Introduction of spirometry into clinical practice in Georgetown, Guyana: quality and diagnostic outcomes.

SETTING: Georgetown Public Hospital Corporation (GPHC), a 600-bed publicly funded referral hospital in Georgetown, Guyana. OBJECTIVE: To assess spirometry quality and diagnostic outcomes 2 years after the introduction of spirometry into routine clinical practice at GPHC. DESIGN: We performed a retrospective review of 476 consecutive spirometry assessments performed from November 2013 to November 2015. We assessed the proportion and trend of spirometry tests meeting acceptability criteria, along with diagnostic interpretations and spirometry laboratory referral patterns. RESULTS: Overall, 80.4% of the 454 initial spirometry measurements on unique patients met the acceptability criteria, with no significant change in the proportion of acceptable spirometry over the study period (P = 0.450). Of the 369 (81.3%) first tests considered interpretable, 139 (30.6%) were normal, 151 (33.3%) were obstructive, 54 (11.9%) were suggestive of a restrictive pattern, 25 (5.5%) were suggestive of a mixed disorder and 119 (26.2%) tests met the definition of reversibility. CONCLUSION: Over a 2-year period, high-quality spirometry was performed in GPHC, a publicly funded hospital in a middle-income country with no pre-existing specialised respiratory service.

Coupled anthropogenic anomalies of radionuclides and major elements in estuarine sediments.

Concentrations of fertilizer industry-derived P (up to 3.4%), Ca (up to 6.1%), (226)Ra (up to 744 Bq kg(-1)) and (210)Pb (up to 1317 Bq kg(-1)) at least one order of magnitude above natural levels were recorded in a sediment core from Morrão River estuary (SE Brazil). Unsupported (210)Pb (= total (210)Pb-(226)Ra) activities unexplained by atmospheric fallout and deviations from the radionuclides secular equilibrium also indicated strong anomalies. Anomalous constituents were positively correlated with each other and negatively correlated with clay mineral-bearing elements. These negative correlations were explained by a depletion of natural sediment constituents due to a dilution caused by elevated inputs of steel industry-derived elements (mainly by Fe levels up to 24%). Absolute data and normalizations by a proxy for clays (Al) and anthropogenic Fe evidenced variabilities in the quality of coastal and land-derived sediment inputs, mainly due to changes in the relative contributions from industrial sources.

Apneia e respiracao periodica durante o sono,em recem-nascidos.Aspectos poligraficos. / Apneia and periodic respiration during sleep in newborn infants. Polygraphic aspects

Foram avaliados aspectos do registro poligrafico de 30 recem-nascidos, encaminhados por apresentarem apneias no bercario.A ida de gestacional foi 32,8 +/- 3,7 e a idade concepcional 36,0 +/- 2,4 semanas.O tracado poligrafico foi realizado durante cinco horas de sono. Apneias curtas (10-20 s) ocorreram em 18 casos e longas (> 20 s) em quatro. Houve predominio de apneias centrais sobre as obstrutivas e mistas. Apneias curtas mostraram discreta tendencia a ocorrer mais no estagio ativo. Respiracoes periodicas ocorreram em toda a amostra, sendo a media 4,8 +/- 0,6/h.As respiracoes periodicas de 30 a 60 s de duracao foram as mais comuns, surgindo em maior numero de criancas, em maior frequencia e com predominio no estagio ativo (p = 0,03). O indice de respiracoes periodicas foi em media 10,1 +/- 2,0, sendo observados indices maiores no estagio ativo do que no quieto (p = 0,04)