scholarly journals Rapid ascents of Mt Everest: normobaric hypoxic preacclimatization

2020 ◽  
Vol 27 (6) ◽  
Author(s):  
Markus Tannheimer ◽  
Raimund Lechner
Keyword(s):  
Flow Rate ◽  
Supplemental Oxygen ◽  
Activity Levels ◽  
Relative Importance ◽  
Hypoxic Training ◽  
Rate Of Oxygen Consumption ◽  
Rapid Ascent ◽  
Main Components ◽  
Available Information ◽  
Inspired Oxygen

Abstract Background Acclimatization to high altitude is time consuming. An expedition to Mt Everest (8848 m) requires roughly 8 weeks. Therefore it seems very attractive to reach the summit within 3 weeks from home, which is currently promised by some expedition tour operators. These rapid ascent expeditions are based on two main components, normobaric hypoxic training (NHT) prior to the expedition and the use of high flow supplemental oxygen (HFSO2). We attempted to assess the relative importance of these two elements. Methods We evaluated the effect of NHT on the basis of the available information of these rapid ascent expeditions and our experiences made during an expedition to Manaslu (8163 m) where we used NHT for preacclimatization. To evaluate the effect of an increased O2 flow rate we calculated its effect at various activity levels at altitudes of 8000 m and above. Results So far rapid ascents to Mt Everest have been successful. The participants carried out 8 weeks of NHT, reaching sleeping altitudes = 7100 m and spent at least 300 h in NH. At rest a flow rate of 2 l O2/min is sufficient to keep the partial pressure of inspired oxygen (PIO2) close to 50 mm Hg even at the summit. For ativities of ~80% of the maximum rate of oxygen consumption (VO2max) at the summit 6 l O2/min are required to maintain a PIO2 above 50 mm Hg. Discussion NHT for preacclimatization seems to be the decisive element of the offered rapid ascent expeditions. An increased O2 flow rate of 8 l/min is not mandatory for climbing Mt Everest. Conclusions Preacclimatization using normobaric hypoxica (NH) is far more important than the use of HFSO2. We think that NHT will be widely used in the future. The most effective regimen of preacclimatization in NH, the duration of each session and the optimal FIO2 are still unclear and require further study.

Effectiveness of a Modified Version of Airflow Therapy

1982 ◽  
Vol 47 (2) ◽  
pp. 160-164
Author(s):  
Glenn L. Falkowski ◽  
Arthur M. Guilford ◽  
Jack Sandler
Keyword(s):  
Success Rate ◽  
Scientific Literature ◽  
Future Research ◽  
Relative Importance ◽  
Differential Effectiveness ◽  
History Of ◽  
One Year ◽  
Main Components

Utilizing airflow therapy, Schwartz (1976) has claimed an 89% success rate with stutterers following treatment and an 83% success rate at one year follow-up. Such claims have yet to be documented in the scientific literature. The purposes of this study were: (a) to investigate the effectiveness of a modified version of airflow therapy; (b) to examine the relative importance of its two main components—passive airflow and elongation of the first vowel spoken. The speech of two adult male stutterers with a lengthy history of stuttering, was assessed with spontaneous speaking and reading tasks. Results indicated marked improvement in both subjects' speech on the reading task was maintained at follow-up 10 weeks later. For spontaneous speech, results were generally weaker and less durable. Effects of the two treatment components were cumulative and did not allow determination of any differential effectiveness between components. Implications of these findings were considered and directions for future research discussed.

scholarly journals Baricitinib improves respiratory function in patients treated with corticosteroids for SARS-CoV-2 pneumonia: an observational cohort study

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 399-407 ◽  
Author(s):  
Jose Luis Rodriguez-Garcia ◽  
Gines Sanchez-Nievas ◽  
Juan Arevalo-Serrano ◽  
Cristina Garcia-Gomez ◽  
Jose Maria Jimenez-Vizuete ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Viral Entry ◽  
Supplemental Oxygen ◽  
Janus Kinase ◽  
Arterial Oxygen ◽  
High Dose ◽  
Observational Cohort ◽  
Fraction Of Inspired Oxygen ◽  
Mean Differences ◽  
Inspired Oxygen

Abstract Objectives The Janus kinase (JAK) inhibitor baricitinib may block viral entry into pneumocytes and prevent cytokine storm in patients with SARS-CoV-2 pneumonia. We aimed to assess whether baricitinib improved pulmonary function in patients treated with high-dose corticosteroids for moderate to severe SARS-CoV-2 pneumonia. Methods This observational study enrolled patients with moderate to severe SARS-CoV-2 pneumonia [arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2) <200 mmHg] who received lopinavir/ritonavir and HCQ plus either corticosteroids (CS group, n = 50) or corticosteroids and baricitinib (BCT-CS group, n = 62). The primary end point was the change in oxygen saturation as measured by pulse oximetry (SpO2)/FiO2 from hospitalization to discharge. Secondary end points included the proportion of patients requiring supplemental oxygen at discharge and 1 month later. Statistics were adjusted by the inverse propensity score weighting (IPSW). Results A greater improvement in SpO2/FiO2 from hospitalization to discharge was observed in the BCT-CS vs CS group (mean differences adjusted for IPSW, 49; 95% CI: 22, 77; P < 0.001). A higher proportion of patients required supplemental oxygen both at discharge (62.0% vs 25.8%; reduction of the risk by 82%, OR adjusted for IPSW, 0.18; 95% CI: 0.08, 0.43; P < 0.001) and 1 month later (28.0% vs 12.9%, reduction of the risk by 69%, OR adjusted for IPSW, 0.31; 95% CI: 0.11, 0.86; P = 0.024) in the CS vs BCT-CS group. Conclusions . In patients with moderate to severe SARS-CoV-2 pneumonia a combination of baricitinib with corticosteroids was associated with greater improvement in pulmonary function when compared with corticosteroids alone. Trial registration European Network of Centres for Pharmacoepidemiology and Pharmacovigilance, ENCEPP (EUPAS34966, http://www.encepp.eu/encepp/viewResource.htm? id = 34967)

Relationship Between Flow Pattern and Pressure Distribution in Venturi Scrubber

2014 ◽  
Author(s):  
Naoki Horiguchi ◽  
Hiroyuki Yoshida ◽  
Akiko Kaneko ◽  
Yutaka Abe
Keyword(s):  
Flow Rate ◽  
Nuclear Power ◽  
Power Plants ◽  
Gas Flow ◽  
The Self ◽  
Radioactive Materials ◽  
Venturi Scrubber ◽  
Nuclear Disaster ◽  
Severe Accidents ◽  
Main Components

As revealed by Fukushima Daiichi nuclear disaster, countermeasures against severe accidents in nuclear power plants are an urgent need. In particular, from the viewpoint of protecting containment and suppressing diffusion of the radioactive materials, it is most important to install filtered venting devices to release high pressure contaminated gas to the atmosphere with elimination radioactive materials in the gas. A Multi Venturi Scrubber System (MVSS) is one of the filtered venting devices, and used in European reactors [1, 2]. One of the main components of the MVSS is a Venturi Scrubber (VS). It is considered that a dispersed or dispersed annular flow is formed in the VS by a self-priming phenomena. In the self-priming phenomena, the liquid was suctioned from a surrounding region of the VS to the inside of the VS. And a part of the radioactive materials are eliminated through the gas-liquid interface of the dispersed or annular dispersed flow. Therefore, to consider the MVSS operation characteristics, it is important whether to occur the self-priming or not and the liquid flow rate of the self-priming of the VS. The objective of this paper is to understand the self-priming phenomena of the VS for the filtered venting. And theoretical analysis and experiment were conducted. By comparing these results, we discussed about the mechanism of the self-priming phenomena. As results, the self-priming phenomena in the VS was confirmed and, at a high gas flow rate, the suspension of the self-priming is confirmed experimentally and theoretically.

scholarly journals Results From the Mozambique 2016 Report Card on Physical Activity for Children and Adolescents

2016 ◽  
Vol 13 (s2) ◽  
pp. S213-S217 ◽  
Author(s):  
António Prista ◽  
Timoteo Daca ◽  
Francisco Tchonga ◽  
Eduardo Machava ◽  
Cremildo Macucule ◽  
...  
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Rural Areas ◽  
Sport Participation ◽  
Report Card ◽  
Activity Levels ◽  
Sedentary Behaviors ◽  
Urban Centers ◽  
Organized Sport ◽  
Available Information

Background:This article describes the procedures and development of the 2016 Mozambican Report Card on Physical Activity for Children and Adolescents.Methods:Following the procedures adopted in 2014 for that year’s report card, comprehensive searches on new data related to indicators of physical activity (PA) were done. A committee composed of physical activity and sports specialists graded each indicator consistent with the process and methodology outlined by the Active Healthy Kids Canada Report Card model.Results:Nine indicators of PA were graded. Compared with 2014 there were several differences which were caused by changes in the country as well as a more effective evaluation from the committee. The following grades were assigned: Overall Physical Activity Levels, C; Organized Sport Participation, F; Active Play, D; Active Transportation, C; Schools, D; Community and the Built Environment, F; and Government, F. Sedentary Behaviors and Family and Peers were graded Incomplete due to the lack of available information.Conclusions:The decline of the PA habits in urban centers reported in 2014 are accentuated and is influencing the rural areas in several ways. At present, there is no strategy or effective action from authorities to reverse this negative trend.

scholarly journals Antifungal Activity and Chemical Constituents of the Essential Oil from Leaves of Nectandra longifolia (Ruiz & Pav.) Nees.

2016 ◽  
Vol 12 (1) ◽  
pp. 66-73
Author(s):  
Daniel Plazas-Jiménez ◽  
Victor Enrique Macias-Villamizar ◽  
Ericsson Coy-Barrera
Keyword(s):  
Chemical Composition ◽  
Antifungal Activity ◽  
Essential Oil ◽  
Growth Inhibition ◽  
Mycelial Growth ◽  
Steam Distillation ◽  
Chemical Constituents ◽  
Main Components ◽  
Available Information ◽  
Dose Dependent

“Yellow moena” (Nectandra longifolia: Lauraceae) is a fragrant leaves-possessing plant commonly used for timber purposes. Nevertheless, so far, there is not available information about its chemical composition. Thus, in the present work is described the components of the essential oil from N. longifolia leaves. The oil was extracted by steam distillation and analyzed by GC/FID  and GC/MS. Twenty eight compounds were therefore identified. The main components were found to be terpinen-4-ol (53.1%), α-terpinene (6.8%), α-phellandrene (4.5%), and β-pinene (3.8%). The chemical composition of essential oil from N. longifolia leaves was consequently in agreement to that of several neotropical Lauraceae plants. In addition, the oil exhibited good antifungal activity against F. oxysporum through dose-dependent mycelial growth inhibition (using amended media and fumigant assays).

scholarly journals Haemolymph Mg(2+) regulation in decapod crustaceans: physiological correlates and ecological consequences in polar areas

2000 ◽  
Vol 203 (8) ◽  
pp. 1383-1393
Author(s):  
M. Frederich ◽  
F.J. Sartoris ◽  
W.E. Arntz ◽  
H. Portner
Keyword(s):  
Heart Rate ◽  
Oxygen Consumption ◽  
Southern Ocean ◽  
Cold Water ◽  
Synergistic Effects ◽  
Carcinus Maenas ◽  
Activity Levels ◽  
Decapod Crustaceans ◽  
Temperature Range ◽  
Rate Of Oxygen Consumption

Reptant decapod crustaceans are almost absent from the Southern Ocean south of the Antarctic Convergence. We tested the hypothesis that this may be due to the reduced ability of this group to regulate Mg(2+) levels in the haemolymph ([Mg(2+)](HL)). Mg(2+) acts as an anaesthetic in marine invertebrates and its level is higher in Reptantia (crabs such as Cancer spp., Chionoecetes spp., Maja spp., 30–50 mmol l(−)(1)) than in Natantia (prawns such as Pandalus spp., Palaemon spp., Crangon spp., 5–12 mmol l(−)(1)). We varied [Mg(2+)](HL) in three species of reptant decapod crustaceans, Carcinus maenas, Hyas araneus and Eurypodius latreillei, and investigated heart rate, the rate of oxygen consumption and levels of spontaneous and forced activity at different temperatures. The rate of oxygen consumption and heart rate increased significantly with reduction in [Mg(2+)](HL) over the entire temperature range investigated in E. latreillei. In H. araneus, an increase in metabolic and heart rates compared with control values was found only at temperatures below 2 degrees C. Forced and spontaneous activity levels increased significantly in the group of [Mg(2+)](HL)-reduced animals below 0 degrees C, at which control animals were mostly inactive. At a reduced [Mg(2+)](HL) of 5–12 mmol l(−)(1), which is the [Mg(2+)](HL) of caridean shrimps in the Southern Ocean, Q(10) and activation energy were reduced for all these variables and extended the temperature range over which physiological functions were maintained. We suggest that the high [Mg(2+)](HL) in Reptantia causes relaxation of the animals and reduces their scope for activity, especially at temperatures below 0 degrees C. The hypothesis that the synergistic effects of high [Mg(2+)](HL) and low temperature probably prevented the Reptantia from recolonizing the permanently cold water of polar areas is discussed.

scholarly journals Clinical Outcome of Patients with COVID-19 Pneumonia Treated with Corticosteroids and Colchicine in Colombia

2020 ◽  
Author(s):  
Miguel Alejandro Pinzón ◽  
Doris Cardona Arango ◽  
Juan Felipe Betancur ◽  
Héctor Holguín ◽  
Carolina Arias Arias ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Supplemental Oxygen ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Oxygen Fraction ◽  
Management Protocol ◽  
Patient’S Information ◽  
Polymerase Chain ◽  
Inspired Oxygen ◽  
Specific Antiviral Therapy

Abstract Background: To date, there is no specific antiviral therapy for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (Covid-19). Since there is no specific therapy against SARS-CoV2, current efforts aim to prevent contagion through public health measures and develop a protective vaccine. While waiting for the latter, it is necessary to evaluate the drugs that at least, in initial studies, suggested some degree of utility in the management of Covid-19 or its complications.The Objective of the study was to describe the clinical manifestations and outcomes of patients with severe Covid-19 Pneumonia treated with corticosteroids and colchicine.Materials and Methods: A cross sectional study of 301 adult patients with Covid-19 Pneumonia confirmed by Real-Time Polymerase Chain Reaction for SARS-CoV2 (RT-PCR SARS-CoV2), Berlin protocol, who required hospitalization in three hospitals in Antioquia, Colombia. Patients were treated according to the institutional protocol (from March 20, 2020 to June 30, 2020) with corticosteroid if the patient required supplemental oxygen. From July 1, 2020, the management protocol changed with the addition of colchicine to all patients admitted to the institutions. The treatment was supervised and monitored by the same specialist in infectology of the institutions. We describe the clinical manifestations and outcomes of the patients who received these treatments. The patient’s information was analyzed according to the outcome of interest (alive/dead) with univariate, bivariate, and multivariate measures to adjust the variables that presented statistical association.Results: All patients had pneumonia documented by chest computed tomography with ground glass images and presented an alveolar pressure / inspired oxygen fraction (PaFi) less than 300. 240 (79.7%) of patients received corticosteroids, and 145 (48.2%) also received colchicine; of these, 14 (9.6%) died vs. 23 (14.7%) of those who did not receive it. Hospital mortality due to severe Covid-19 Pneumonia was 12.3% in three hospitals in Colombia.Conclusions: Treatment with corticosteroids and colchicine for managing patients with severe Covid-19 pneumonia was associated with low mortality at the hospital level. Randomized, placebo-controlled studies are required to evaluate the effect of corticosteroids and colchicine on complications or death from Covid-19.

scholarly journals 507. Impact of Baricitinib on Outcomes in Patients Treated with Remdesivir and Dexamethasone for SARS-CoV-2 Pneumonia: A Retrospective Cohort Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S355-S356
Author(s):  
Lauren Dea ◽  
Hal Piwonka ◽  
Learned Gonzales ◽  
Shubha Kerkar ◽  
Xolani Mdluli ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Hospital Readmissions ◽  
Invasive Mechanical Ventilation ◽  
Dual Therapy ◽  
Supplemental Oxygen ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Day Hospital ◽  
Fraction Of Inspired Oxygen ◽  
Inspired Oxygen

Abstract Background There is a lack of data specifically addressing the effects of triple therapy consisting of baricitinib plus remdesivir plus dexamethasone compared to dual therapy with remdesivir plus dexamethasone among patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia. Methods This retrospective study enrolled hospitalized adults with SARS-CoV-2 receiving supplemental oxygen without invasive mechanical ventilation (IMV) being treated baricitinib (≤10 days) plus remdesivir (≤10 days) plus dexamethasone (≤10 days) or remdesivir (≤10 days) plus dexamethasone (≤10 days). The primary endpoint was 28-day mortality. Secondary objectives of this study were to measure progression to IMV, pulse oximetry (SpO2)/fraction of inspired oxygen (FiO2) from hospitalization to discharge, hospital length of stay (LOS), 14-day mortality, 14-day hospital readmissions, inflammatory markers, and safety outcomes. Results Among patients receiving supplemental oxygen without IMV, 28-day mortality for triple therapy vs. dual therapy was 20% and 24%, respectively (P=1.000). The effect of triple therapy compared to dual therapy on lung function was demonstrated by a 76% vs. 25% increase in SpO2/FiO2. This benefit must be contextualized by an increased progression to IMV among patients receiving triple therapy compared to dual therapy (10 patients [50%] vs. 7 patients [28%], respectively; P=0.130). The increased incidence of IMV translated to a significantly longer hospital LOS among patients receiving triple therapy compared to dual therapy (26 days vs. 17 days, respectively; P=0.001). Conclusion In patients receiving supplemental oxygen without IMV for SARS-CoV-2, triple therapy was not associated with a clinically meaningful reduction in 28-day mortality when compared to dual therapy. Disclosures All Authors: No reported disclosures

Artificial ventilation in cardiopulmonary resuscitation

2016 ◽  
Author(s):  
Jasmeet Soar ◽  
Jerry P. Nolan
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Patient Characteristics ◽  
Supplemental Oxygen ◽  
Spontaneous Circulation ◽  
Chest Compressions ◽  
Ventilation Technique ◽  
Effective Ventilation ◽  
Ability And Willingness ◽  
Inspired Oxygen

When cardiac arrest occurs, cardiopulmonary resuscitation (CPR) should be started with chest compressions first. The use of ventilations is determined by the training of rescuers, their ability and willingness to provide rescue breaths, patient characteristics, and the underlying cause of the cardiac arrest. Trained rescuers should give two ventilations after every 30 compressions, or once the airway is secured with a tracheal tube, ventilate the patient at 10 breaths/min without any pause in chest compressions. Rescuers who are unable or unwilling to provide effective ventilation, while awaiting expert help should use compression-only CPR. Ventilations are needed for the treatment of cardiac arrest in children, when arrest is from a primary respiratory cause, or during a prolonged cardiac arrest. Choice of ventilation technique depends on rescuer skills and the airway used. Effective oxygenation and ventilation can be maintained during CPR with a tidal volume of approximately 500 mL given over an inspiratory time of 1 second. Rescuers should give supplemental oxygen in as high a concentration as possible during CPR in order to rapidly correct tissue hypoxia. Once restoration of a spontaneous circulation has been achieved the inspired oxygen should be adjusted to maintain oxygen saturation between 94 and 98%.

Multicenter Trial of Single-Dose Modified Bovine Surfactant Extract (Survanta) for Prevention of Respiratory Distress Syndrome

PEDIATRICS ◽  
1990 ◽  
Vol 85 (6) ◽  
pp. 1092-1102
Author(s):  
Roger F. Soll ◽  
Ronald E. Hoekstra ◽  
John J. Fangman ◽  
Anthony J. Corbet ◽  
James M. Adams ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Clinical Status ◽  
Supplemental Oxygen ◽  
Assisted Ventilation ◽  
Fraction Of Inspired Oxygen ◽  
Alveolar Oxygen ◽  
Inspired Oxygen

A multicenter, prospective randomized controlled trial was performed comparing the efficacy of a single intratracheal dose of modified bovine surfactant extract (Survanta, 100 mg/kg, Abbott Laboratory, North Chicago, IL) with air placebo in preventing respiratory distress syndrome. Infants were enrolled if they were estimated to be between 24 and 30 weeks' gestation, weighed between 750 and 1250 g, and were intubated and stabilized within 15 minutes after birth. A total of 160 infants were treated (79 with surfactant, 81 with air placebo) between 4 and 37 minutes after birth (median time 12 minutes). Of these, 5 infants were excluded from the final analysis. The 72-hour average values for the arterial-alveolar oxygen ratio, fraction of inspired oxygen, and mean airway pressure were calculated from the area under the curve of scheduled values measured throughout 72 hours. Clinical status was classified using five ordered categories (no supplemental oxygen or assisted ventilation, supplemental oxygen only, continuous positive airway pressure or assisted ventilation with intermittent mandatory ventilation ≤6 breaths/min, assisted ventilation with intermittent mandatory ventilation >6 breaths/min, death). Chest radiographs at 24 hours were graded for severity of respiratory distress syndrome. Infants receiving Survanta had less severe radiographic changes at 24 hours of age and decreased average fraction of inspired oxygen (31% vs 42%, P = .002) compared with control infants. No differences were noted in the average arterial-alveolar oxygen ratio, mean airway pressure, or clinical status on days 7 and 28. A beneficial effect was noted in the incidence of pneumothorax (P = .057) and an increase was noted in the incidence of necrotizing enterocolitis (P = .052). No differences in incidence of patent ductus arteriosus, intraventricular hemorrhage, sepsis, or bronchopulmonary dysplasia were seen. According to results of a secondary analysis, there was improvement in the fraction of inspired oxygen and a greater number of survivors without bronchopulmonary dysplasia in the subgroup of infants weighing <1000 g who were treated with surfactant. It was concluded that a single dose of Survanta given shortly after birth resulted in decreased severity of chest radiographic findings 24 hours after treatment and improved oxygenation during 72 hours after treatment, but did not improve other acute measures of disease severity or clinical status later in the neonatal period. The group at highest risk for respiratory distress syndrome (infants with birth weights between 750 and 999 g) may benefit the most from preventive therapy.

Sign in / Sign up

Export Citation Format

Share Document