RESUMEN
Aspiration is common in mechanically ventilated patients and may predispose patients to aspiration pneumonia, chemical pneumonitis, and chronic lung damage. Pepsin A is a specific marker of gastric fluid aspiration and is often detected in ventilated pediatric patients. We investigated the effect of oral care and throat suctioning in the detection of pepsin A in tracheal aspirates (TAs) up to 4 hours after these procedures. Methods: Twelve pediatric patients between age 2 weeks to 14 years who underwent intubation for cardiac surgery were enrolled in this study. Six of the 12 patients were consented before their surgery with initial specimen collected at the time of intubation and last one shortly before extubation (intubation duration < 24 hours). The remaining 6 patients were consented after cardiac surgery. All specimens were collected per routine care per respiratory therapy protocol and shortly before extubation (intubation duration > 24 hours). Tracheal fluid aspirates were collected every 4 to 12 hours in the ventilated patients. Enzymatic assay for gastric pepsin A and protein determination were performed. The time of oral care and throat suctioning within 4 hours prior was recorded prospectively. Results: A total of 342 TA specimens were obtained from the 12 intubated pediatric patients during their course of hospitalization; 287 (83.9%) showed detectable total pepsin (pepsin A and C) enzyme activity (> 6 ng/mL) and 176 (51.5%) samples had detectable pepsin A enzyme levels (>6 ng/mL of pepsin A). Only 29 samples of 76 samples (38.2%) had evidence of microaspiration after receiving oral care, while 147 of 266 (55.3%) samples were pepsin A positive when no oral care was provided. Odds ratio is 0.50 (Cl 0.30-0.84), and the number needed to treat is 5.8 (Confidence interval 3.4-22.3). Testing air filters for pepsin was not beneficial. Conclusion: Oral care is a highly effective measure to prevent microaspiration of gastric fluid in ventilated pediatric patients. The number needed to treat (5.8) suggests this is a very effective prevention strategy. Our study suggests that pepsin A is a useful and sensitive biomarker that allows identification of gastric aspiration.
RESUMEN
The IsoDAR collaboration is developing a high-current cyclotron for a neutrino search experiment. Designed to deliver 10 mA of 60 MeV protons, the current and power of this cyclotron far exceed those of existing accelerators, opening new possibilities for the production of radiopharmaceutical isotopes, producing very high-activity samples in very short times. The cyclotron can also be easily configured to deliver ions other than protons including 1 mA of alpha particles at 240 MeV: this flexibility gives a broad reach into new areas of isotope production. We explain how IsoDAR overcomes the beam limits of commercial cyclotrons, and how it could represent the next step in isotope production rates.
RESUMEN
The axion is a promising dark matter candidate, which was originally proposed to solve the strong-CP problem in particle physics. To date, the available parameter space for axion and axionlike particle dark matter is relatively unexplored, particularly at masses m_{a}â²1 µeV. ABRACADABRA is a new experimental program to search for axion dark matter over a broad range of masses, 10^{-12}â²m_{a}â²10^{-6} eV. ABRACADABRA-10 cm is a small-scale prototype for a future detector that could be sensitive to the QCD axion. In this Letter, we present the first results from a 1 month search for axions with ABRACADABRA-10 cm. We find no evidence for axionlike cosmic dark matter and set 95% C.L. upper limits on the axion-photon coupling between g_{aγγ}<1.4×10^{-10} and g_{aγγ}<3.3×10^{-9} GeV^{-1} over the mass range 3.1×10^{-10}-8.3×10^{-9} eV. These results are competitive with the most stringent astrophysical constraints in this mass range.