RESUMEN
OBJECTIVE: Dysphagia is a significant complication in fourth ventricle surgery. Corticobulbar motor evoked potentials (CB-MEPs) of the lower cranial nerves may provide real-time information possibly correlating with postoperative swallowing dysfunction, and the vagus nerves may prove ideal for this purpose. However, the literature is heterogeneous, non-systematic, and inconclusive on this topic. The object of this retrospective study was to evaluate the correlation between CB-MEPs of the vagus nerve and postoperative worsening or new-onset swallowing deficits in intraaxial fourth ventricle surgery. METHODS: In 21 consecutive patients undergoing surgery for fourth ventricle intraaxial tumors between February 2018 and October 2022, endotracheal tubes with two applied electrodes contacting the vocal cords were used to record vagus nerve MEPs including values at baseline, the end of surgery, and the minimum value during the operation. From the mean value of right and left vagus nerve MEP amplitudes, the minimum-to-baseline amplitude ratio (MBR) and final-to-baseline amplitude ratio (FBR) were calculated. These indexes were correlated with postoperative swallowing function. RESULTS: Given their clinical significance, receiver operating characteristic curves were obtained to evaluate the performance of these indexes in predicting postoperative swallowing function. The area under the curve (AUC) was 0.850 (p < 0.001) and the best cutoff for FBR was 67.55% for the worsening of swallowing in the postoperative period. The AUC was 0.750 (p = 0.026) and the best cutoff was 46.37% in MBR for the absence of a swallowing disorder at the late follow-up. CONCLUSIONS: This study confirmed that vagus nerve MEPs are reliable predictors of postoperative swallowing function in fourth ventricle surgery and can be feasibly used as an intraoperative monitoring technique.
RESUMEN
This study evaluated the steam gasification potential of three residues from Brazilian agro-industry by assessing their reaction kinetics and syngas production at temperatures from 650 to 850°C and a steam partial pressure range of 0.05 to 0.3bar. The transition temperature between kinetic control and diffusion control regimes was identified. Prior to the gasification tests, the raw biomasses, namely apple pomace, spent coffee grounds and sawdust, were pyrolyzed in a fixed-bed quartz tubular reactor under controlled conditions. Gasification tests were performed isothermally in a magnetic suspension thermobalance and the reaction products were analyzed by a gas chromatograph with TCD/FID detectors. According to the characterization results, the samples presented higher carbon and lower volatile matter contents than the biomasses. Nevertheless, all of the materials had high calorific value. Syngas production was influenced by both temperature and steam partial pressure. Higher concentrations of H2 and CO were found in the conversion range of 50-80% and higher concentrations of CO2 in conversions around 10%, for all the gasified biochars. The H2/CO decreased with increasing temperature, mainly in kinetic control regime, in the lower temperature range. The results indicate the gasification potential of Brazilian biomass residues and are an initial and important step in the development of gasification processes in Brazil.