic orphan receptor RORC2, a marker of Th17 cells, in bronchial biopsies from patients with stable COPD of different severity compared with age-matched control subjects. The expression of IL-17A, IL-17F, IL-21, IL-22, IL-23 and RORC2 was measured in the bronchial mucosa using immunohistochemistry and/or quantitative polymerase chain reaction. The number of IL-22(+) and IL-23(+) immunoreactive cells is increased in the bronchial epithelium of stable COPD compared with control groups. In addition, the number of IL-17A(+) and IL-22(+) immunoreactive cells is increased in the bronchial submucosa of stable COPD compared with control non-smokers. In all smokers, with and without disease, and in patients with COPD alone, the number of IL-22(+) cells correlated significantly with the number of both CD4(+) and CD8(+) cells in the bronchial mucosa. RORC2 mRNA expression in the bronchial mucosa was not significantly different between smokers with normal lung function and COPD. Further, we report that endothelial cells express high levels of IL-17A and IL-22. Increased expression of the Th17-related cytokines IL-17A, IL-22 and IL-23 in COPD patients may reflect their involvement, and that of specific IL-17-producing cells, in driving the chronic inflammation seen in COPD.

Ependimoma simulando cavernoma do terceiro ventrículo: relato de caso / Ependymoma mimicking cavernous malformation of the third ventricle: case report

Introdução: Erro diagnóstico de lesões do terceiro ventrículonão são raras. Descrição do caso: Os autores relatamum paciente que se apresentou com uma lesão no terceiroventrículo cuja aparência inicial em exames de neuroimagemlevou ao diagnóstico de malformação cavernosa. Um acessotranscaloso transcoroídeo foi realizado e ressecção completada lesão foi obtida. Análise histopatológica e imunohistoquímicarevelaram um raro diagnóstico de ependimoma doterceiro ventrículo. Conclusão: Ependimomas não devem seromitidos dos diagnósticos diferenciais de lesões do terceiroventrículo, apesar de tal localização não ser usual para estaslesões e serem raramente descritas.

Relationship between the coronal suture and the central lobe: how important is it and how can we use it in surgical planning? / Relação entre a sutura coronária e o lobo central: qual a sua importância e como podemos usá-la no planejamento cirurgico?

The surgical treatment of the lesions located in the central lobe is a very difficult task for the neurosurgeon. The overall aim of this study is to verify the correlation of the coronal suture and the structures of the central lobe in 32 cadaver hemisphere brains and the importance of this information in surgical planning. The measurement of the nasion to the coronal suture ranged from 11.5 to 13.5 cm. The distance between the coronal suture in the midline to the central, precentral and paracentral sulcus ranged from 5.0 to 6.6, 2.5 to 4.5 and 1.3 to 4.0 cm respectively. Particularly in the normal cortex these measurements can be used to guide the surgical access. However, the identification of the central sulcus is not easy when the anatomical pattern is distorted or displaced by a lesion or edema. In cases such as these the use of other tools becomes crucial for good surgical planning and cortical mapping or awake craniotomy for a safer resection of the lesion as well.

O tratamento cirúrgico de lesões localizadas no lobo central é difícil para o neurocirurgião. O objetivo deste estudo é verificar a relação da sutura coronária com as estruturas do lobo central utilizando-se de dissecção realizada em 32 hemisférios cerebrais de 16 cadáveres, assim como, a importância desta informação no planejamento cirúrgico. A medida da distância entre o nasion e a sutura coronária variou entre 11,5 e 13,5 cm. A distância da sutura coronária na linha média para os sulcos central, pré-central e paracentral variou de 5,0 a 6,6 cm, 2,5 a 4,5 cm e 1,3 a 4,0 cm respectivamente. O conhecimento destas medidas pode ser usado no planejamento cirúrgico principalmente num córtex normal. Porém, a identificação do sulco central é difícil quando as estruturas anatômicas estão deslocadas pela lesão ou quando há edema. Nestes casos a utilização de outros meios diagnósticos para o planejamento cirúrgico torna-se necessária, como também a estimulação cortical ou a craniotomia com o paciente acordado pode proporcionar uma ressecção mais segura da lesão.

CD1a down-regulation in primary invasive ductal breast carcinoma may predict regional lymph node invasion and patient outcome.

AIMS: CD1a is a molecule belonging to the highly conserved group of CD1 proteins. Its expression in dendritic cells is related to the presentation of tumour-derived glycolipid antigens to T cells and, consequently, the development of a successful antitumour response. The aim was to investigate the presence of CD1a+ cells in both primary tumours and lymph nodes (LN) of a series of 35 invasive ductal carcinomas by both immunohistochemistry and reverse transcription-polymerase chain reaction. METHODS AND RESULTS: CD1a antigen was more expressed in N0 than N1 breast cancer (P < 0.0001) in both primary lesions and LN metastases and correlated positively and significantly with oestrogen (ER) (P = 0.0025) and progesterone (P = 0.0226) receptor (PR) status, as well as CD4+ and CD8+ T-lymphocyte infiltration. CONCLUSIONS: This is the first report to show a link between CD1a+ mononuclear cells in breast cancer and in paired LN metastases. The positive and significant correlations between the number of CD1a+ cells and positivity of the primary tumour for ER and PR suggest a possible role for CD1a as a prognostic marker for breast cancer, raising the possibility that hormone receptor-positive breast cancer patients may have a better prognosis in the presence of greater dendritic cell infiltration.

Contribution of bronchial biopsies in the evaluation of pathogenesis and progression of COPD.

This review summarizes and discusses the lung pathology of COPD patients emphasising on inflammatory cell phenotypes and mechanisms which prevail in different clinical conditions. In bronchial biopsies a series of events takes place during the progression of the disease from mild to severe. T-lymphocytes, particularly CD8+ cells and macrophages are the prevalent inflammatory cells in the lungs of healthy smokers and patients with mild/moderate COPD. This T-cell activation seems to be sustained by CD4+, CD8+ cells and macrophages expressing transcription factors and Tc1 cytokines such as NF-kB, STAT4 and IFNgamma. In contrast, severe disease is characterized by lymphocytes producing greater amounts of TGF-beta1 and by an increase of nitrotyrosine immunoreactivity and activated neutrophils, macrophages and MPO+ cells. However, the mechanisms involved in neutrophilic migration and adhesion are currently under investigation. Recent data has shown that in severe COPD there is an impaired neutrophil capability to respond to chemotactic stimuli, as well as an increased collagen adhesion of neutrophils due to the up-regulation of CD44 and CD11b receptors. This data together, may account for the increased neutrophilia observed in the severe disease states of COPD. In this context, insights obtained from the tissutal analysis of bronchial biopsies represent an irreplaceable route to further progresses in to the pathogenesis of this disease.

Strategies for resection of lesions in the motor area: preliminary results in 42 surgical patients / Estratégias para ressecção de lesões em área motora: resultados preliminares em 42 pacientes operados

In recent years considerable technological advances have been made with the purpose of improving the surgical results in the treatment of eloquent lesions. The overall aim of this study is to evaluate the postoperative surgical outcome in 42 patients who underwent surgery to remove lesions around the motor cortex, in which preoperative planning by using neuroimaging exams, anatomical study, appropriate microsurgery technique and auxiliary methods such as cortical stimulation were performed. Twenty-two patients (52.3 percent) presented a normal motor function in the preoperative period. Of these, six developed transitory deficit. Twenty patients (47.6 percent) had a motor deficit preoperatively, nevertheless 90 percent of these improved postoperatively. Surgery in the motor area becomes safer and more effective with preoperative localization exams, anatomical knowledge and appropriate microsurgery technique. Cortical stimulation is important because it made possible to maximize the resection reducing the risk of a motor deficit. Stereotaxy method was useful in the location of subcortical lesions.

Nos últimos anos, consideráveis avanços tecnológicos, principalmente métodos de localização funcional do córtex cerebral, têm surgido no sentido de melhorar os resultados cirúrgicos no tratamento de lesões em áreas eloqüentes. O objetivo deste estudo é avaliar os resultados pós-operatórios em 42 pacientes submetidos à ressecção de lesões em área motora, utilizando-se de planejamento com exames de neuroimagem, conhecimento anatômico, técnica microcirúrgica adequada e métodos auxiliares a exemplo do estimulador cortical. Vinte e dois pacientes (52,3 por cento) apresentavam força muscular normal no pré-operatório. Destes, seis apresentaram déficit motor transitório. Vinte pacientes (47,6 por cento) tinham déficit motor no pré-operatório, mas 90 por cento destes apresentaram melhora no pós-operatório. A cirurgia em área motora se torna mais segura e eficaz com a utilização de planejamento pré-operatório baseado nos exames de imagem, conhecimento anatômico e técnica microcirúrgica adequada. A utilização de estimulador cortical é importante para maximizar a ressecção minimizando o risco de déficit motor. A estereotaxia foi útil na localização de lesões subcorticais.

Strategies for resection of lesions in the motor area: preliminary results in 42 surgical patients.

In recent years considerable technological advances have been made with the purpose of improving the surgical results in the treatment of eloquent lesions. The overall aim of this study is to evaluate the postoperative surgical outcome in 42 patients who underwent surgery to remove lesions around the motor cortex, in which preoperative planning by using neuroimaging exams, anatomical study, appropriate microsurgery technique and auxiliary methods such as cortical stimulation were performed. Twenty-two patients (52.3%) presented a normal motor function in the preoperative period. Of these, six developed transitory deficit. Twenty patients (47.6%) had a motor deficit preoperatively, nevertheless 90% of these improved postoperatively. Surgery in the motor area becomes safer and more effective with preoperative localization exams, anatomical knowledge and appropriate microsurgery technique. Cortical stimulation is important because it made possible to maximize the resection reducing the risk of a motor deficit. Stereotaxy method was useful in the location of subcortical lesions.

Simple and effective gas chromatographic mass spectrometric procedure for the speciation analysis of organotin compounds in specimens of marine mussels. An evaluation of the organotin pollution of the lagoon of venice.

This paper describes a simple, effective analytical procedure, based on a gas chromatographic mass spectrometric technique, for the speciation analysis of organotin compounds (OTC) in mussel samples. The direct alkylation reaction of the organotin chlorides in the aqueous digestion solution by NaBEt(4) allowed a short analysis time and a good recovery. The evaluation of the yield of each step constituting the analytical procedure indicated that the alkylation step is the most critical one. The proposed method was advantageously utilised to monitor the level of OTC pollution of the Lagoon of Venice. All the sites examined, both near to and far from anthropogenic activities, revealed significant levels of OTC pollution.