Impaired pulmonary function after treatment for tuberculosis: the end of the disease?
Chushkin, Mikhail Ivanovich; Ots, Oleg Nikolayevich
2017-01-01
To evaluate the prevalence of pulmonary function abnormalities and to investigate the factors affecting lung function in patients treated for pulmonary tuberculosis. A total of 214 consecutive patients (132 men and 82 women; 20-82 years of age), treated for pulmonary tuberculosis and followed at a local dispensary, underwent spirometry and plethysmography at least one year after treatment. Pulmonary impairment was present in 102 (47.7%) of the 214 patients evaluated. The most common functional alteration was obstructive lung disease (seen in 34.6%). Of the 214 patients, 60 (28.0%) showed reduced pulmonary function (FEV1 below the lower limit of normal). Risk factors for reduced pulmonary function were having had culture-positive pulmonary tuberculosis in the past, being over 50 years of age, having recurrent tuberculosis, and having a lower level of education. Nearly half of all tuberculosis patients evolve to impaired pulmonary function. That underscores the need for pulmonary function testing after the end of treatment. Avaliar a prevalência de alterações da função pulmonar e investigar os fatores que afetam a função pulmonar em pacientes tratados para tuberculose pulmonar. Um total de 214 pacientes consecutivos (132 homens e 82 mulheres; 20-82 anos de idade), tratados para tuberculose pulmonar e acompanhados em um dispensário local, foi submetido a espirometria e pletismografia pelo menos um ano após o tratamento. O comprometimento pulmonar estava presente em 102 (47,7%) dos 214 pacientes avaliados. A alteração funcional mais comum foi o distúrbio ventilatório obstrutivo (observado em 34,6%). Dos 214 pacientes, 60 (28,0%) apresentaram função pulmonar reduzida (VEF1 abaixo do limite inferior de normalidade). Os fatores de risco para função pulmonar reduzida foram tuberculose pulmonar com cultura positiva no passado, idade acima de 50 anos, recidiva de tuberculose e menor nível de escolaridade. Quase metade de todos os pacientes com tuberculose evolui com comprometimento da função pulmonar. Isso reforça a necessidade de testes de função pulmonar após o término do tratamento.
Carneiro, Renata Mota; van Bellen, Bonno; Santana, Pablo Rydz Pinheiro; Gomes, Antônio Carlos Portugal
2017-01-01
Resumo Contexto Devido à maior aplicação de exames de imagem rotineiros, especialmente nos pacientes com neoplasia para controle da doença, vem aumentando o diagnóstico de tromboembolismo pulmonar (TEP) incidental, importante fator de morbimortalidade associado. Objetivo Identificar os casos de TEP incidental em pacientes oncológicos submetidos a tomografia computadorizada (TC) de tórax, correlacionando aspectos clínicos e fatores de risco associados. Métodos Estudo retrospectivo de todos os episódios de TEP ocorridos de janeiro de 2013 a junho de 2016, com seleção dos pacientes oncológicos e divisão deles em dois grupos: com suspeita clínica e sem suspeita clínica (incidentais) de embolia pulmonar. Resultados Foram avaliados 468 pacientes com TEP no período citado. Destes, 23,1% eram oncológicos, entre os quais 44,4% apresentaram achado incidental de embolia pulmonar na TC de tórax. Não houve diferença estatística entre os grupos para sexo, idade e tabagismo. Quanto à procedência, 58,3% dos pacientes sem suspeita clínica eram de origem ambulatorial e 41,7% com suspeita de TEP vinham do pronto-socorro (p < 0,001). As neoplasias mais prevalentes foram de pulmão (17,6%), intestino (15,7%) e mama (13,0%). Aqueles com achado incidental apresentaram significativamente mais metástases, sem diferença entre os grupos para realização de quimioterapia, radioterapia ou cirurgia recente. Quanto aos sintomas apresentados, 41,9% daqueles sem suspeita clínica tinham queixas sugestivas de TEP quando realizaram o exame. Conclusão TEP incidental é frequente em pacientes oncológicos, especialmente naqueles provenientes de seguimento ambulatorial e em estágios avançados da doença. Sintomas sugestivos de TEP estavam presentes em pacientes sem suspeita clínica ao realizarem a TC de tórax. PMID:29930652
Terapia fibrinolítica sistêmica no tromboembolismo pulmonar
Ceresetto, José Manuel; Marques, Marcos Arêas
2017-01-01
Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central. PMID:29930636
Soder, Stephan Adamour; Barth, Frederico; Perin, Fabiola Adelia; Felicetti, José Carlos; Camargo, José de Jesus Peixoto; Camargo, Spencer Marcantônio
2017-01-01
To describe our experience with video-assisted thoracic surgery (VATS) for anatomic pulmonary resection at a referral center for thoracic surgery in Brazil. All patients who underwent anatomic pulmonary resection by VATS between 2010 and 2015 were included. Clinical and pathological data, as well as postoperative complications, were analyzed. A total of 117 pulmonary resections by VATS were performed, of which 98 were lobectomies and 19 were anatomic segmentectomies. The mean age of the patients was 63.6 years (range, 15-86 years). Females predominated (n = 69; 59%). The mean time to chest tube removal was 2.47 days, and the mean length of ICU stay was 1.88 days. The mean length of hospital stay was 4.48 days. Bleeding ≥ 400 mL occurred in 15 patients. Conversion to thoracotomy was required in 4 patients. Our results are similar to those published in major international studies, indicating that VATS is an important strategy for pulmonary resection. They also show that VATS can be safely performed with adequate training. This technique should be used more often for the treatment of lung diseases in Brazil. Relatar a experiência com cirurgia torácica videoassistida (CTVA) para ressecções pulmonares anatômicas em um centro nacional de referência de cirurgia torácica no Brasil. Foram incluídos todos os pacientes tratados com ressecções pulmonares anatômicas por CTVA entre 2010 e 2015 e analisados dados clínicos e patológicos, assim como complicações pós-operatórias. Foram realizadas 117 ressecções pulmonares por CTVA, sendo 98 lobectomias e 19 segmentectomias anatômicas. A média de idade foi de 63,6 anos (variação, 15-86 anos), sendo a maioria mulheres (n = 69; 59%). A média de tempo de permanência com dreno foi de 2,47 dias e a de estada em UTI foi de 1,88 dias. A média de tempo de internação foi de 4,48 dias. Sangramento ≥ 400 ml ocorreu em 15 pacientes. Houve conversão para toracotomia em 4 pacientes. Nossos resultados vão ao encontro de publicações em grandes séries internacionais, corroborando que a CTVA é uma importante via de execução de ressecções pulmonares e que pode ser realizada com segurança quando há treinamento adequado, devendo ser mais utilizada no Brasil para o tratamento das doenças pulmonares.
Hard metal lung disease: a case series.
Mizutani, Rafael Futoshi; Terra-Filho, Mário; Lima, Evelise; Freitas, Carolina Salim Gonçalves; Chate, Rodrigo Caruso; Kairalla, Ronaldo Adib; Carvalho-Oliveira, Regiani; Santos, Ubiratan Paula
2016-01-01
To describe diagnostic and treatment aspects of hard metal lung disease (HMLD) and to review the current literature on the topic. This was a retrospective study based on the medical records of patients treated at the Occupational Respiratory Diseases Clinic of the Instituto do Coração, in the city of São Paulo, Brazil, between 2010 and 2013. Of 320 patients treated during the study period, 5 (1.56%) were diagnosed with HMLD. All of those 5 patients were male (mean age, 42.0 ± 13.6 years; mean duration of exposure to hard metals, 11.4 ± 8.0 years). Occupational histories were taken, after which the patients underwent clinical evaluation, chest HRCT, pulmonary function tests, bronchoscopy, BAL, and lung biopsy. Restrictive lung disease was found in all subjects. The most common chest HRCT finding was ground glass opacities (in 80%). In 4 patients, BALF revealed multinucleated giant cells. In 3 patients, lung biopsy revealed giant cell interstitial pneumonia. One patient was diagnosed with desquamative interstitial pneumonia associated with cellular bronchiolitis, and another was diagnosed with a hypersensitivity pneumonitis pattern. All patients were withdrawn from exposure and treated with corticosteroid. Clinical improvement occurred in 2 patients, whereas the disease progressed in 3. Although HMLD is a rare entity, it should always be included in the differential diagnosis of respiratory dysfunction in workers with a high occupational risk of exposure to hard metal particles. A relevant history (clinical and occupational) accompanied by chest HRCT and BAL findings suggestive of the disease might be sufficient for the diagnosis. Descrever aspectos relacionados ao diagnóstico e tratamento de pacientes com doença pulmonar por metal duro (DPMD) e realizar uma revisão da literatura. Estudo retrospectivo dos prontuários médicos de pacientes atendidos no Serviço de Doenças Respiratórias Ocupacionais do Instituto do Coração, localizado na cidade de São Paulo, entre 2010 e 2013. Entre 320 pacientes atendidos no período do estudo, 5 (1,56%) foram diagnosticados com DPMD. Todos os pacientes eram do sexo masculino, com média de idade de 42,0 ± 13,6 anos e média de tempo de exposição a metal duro de 11,4 ± 8,0 anos. Os pacientes foram submetidos a avaliação clinica, história ocupacional, TCAR de tórax, prova de função pulmonar, broncoscopia com LBA e biópsia pulmonar. Todos apresentaram distúrbio ventilatório restritivo. O achado de imagem à TCAR de tórax mais frequente foi de opacidades em vidro fosco (em 80%). Em 4 pacientes, o LBA revelou presença de células gigantes multinucleadas. Em 3, foi diagnosticada pneumonia intersticial por células gigantes na biópsia pulmonar. Houve o diagnóstico de pneumonia intersticial descamativa associada à bronquiolite celular em 1 paciente e de pneumonite de hipersensibilidade em 1. Todos foram afastados da exposição e tratados com corticoide. Houve melhora em 2 pacientes e progressão da doença em 3. Apesar de ser uma entidade rara, a DPMD deve ser sempre considerada em trabalhadores com risco ocupacional elevado de exposição a metais duros. A história clínica e ocupacional associada a achados em TCAR de tórax e LBA sugestivos da doença podem ser suficientes para o diagnóstico.
Vieira, Ana Karine; Alvim, Cristina Gonçalves; Carneiro, Maria Cristina Marquez; Ibiapina, Cássio da Cunha
2016-01-01
To evaluate pulmonary function and functional capacity in children and adolescents with sickle cell disease. This was a cross-sectional study involving 70 children and adolescents (8-15 years of age) with sickle cell disease who underwent pulmonary function tests (spirometry) and functional capacity testing (six-minute walk test). The results of the pulmonary function tests were compared with variables related to the severity of sickle cell disease and history of asthma and of acute chest syndrome. Of the 64 patients who underwent spirometry, 15 (23.4%) showed abnormal results: restrictive lung disease, in 8 (12.5%); and obstructive lung disease, in 7 (10.9%). Of the 69 patients who underwent the six-minute walk test, 18 (26.1%) showed abnormal results regarding the six-minute walk distance as a percentage of the predicted value for age, and there was a ≥ 3% decrease in SpO2 in 36 patients (52.2%). Abnormal pulmonary function was not significantly associated with any of the other variables studied, except for hypoxemia and restrictive lung disease. In this sample of children and adolescents with sickle cell disease, there was a significant prevalence of abnormal pulmonary function. The high prevalence of respiratory disorders suggests the need for a closer look at the lung function of this population, in childhood and thereafter. Avaliar a função pulmonar e a capacidade funcional em crianças e adolescentes com doença falciforme. Estudo transversal com 70 crianças e adolescentes com doença falciforme (8-15 anos), submetidos a testes de função respiratória (espirometria) e de capacidade funcional (teste de caminhada de seis minutos). Os resultados da avaliação da função pulmonar foram comparados com variáveis relacionadas à gravidade da doença falciforme e à presença de história de asma e de síndrome torácica aguda. Dos 64 pacientes submetidos à espirometria, 15 (23,4%) apresentaram resultados alterados: distúrbio ventilatório restritivo, em 8; (12,5%) e distúrbio respiratório obstrutivo, em 7 (10,9%). Dos 69 pacientes submetidos ao teste de caminhada de seis minutos, 18 (26,1%) apresentaram resultados alterados na distância em % do previsto para a idade, e houve uma queda ≥ 3% na SpO2 em 36 (52,2%) dos pacientes. Não houve associações significativas entre função pulmonar alterada e as outras variáveis analisadas, exceto para hipoxemia e distúrbio ventilatório restritivo. Observou-se uma significativa prevalência de alterações na função pulmonar nesta amostra de crianças e adolescentes com doença falciforme. A elevada prevalência de distúrbios ventilatórios sugere a necessidade de um olhar mais atento à função pulmonar desde a infância nessa população.
Trombo flutuante em veia femoral
Bertanha, Matheus; Pimenta, Rafael Elias Farres; Brandão, Gustavo Muçouçah Sampaio; Sobreira, Marcone Lima; Moura, Regina; Jaldin, Rodrigo Gibin; de Camargo, Paula Angeleli Bueno; Yoshida, Winston Bonetti
2017-01-01
Resumo O trombo venoso flutuante em veia femoral é um tipo de trombo com alto potencial de embolização pulmonar. Entretanto, ainda é controversa a conduta mais apropriada nesses casos. Tratamentos clínicos com anticoagulantes ou fibrinolíticos e trombectomias abertas ou por meio de dispositivos endovasculares vêm sendo empregados ainda sem um critério de indicação bem definido. Apresentamos três casos clínicos de trombos flutuantes em veia femoral, de etiologias distintas, cujos tratamentos e respectivas evoluções serão discutidos. PMID:29930666
Pre-treatment with dexamethasone attenuates experimental ventilator-induced lung injury.
Reis, Fernando Fonseca Dos; Reboredo, Maycon de Moura; Lucinda, Leda Marília Fonseca; Bianchi, Aydra Mendes Almeida; Rabelo, Maria Aparecida Esteves; Fonseca, Lídia Maria Carneiro da; Oliveira, Júlio César Abreu de; Pinheiro, Bruno Valle
2016-01-01
To evaluate the effects that administering dexamethasone before the induction of ventilator-induced lung injury (VILI) has on the temporal evolution of that injury. Wistar rats were allocated to one of three groups: pre-VILI administration of dexamethasone (dexamethasone group); pre-VILI administration of saline (control group); or ventilation only (sham group). The VILI was induced by ventilation at a high tidal volume. Animals in the dexamethasone and control groups were euthanized at 0, 4, 24, and 168 h after VILI induction. We analyzed arterial blood gases, lung edema, cell counts (total and differential) in the BAL fluid, and lung histology. At 0, 4, and 24 h after VILI induction, acute lung injury (ALI) scores were higher in the control group than in the sham group (p < 0.05). Administration of dexamethasone prior to VILI induction decreased the severity of the lung injury. At 4 h and 24 h after induction, the ALI score in the dexamethasone group was not significantly different from that observed for the sham group and was lower than that observed for the control group (p < 0.05). Neutrophil counts in BAL fluid were increased in the control and dexamethasone groups, peaking at 4 h after VILI induction (p < 0.05). However, the neutrophil counts were lower in the dexamethasone group than in the control group at 4 h and 24 h after induction (p < 0.05). Pre-treatment with dexamethasone also prevented the post-induction oxygenation impairment seen in the control group. Administration of dexamethasone prior to VILI induction attenuates the effects of the injury in Wistar rats. The molecular mechanisms of such injury and the possible clinical role of corticosteroids in VILI have yet to be elucidated. Avaliar os efeitos da administração de dexametasona antes da indução de lesão pulmonar induzida por ventilação mecânica (LPIVM) na evolução temporal dessa lesão. Ratos Wistar foram alocados em um dos três grupos: administração de dexametasona pré-LPIVM (grupo dexametasona); administração de salina pré-LPIVM (grupo controle); e somente ventilação (grupo sham). A LPIVM foi realizada por ventilação com volume corrente alto. Os animais dos grupos dexametasona e controle foram sacrificados em 0, 4, 24 e 168 h após LPIVM. Analisamos gasometria arterial, edema pulmonar, contagens de células (totais e diferenciais) no lavado broncoalveolar e histologia de tecido pulmonar. Em 0, 4 e 24 h após LPIVM, os escores de lesão pulmonar aguda (LPA) foram maiores no grupo controle que no grupo sham (p < 0,05). A administração de dexametasona antes da LPIVM reduziu a gravidade da lesão pulmonar. Em 4 e 24 h após a indução, o escore de LPA no grupo dexametasona não foi significativamente diferente daquele observado no grupo sham e foi menor que o observado no grupo controle (p < 0,05). As contagens de neutrófilos no lavado broncoalveolar estavam aumentadas nos grupos controle e dexametasona, com pico em 4 h após LPIVM (p < 0,05). Entretanto, as contagens de neutrófilos foram menores no grupo dexametasona que no grupo controle em 4 e 24 h após LPIVM (p < 0,05). O pré-tratamento com dexametasona também impediu o comprometimento da oxigenação após a indução visto no grupo controle. A administração de dexametasona antes de LPIVM atenua os efeitos da lesão em ratos Wistar. Os mecanismos moleculares dessa lesão e o possível papel clínico dos corticosteroides na LPIVM ainda precisam ser elucidados.
Araujo, Pedro Henrique Xavier Nabuco de; Terra, Ricardo Mingarini; Santos, Thiago da Silva; Chate, Rodrigo Caruso; Paiva, Antonio Fernando Lins de; Pêgo-Fernandes, Paulo Manuel
2017-01-01
To evaluate the role of intrapleural positioning of a pleural catheter in early lung expansion and pleurodesis success in patients with recurrent malignant pleural effusion (RMPE). This was a retrospective study nested into a larger prospective cohort study including patients with RMPE recruited from a tertiary university teaching hospital between June of 2009 and September of 2014. The patients underwent pleural catheter insertion followed by bedside pleurodesis. Chest CT scans were performed twice: immediately before pleurodesis (iCT) and 30 days after pleurodesis (CT30). Catheter positioning was categorized based on iCT scans as posterolateral, anterior, fissural, and subpulmonary. We used the pleural volume on iCT scans to estimate early lung expansion and the difference between the pleural volumes on CT30 and iCT scans to evaluate radiological success of pleurodesis. Clinical pleurodesis success was defined as no need for any other pleural procedure. Of the 131 eligible patients from the original study, 85 were included in this nested study (64 women; mean age: 60.74 years). Catheter tip positioning was subpulmonary in 35 patients (41%), anterior in 23 (27%), posterolateral in 17 (20%), and fissural in 10 (12%). No significant differences were found among the groups regarding early lung expansion (median residual pleural cavity = 377 mL; interquartile range: 171-722 mL; p = 0.645), radiological success of pleurodesis (median volume = 33 mL; interquartile range: -225 to 257 mL; p = 0.923), and clinical success of pleurodesis (85.8%; p = 0.676). Our results suggest that the position of the tip of the pleural catheter influences neither early lung expansion nor bedside pleurodesis success in patients with RMPE. Avaliar o papel do posicionamento intrapleural do cateter pleural na expansão pulmonar precoce e no sucesso da pleurodese em pacientes com derrame pleural maligno recorrente (DPMR). Trata-se de um estudo retrospectivo aninhado em um estudo prospectivo de coorte maior com pacientes com DPMR recrutados em um hospital-escola universitário terciário entre junho de 2009 e setembro de 2014. Os pacientes foram submetidos a inserção de cateter pleural e, em seguida, pleurodese à beira do leito. A TC de tórax foi realizada duas vezes: imediatamente antes da pleurodese (TCi) e 30 dias após a pleurodese (TC30). Com base na TCi, a posição do cateter foi classificada em posterolateral, anterior, fissural e subpulmonar. Usamos o volume pleural na TCi para estimar a expansão pulmonar precoce e a diferença entre os volumes pleurais na TC30 e na TCi a fim de avaliar o sucesso radiológico da pleurodese. Considerou-se que a pleurodese teve êxito clínico quando não foi necessário realizar nenhum outro procedimento pleural. Dos 131 pacientes elegíveis do estudo original, 85 foram incluídos neste estudo aninhado (64 mulheres; média de idade: 60,74 anos). A posição da ponta do cateter foi subpulmonar em 35 pacientes (41%), anterior em 23 (27%), posterolateral em 17 (20%) e fissural em 10 (12%). Não houve diferenças significativas entre os grupos quanto à expansão pulmonar precoce (mediana da cavidade pleural residual = 377 ml; intervalo interquartil: 171-722 ml; p = 0,645), sucesso radiológico da pleurodese (mediana do volume = 33 ml; intervalo interquartil: -225 a 257 ml; p = 0,923) e sucesso clínico da pleurodese (85,8%; p = 0,676). Nossos resultados sugerem que a posição da ponta do cateter pleural não influencia nem a expansão pulmonar precoce nem o sucesso da pleurodese à beira do leito em pacientes com DPMR.
Effects of emissions from sugar cane burning on the trachea and lungs of Wistar rats.
Matos, Verena Sampaio Barbosa; Gomes, Felipe da Silva; Oliveira, Tarcio Macena; Schulz, Renata da Silva; Ribeiro, Lídia Cristina Villela; Gonzales, Astria Dias Ferrão; Lima, Januário Mourão; Guerreiro, Marcos Lázaro da Silva
2017-01-01
To evaluate the effects of exposure to emissions from sugar cane burning on inflammatory mechanisms in tissues of the trachea and lung parenchyma in Wistar rats after different periods of exposure. This was an experimental open randomized study. The animals were divided into four groups: a control group (CG) underwent standard laboratory conditions, and three experimental groups were exposed to emissions from sugar cane burning over different periods of time, in days-1 (EG1), 7 (EG7), and 21 (EG21). After euthanasia with 200 mg/kg of ketamine/xylazine, fragments of trachea and lung were collected and fixed in 10% formalin. Histological analyses were performed with H&E and picrosirius red staining. No inflammatory infiltrates were found in the tissues of CG rats. The histological examination of tissues of the trachea and lung parenchyma revealed that the inflammatory process was significantly more intense in EG7 than in the CG (p < 0.05 and p < 0.01, respectively). In comparison with the CG and EG1, angiogenesis in the lung parenchyma and collagen deposition in tracheal tissues were significantly greater only in EG21 (p < 0.001 and p < 0.01, respectively). In this sample, emissions from sugar cane burning induced acute focal and diffuse inflammation in the lamina propria of tracheal tissues, with no loss of ciliated epithelial tissue. In the lung parenchyma of the animals in the experimental groups, there was interstitial and alveolar edema, together with polymorphonuclear cell infiltrates. Avaliar os efeitos da exposição à fumaça da queima da cana-de-açúcar sobre mecanismos inflamatórios em tecidos de traqueia e de parênquima pulmonar de ratos Wistar após diferentes períodos de exposição. Estudo experimental, randomizado, não cego. Os animais foram divididos em quatro grupos: controle (GC), sob condições padrão de laboratório e os demais expostos à fumaça da queima da cana-de-açúcar por diferentes períodos: em 1 (GE1), 7 (GE7) e 21 (GE21) dias. Após a eutanásia com 200 mg/kg de ketamina/xilazina, foram coletados fragmentos de traqueia e pulmão e fixadas em formol 10%. Análises histológicas foram realizadas com coloração com H&E e picrosírius. Não houve infiltrado inflamatório nos tecidos no GC. O processo inflamatório na análise histológica de tecidos de traqueia e de parênquima pulmonar foi significativamente mais intenso no GE7 quando comparado ao GC (p < 0,05 e p < 0,01, respectivamente). Em comparação com os grupos GC e GE1, apenas no GE21 foi observada angiogênese significativa no parênquima pulmonar e aumento significativo de depósitos de colágeno em tecido de traqueia (p < 0,001 e p < 0,01, respectivamente). Nesta amostra, a fumaça da queima de cana-de-açúcar induziu processo inflamatório focal, difuso e agudo em tecidos de traqueia na lâmina própria, sem perda do tecido epitelial ciliado. Houve presença de edemas intersticiais e alveolares e infiltrados de células polimorfonucleares no parênquima pulmonar nos animais dos grupos experimentais.
Muñoz-Torrico, Marcela; Rendon, Adrian; Centis, Rosella; D'Ambrosio, Lia; Fuentes, Zhenia; Torres-Duque, Carlos; Mello, Fernanda; Dalcolmo, Margareth; Pérez-Padilla, Rogelio; Spanevello, Antonio; Migliori, Giovanni Battista
2016-01-01
The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year. We carried out a non-systematic literature review based on a PubMed search using specific keywords (various combinations of the terms "tuberculosis", "rehabilitation", "multidrug-resistant tuberculosis", "pulmonary disease", "obstructive lung disease", and "lung volume measurements"). The reference lists of the most important studies were retrieved in order to improve the sensitivity of the search. Manuscripts written in English, Spanish, and Russian were selected. The main areas of interest were tuberculosis sequelae following tuberculosis diagnosis and treatment; "destroyed lung"; functional evaluation of sequelae; pulmonary rehabilitation interventions (physiotherapy, long-term oxygen therapy, and ventilation); and multidrug-resistant tuberculosis.The evidence found suggests that tuberculosis is definitively responsible for functional sequelae, primarily causing an obstructive pattern on spirometry (but also restrictive and mixed patterns), and that there is a rationale for pulmonary rehabilitation. We also provide a list of variables that should be discussed in future studies on pulmonary rehabilitation in patients with post-tuberculosis sequelae. RESUMO O papel da tuberculose como uma prioridade de saúde pública e a disponibilidade de ferramentas diagnósticas para avaliar o estado funcional (espirometria, pletismografia e DLCO), a gasometria arterial, a capacidade de realizar exercícios, as lesões (radiografia de tórax e TC) e a qualidade de vida justificam o esforço de se considerar o que deve ser feito quando os pacientes completam seu tratamento. Até onde sabemos, nenhuma revisão avaliou esse tópico de forma abrangente. Nosso objetivo foi revisar as evidências disponíveis e obter algumas conclusões sobre o futuro papel da fase de "tratamento pós-tuberculose", que irá potencialmente impactar milhões de casos todos os anos. Realizou-se uma revisão não sistemática da literatura tendo como base uma pesquisa no PubMed usando palavras-chave específicas (várias combinações dos termos "tuberculose", "reabilitação", "tuberculose multirresistente", "doença pulmonar", "doença pulmonar obstrutiva", e "medidas de volume pulmonar"). As listas de referências dos artigos principais foram recuperadas para melhorar a sensibilidade da busca. Foram selecionados manuscritos escritos em inglês, espanhol e russo. As principais áreas de interesse foram sequelas de tuberculose após diagnóstico e tratamento; "pulmão destruído"; avaliação funcional das sequelas; intervenções de reabilitação pulmonar (fisioterapia, oxigenoterapia de longo prazo e ventilação); e tuberculose multirresistente. As evidências encontradas sugerem que a tuberculose é definitivamente responsável por sequelas funcionais, principalmente causando um padrão obstrutivo na espirometria (mas também padrões restritivos e mistos) e que há razão para a reabilitação pulmonar. Fornecemos também uma lista de variáveis a serem discutidas em futuros estudos sobre reabilitação pulmonar em pacientes com sequelas pós-tuberculose.
Pleuroparenchymal fibroelastosis: report of two cases in Brazil.
Gomes, Paula Silva; Shiang, Christina; Szarf, Gilberto; Coletta, Ester Nei Aparecida Martins; Pereira, Carlos Alberto de Castro
2017-01-01
Pleuroparenchymal fibroelastosis (PPFE) is a rare lung disease. It can be idiopathic or associated with any one of various conditions. To our knowledge, this is the first report of two cases of PPFE in Brazil. Our first patient presented with pleural and subpleural fibrosis in the upper lobes; a spiculated nodule in the left upper lobe; and a mild reticular pattern in the lower lobes. Surgical lung biopsy revealed PPFE in the upper lobes, including the nodule, and unclassified interstitial pneumonia in the left lower lobe. Our second patient had a history of exposure to domestic birds, indicating a risk of hypersensitivity pneumonitis, and presented with advanced lung disease, predominantly in the upper lobes, together with subpleural fibrosis.That patient underwent lung transplantation. In the explant specimen, PPFE and granulomas were identified, suggesting hypersensitivity pneumonitis as an associated cause. RESUMO A fibroelastose pleuroparenquimatosa (FEPP) é uma doença pulmonar rara, podendo ser idiopática ou associada a diversas condições. Pelo que sabemos, este é o primeiro relato de dois casos de FEPP no Brasil. Nosso primeiro paciente apresentava fibrose pleural e subpleural nos lobos superiores, um nódulo espiculado no lobo superior esquerdo e um padrão reticular discreto nos lobos inferiores. A biópsia pulmonar cirúrgica demonstrou FEPP nos lobos superiores, incluindo no nódulo, e pneumonia intersticial não classificada no lobo inferior esquerdo. Nosso segundo paciente tinha história de exposição a aves domésticas, indicando um risco de pneumonite de hipersensibilidade, e doença pulmonar avançada predominando em lobos superiores, com fibrose subpleural. Esse paciente foi submetido a transplante pulmonar. No espécime do explante, FEPP e granulomas foram identificados, sugerindo pneumonite de hipersensibilidade como causa associada.
Phenotypes of asthma in low-income children and adolescents: cluster analysis.
Cabral, Anna Lucia Barros; Sousa, Andrey Wirgues; Mendes, Felipe Augusto Rodrigues; Carvalho, Celso Ricardo Fernandes de
2017-01-01
Studies characterizing asthma phenotypes have predominantly included adults or have involved children and adolescents in developed countries. Therefore, their applicability in other populations, such as those of developing countries, remains indeterminate. Our objective was to determine how low-income children and adolescents with asthma in Brazil are distributed across a cluster analysis. We included 306 children and adolescents (6-18 years of age) with a clinical diagnosis of asthma and under medical treatment for at least one year of follow-up. At enrollment, all the patients were clinically stable. For the cluster analysis, we selected 20 variables commonly measured in clinical practice and considered important in defining asthma phenotypes. Variables with high multicollinearity were excluded. A cluster analysis was applied using a twostep agglomerative test and log-likelihood distance measure. Three clusters were defined for our population. Cluster 1 (n = 94) included subjects with normal pulmonary function, mild eosinophil inflammation, few exacerbations, later age at asthma onset, and mild atopy. Cluster 2 (n = 87) included those with normal pulmonary function, a moderate number of exacerbations, early age at asthma onset, more severe eosinophil inflammation, and moderate atopy. Cluster 3 (n = 108) included those with poor pulmonary function, frequent exacerbations, severe eosinophil inflammation, and severe atopy. Asthma was characterized by the presence of atopy, number of exacerbations, and lung function in low-income children and adolescents in Brazil. The many similarities with previous cluster analyses of phenotypes indicate that this approach shows good generalizability. Estudos que caracterizam fenótipos de asma predominantemente incluem adultos ou foram realizados em crianças e adolescentes de países desenvolvidos; portanto, sua aplicabilidade em outras populações, tais como as de países em desenvolvimento, permanece indeterminada. Nosso objetivo foi determinar como crianças e adolescentes asmáticas de baixa renda no Brasil são distribuídos através de uma análise de clusters. Foram incluídos 306 crianças e adolescentes (6-18 anos de idade) com diagnóstico clínico de asma e sob tratamento médico por pelo menos um ano de acompanhamento. No momento da inclusão, todos os pacientes estavam clinicamente estáveis. Vinte variáveis comumente determinadas na prática clínica e consideradas importantes na definição dos fenótipos de asma foram selecionadas para a análise de clusters. As variáveis com alta multicolinearidade foram excluídas. Uma análise de clusters foi realizada utilizando-se um teste aglomerativo em duas etapas e log-likelihood distance measure. Três clusters foram definidos para nossa população. O cluster 1 (n = 94) incluiu indivíduos com função pulmonar normal, inflamação eosinofílica leve, poucas exacerbações, início mais tardio da asma e atopia leve. O cluster 2 (n = 87) incluiu pacientes com função pulmonar normal, número moderado de exacerbações, início precoce da asma, inflamação eosinofílica mais grave e atopia moderada. O cluster 3 (n = 108) incluiu pacientes com função pulmonar ruim, exacerbações frequentes, inflamação eosinofílica e atopia graves. A asma foi caracterizada por presença de atopia, número de exacerbações e função pulmonar em crianças e adolescentes de baixa renda no Brasil. As muitas semelhanças entre esta e outras análises de clusters de fenótipos indicam que essa abordagem apresenta boa generalização.
Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room.
Mancuso, Frederico José Neves; Siqueira, Vicente Nicoliello; Moisés, Valdir Ambrósio; Gois, Aécio Flavio Teixeira; Paola, Angelo Amato Vincenzo de; Carvalho, Antonio Carlos Camargo; Campos, Orlando
2014-10-28
Background: Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. Objective: To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. Methods: One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. Results: The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. Conclusion: The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.Fundamento: As urgências cardiovasculares são causas importantes de procura por atendimento médico, sendo fundamentais a rapidez e a precisão no diagnóstico para diminuir sua morbimortalidade. Objetivo: Avaliar o uso da ecocardiografia direcionada como complemento diagnóstico ao exame físico em um serviço terciário de emergências clínicas. Métodos: Foram incluídos cem pacientes adultos sem doenças cardíacas ou pulmonares conhecidas que procuraram atendimento de urgência com queixas cardiológicas. Foram excluídos pacientes com alterações isquêmicas no eletrocardiograma ou febre. A ecocardiografia direcionada foi realizada logo após a avaliação inicial do paciente na sala de emergência, com aparelho ultraportátil GE Vscan, avaliando subjetivamente: dimensões das cavidades, função sistólica ventricular, fluxos intracardíacos pelo mapeamento de fluxo em cores, pericárdio e aorta. Resultados: A idade média dos pacientes foi 61 ± 17 anos. O quadro clínico inicial foi dor torácica (52 pacientes), dispneia (32 pacientes), arritmia/avaliação da função ventricular (dez pacientes), hipotensão/tontura (cinco pacientes) e edema periférico (um paciente). Em 28 pacientes a ecocardiografia direcionada confirmou a hipótese diagnóstica inicial: 19 pacientes com insuficiência cardíaca, cinco com síndrome coronariana aguda, dois com tromboembolismo pulmonar e dois com tamponamento cardíaco. Em 17 pacientes, a ecocardiografia direcionada alterou o diagnóstico, afastando a hipótese clínica inicial em dez casos com suspeita de insuficiência cardíaca, dois com suspeita de tromboembolismo pulmonar, dois com hipotensão a esclarecer, e em cada um dos três restantes com suspeitas de síndrome coronariana aguda, tamponamento cardíaco e dissecção de aorta. Conclusão: A ecocardiografia direcionada ultraportátil em serviço de emergências clínicas pode definir rapidamente o diagnóstico e, com isso, é possível iniciar mais precocemente o tratamento adequado.
Rocha, Flávia Roberta; Brüggemann, Ana Karla Vieira; Francisco, Davi de Souza; Medeiros, Caroline Semprebom de; Rosal, Danielle; Paulin, Elaine
2017-01-01
To evaluate diaphragmatic mobility in relation to lung function, respiratory muscle strength, dyspnea, and physical activity in daily life (PADL) in patients with COPD. We included 25 patients with COPD, classified according to the Global Initiative for Chronic Obstructive Lung Disease criteria, and 25 healthy individuals. For all of the participants, the following were evaluated: anthropometric variables, spirometric parameters, respiratory muscle strength, diaphragmatic mobility (by X-ray), PADL, and the perception of dyspnea. In the COPD group, diaphragmatic mobility was found to correlate with lung function variables, inspiratory muscle strength, and the perception of dyspnea, whereas it did not correlate with expiratory muscle strength or PADL. In patients with COPD, diaphragmatic mobility seems to be associated with airway obstruction and lung hyperinflation, as well as with ventilatory capacity and the perception of dyspnea, although not with PADL. Avaliar a relação da mobilidade diafragmática com a função pulmonar, força muscular respiratória, dispneia e atividade física de vida diária (AFVD) em pacientes com DPOC. Foram avaliados 25 pacientes com diagnóstico de DPOC, classificados de acordo com critérios da Global Initiative for Chronic Obstructive Lung Disease, e 25 indivíduos saudáveis. Todos foram submetidos às seguintes avaliações: mensuração antropométrica, espirometria, força muscular respiratória, mobilidade diafragmática (por radiografia), AFVD e percepção de dispneia. No grupo DPOC, houve correlações da mobilidade diafragmática com variáveis de função pulmonar, força muscular inspiratória e percepção de dispneia. Não houve correlações da mobilidade diafragmática com força muscular expiratória e AFVD. A mobilidade diafragmática parece estar associada tanto com a obstrução das vias aéreas quanto com a hiperinsuflação pulmonar em pacientes com DPOC, assim como com a capacidade ventilatória e percepção de dispneia, mas não com AFVD.
Winck, Aline Dill; Heinzmann-Filho, João Paulo; Schumann, Deise; Zatti, Helen; Mattiello, Rita; Jones, Marcus Herbert; Stein, Renato Tetelbom
2016-01-01
To compare somatic growth, lung function, and level of physical activity in schoolchildren who had been very-low-birth-weight preterm infants (VLBWPIs) or normal-birth-weight full-term infants. We recruited two groups of schoolchildren between 8 and 11 years of age residing in the study catchment area: those who had been VLBWPIs (birth weight < 1,500 g); and those who had been normal-birth-weight full-term infants (controls, birth weight ≥ 2,500 g). Anthropometric and spirometric data were collected from the schoolchildren, who also completed a questionnaire regarding their physical activity. In addition, data regarding the perinatal and neonatal period were collected from the medical records of the VLBWPIs. Of the 93 schoolchildren screened, 48 and 45 were in the VLBWPI and control groups, respectively. No significant differences were found between the groups regarding anthropometric characteristics, nutritional status, or pulmonary function. No associations were found between perinatal/neonatal variables and lung function parameters in the VLBWPI group. Although the difference was not significant, the level of physical activity was slightly higher in the VLBWPI group than in the control group. Among the schoolchildren evaluated here, neither growth nor lung function appear to have been affected by prematurity birth weight, or level of physical activity. Comparar o crescimento somático, a função pulmonar e o nível de atividade física entre escolares nascidos prematuros com muito baixo peso e escolares nascidos a termo e com peso adequado. Foram recrutados escolares com idade de 8 a 11 anos residentes na mesma área de abrangência do estudo: prematuros e com peso < 1.500 g e controles (nascidos a termo e com peso ≥ 2.500 g). Foram obtidas medidas antropométricas e espirométricas e aplicado um questionário sobre a atividade física. Além disso, foram coletadas informações do período perinatal/neonatal dos recém-nascidos com muito baixo peso (RNMBP) de seus prontuários médicos. Dos 93 escolares avaliados, 48 crianças no grupo RNMBP e 45 no grupo controle. Não houve diferenças significativas entre os grupos em relação às características antropométricas e nutricionais ou aos parâmetros de função pulmonar. Não foram encontradas associações entre as variáveis perinatais/neonatais e parâmetros da função pulmonar dos escolares no grupo RNMBP. Embora sem diferença significativa em relação aos níveis de atividade física, o grupo RNMBP apresentou uma tendência de ser mais ativo que o grupo controle. Nos escolares aqui estudados o crescimento e a função pulmonar parecem não ser afetados por prematuridade, peso ao nascimento ou nível de atividade física.
Impact of Intensive Physiotherapy on Cognitive Function after Coronary Artery Bypass Graft Surgery.
Cavalcante, Elder Dos Santos; Magario, Rosmeiri; Conforti, César Augusto; Cipriano Júnior, Gerson; Arena, Ross; Carvalho, Antonio Carlos C; Buffolo, Enio; Luna Filho, Bráulio
2014-11-01
Background: Coronary artery bypass graft (CABG) is a standard surgical option for patients with diffuse and significant arterial plaque. This procedure, however, is not free of postoperative complications, especially pulmonary and cognitive disorders. Objective: This study aimed at comparing the impact of two different physiotherapy treatment approaches on pulmonary and cognitive function of patients undergoing CABG. Methods: Neuropsychological and pulmonary function tests were applied, prior to and following CABG, to 39 patients randomized into two groups as follows: Group 1 (control) - 20 patients underwent one physiotherapy session daily; and Group 2 (intensive physiotherapy) - 19 patients underwent three physiotherapy sessions daily during the recovery phase at the hospital. Non-paired and paired Student t tests were used to compare continuous variables. Variables without normal distribution were compared between groups by using Mann-Whitney test, and, within the same group at different times, by using Wilcoxon test. The chi-square test assessed differences of categorical variables. Statistical tests with a p value ≤ 0.05 were considered significant. Results: Changes in pulmonary function were not significantly different between the groups. However, while Group 2 patients showed no decline in their neurocognitive function, Group 1 patients showed a decline in their cognitive functions (P ≤ 0.01). Conclusion: Those results highlight the importance of physiotherapy after CABG and support the implementation of multiple sessions per day, providing patients with better psychosocial conditions and less morbidity.Fundamento: A cirurgia de revascularização miocárdica (CRM) é a opção cirúrgica padrão para pacientes com placas arteriais difusas e significativas. Tal procedimento, no entanto, não é desprovido de complicações pós-operatórias, especialmente distúrbios pulmonares e cognitivos. Objetivo: Comparar o impacto de duas abordagens fisioterapêuticas diferentes nas funções pulmonar e cognitiva de pacientes submetidos a CRM. Métodos: Testes de função pulmonar e neuropsicológicos foram aplicados, antes e após CRM, a 39 pacientes randomizados em dois grupos: Grupo 1 - 20 pacientes-controle submetidos a uma sessão de fisioterapia por dia; Grupo 2 - 19 pacientes submetidos a três sessões de fisioterapia por dia durante recuperação no hospital. Testes t de Student pareado e não pareado foram usados para comparar as variáveis contínuas. Variáveis sem distribuição normal foram comparadas entre os grupos usando-se o teste de Mann-Whitney, e, dentro do mesmo grupo em momentos diferentes, usando-se o teste de Wilcoxon. O teste do qui-quadrado avaliou diferenças das variáveis categóricas. Testes estatísticos com p valor ≤ 0,05 foram considerados significativos. Resultados: As alterações da função pulmonar não diferiram significativamente entre os grupos. Entretanto, o mesmo não ocorreu com a função neurocognitiva, que apresentou declínio no Grupo 1, mas não no Grupo 2 (p ≤ 0,01). Conclusão: Tais resultados reforçam a importância da fisioterapia após CRM e da realização de múltiplas sessões por dia, o que oferece aos pacientes melhores condições psicossociais e menos morbidade.
A murine model of elastase- and cigarette smoke-induced emphysema.
Rodrigues, Rubia; Olivo, Clarice Rosa; Lourenço, Juliana Dias; Riane, Alyne; Cervilha, Daniela Aparecida de Brito; Ito, Juliana Tiyaki; Martins, Milton de Arruda; Lopes, Fernanda Degobbi Tenório Quirino Dos Santos
2017-01-01
To describe a murine model of emphysema induced by a combination of exposure to cigarette smoke (CS) and instillation of porcine pancreatic elastase (PPE). A total of 38 C57BL/6 mice were randomly divided into four groups: control (one intranasal instillation of 0.9% saline solution); PPE (two intranasal instillations of PPE); CS (CS exposure for 60 days); and CS + PPE (two intranasal instillations of PPE + CS exposure for 60 days). At the end of the experimental protocol, all animals were anesthetized and tracheostomized for calculation of respiratory mechanics parameters. Subsequently, all animals were euthanized and their lungs were removed for measurement of the mean linear intercept (Lm) and determination of the numbers of cells that were immunoreactive to macrophage (MAC)-2 antigen, matrix metalloproteinase (MMP)-12, and glycosylated 91-kDa glycoprotein (gp91phox) in the distal lung parenchyma and peribronchial region. Although there were no differences among the four groups regarding the respiratory mechanics parameters assessed, there was an increase in the Lm in the CS + PPE group. The numbers of MAC-2-positive cells in the peribronchial region and distal lung parenchyma were higher in the CS + PPE group than in the other groups, as were the numbers of cells that were positive for MMP-12 and gp91phox, although only in the distal lung parenchyma. Our model of emphysema induced by a combination of PPE instillation and CS exposure results in a significant degree of parenchymal destruction in a shorter time frame than that employed in other models of CS-induced emphysema, reinforcing the importance of protease-antiprotease imbalance and oxidant-antioxidant imbalance in the pathogenesis of emphysema. Descrever um modelo murino de enfisema induzido por exposição a fumaça de cigarro (FC) e instilação de elastase pancreática porcina (EPP). Trinta e oito camundongos C57BL/6 foram aleatoriamente divididos em quatro grupos: controle (uma instilação intranasal de solução salina a 0,9%); EPP (duas instilações intranasais de EPP); FC (exposição a FC durante 60 dias) e FC + EPP (duas instilações intranasais de EPP + exposição a FC durante 60 dias). No fim do protocolo experimental, todos os animais foram anestesiados e traqueostomizados para o cálculo de parâmetros de mecânica respiratória. Em seguida, todos os animais foram sacrificados e seus pulmões foram removidos para a medição da intercepção linear média (Lm) e a determinação do número de células imunorreativas a antígeno macrofágico (MAC)-2, metaloproteinase da matriz (MMP)-12 e glicoproteína glicosilada de 91 kDa (gp91phox) no parênquima pulmonar distal e na região peribrônquica. Embora não tenha havido diferenças entre os quatro grupos quanto aos parâmetros de mecânica respiratória avaliados, houve aumento da Lm no grupo FC + EPP. O número de células positivas para MAC-2 na região peribrônquica e no parênquima pulmonar distal foi maior no grupo FC + EPP do que nos outros grupos, assim como o foi o número de células positivas para MMP-12 e gp91phox, porém somente no parênquima pulmonar distal. Nosso modelo de enfisema induzido por instilação de EPP e exposição a FC resulta em um grau significativo de destruição parenquimatosa em um período de tempo menor que o empregado em outros modelos de enfisema induzido por FC, o que reforça a importância do desequilíbrio entre proteases e antiproteases e entre oxidantes e antioxidantes na patogênese do enfisema.
Roxo, Renata Spósito; Xavier, Vivian Bertoni; Miorin, Luiz Antônio; Magalhães, Andrea Olivares; Sens, Yvoty Alves Dos Santos; Alves, Vera Lúcia Dos Santos
2016-01-01
Literature shows that patients undergoing hemodialysis present poor physical conditioning and low tolerance to exercise. They may also suffer from respiratory dysfunctions. The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation on pulmonary function and functional capacity of patients with chronic kidney disease on hemodialysis. Forty adult patients with chronic kidney disease on hemodialysis were prospectively studied and randomized into two groups (control n = 20 and treatment n = 20). The treatment group underwent bilateral femoral quadriceps muscles electrical stimulation for 30 minutes during hemodialysis, three times per week, for two months. The patients were evaluated by pulmonary function test, maximum respiratory pressures, maximum one-repetition test, and six-minute walk test (6MWT), before and after the treatment protocol. The treatment group presented increased maximum inspiratory (MIP) (p = 0.02) and expiratory pressures (MEP) (p < 0.0001), muscular strength in maximum one-repetition test (p < 0.001), and distance covered in the 6MWT (p = 0.03), and decreased systolic blood pressure (p < 0.001) and respiratory frequency (p < 0.001) when compared with the control group. Electrical neuromuscular stimulation had a positive impact on pulmonary function and functional capacity, leading to better physical performance in patients on hemodialysis. Pacientes submetidos à hemodiálise apresentam baixo condicionamento físico além de serem acometidos por disfunções respiratórias. Objetivamos avaliar os efeitos da estimulação elétrica neuromuscular na função pulmonar e capacidade funcional de pacientes com doença renal crônica em hemodiálise. 40 adultos com doença renal crônica em hemodiálise foram estudados prospectivamente e randomizados em dois grupos (controle n = 20 e tratamento n = 20). O grupo tratamento realizou protocolo com estimulação elétrica neuromuscular em quadríceps femoral por 30 minutos durante a hemodiálise, três vezes por semana, durante dois meses. Todos pacientes realizaram espirometria, pressões respiratórias máximas, teste de uma repetição máxima e teste da caminhada dos seis minutos (TC6), antes e após o período de acompanhamento. O grupo tratamento apresentou aumento da pressão inspiratória máxima com p = 0,02 na comparação entre grupos e p < 0,001 para a pressão máxima expiratória. O teste de uma repetição máxima e a distância percorrida no TC6 apresentaram-se maiores após o protocolo no grupo de tratamento com p < 0,001 e 0,03 respectivamente. Houve diminuição da pressão arterial sistólica (p < 0,001) e frequência respiratória (p < 0,001) após a estimulação elétrica quando comparado ao grupo controle. A estimulação elétrica neuromuscular teve impacto positivo sobre a função pulmonar e a capacidade funcional levando ao melhor desempenho físico em pacientes em hemodiálise.
Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions.
Jacomelli, Marcia; Demarzo, Sergio Eduardo; Cardoso, Paulo Francisco Guerreiro; Palomino, Addy Lidvina Mejia; Figueiredo, Viviane Rossi
2016-01-01
Conventional bronchoscopy has a low diagnostic yield for peripheral pulmonary lesions. Radial-probe EBUS employs a rotating ultrasound transducer at the end of a probe that is passed through the working channel of the bronchoscope. Radial-probe EBUS facilitates the localization of peripheral pulmonary nodules, thus increasing the diagnostic yield. The objective of this study was to present our initial experience using radial-probe EBUS in the diagnosis of peripheral pulmonary lesions at a tertiary hospital. We conducted a retrospective analysis of 54 patients who underwent radial-probe EBUS-guided bronchoscopy for the investigation of pulmonary nodules or masses between February of 2012 and September of 2013. Radial-probe EBUS was performed with a flexible 20-MHz probe, which was passed through the working channel of the bronchoscope and advanced through the bronchus to the target lesion. For localization of the lesion and for collection procedures (bronchial brushing, transbronchial needle aspiration, and transbronchial biopsy), we used fluoroscopy. Radial-probe EBUS identified 39 nodules (mean diameter, 1.9 ± 0.7 cm) and 19 masses (mean diameter, 4.1 ± 0.9 cm). The overall sensitivity of the method was 66.7% (79.5% and 25.0%, respectively, for lesions that were visible and not visible by radial-probe EBUS). Among the lesions that were visible by radial-probe EBUS, the sensitivity was 91.7% for masses and 74.1% for nodules. The complications were pneumothorax (in 3.7%) and bronchial bleeding, which was controlled bronchoscopically (in 9.3%). Radial-probe EBUS shows a good safety profile, a low complication rate, and high sensitivity for the diagnosis of peripheral pulmonary lesions. A broncoscopia convencional possui baixo rendimento diagnóstico para lesões pulmonares periféricas. A ecobroncoscopia radial (EBUS radial) emprega um transdutor ultrassonográfico rotatório na extremidade de uma sonda que é inserida no canal de trabalho do broncoscópio. O EBUS radial facilita a localização de nódulos pulmonares periféricos, aumentando assim o rendimento diagnóstico. O objetivo deste estudo foi apresentar nossa experiência inicial com o uso de EBUS radial para o diagnóstico de lesões pulmonares periféricas em um hospital terciário. Foi realizada uma análise retrospectiva de 54 pacientes submetidos à broncoscopia guiada por EBUS radial para a investigação de nódulos ou massas pulmonares entre fevereiro de 2012 e setembro de 2013. O EBUS radial foi realizado com uma sonda flexível de 20 MHz, que foi inserida no canal de trabalho do broncoscópio até chegar à lesão-alvo. A fluoroscopia foi usada para localizar a lesão e realizar procedimentos de coleta (escovado brônquico, aspiração transbrônquica com agulha e biópsia transbrônquica). O EBUS radial identificou 39 nódulos (média de diâmetro: 1,9 ± 0,7 cm) e 19 massas (média de diâmetro: 4,1 ± 0,9 cm). A sensibilidade global do EBUS radial foi de 66,7% (79,5% para as lesões visíveis pelo método e 25% para as lesões não visíveis pelo método). Nas lesões visíveis pelo método, a sensibilidade foi de 91,7% para massas e de 74,1% para nódulos. As complicações foram pneumotórax (3,7%) e sangramento brônquico controlado broncoscopicamente (9,3%). O EBUS radial apresenta bom perfil de segurança, baixo índice de complicações e alta sensibilidade para o diagnóstico de lesões pulmonares periféricas.
Pulmonary Function in a Diving Population Aged Over 40 Years Old: A Cross-Sectional Study
2000-08-01
ADIVP -2 ALLIED GUIDE TO DIVING Fisiologia del ejercicio . la edicion. Madrid. MEDICAL DISORDERS. Publicacion Editorial Medica Panamericana S.A. 1995...activity. 13-5 12. LUCIA MULAS A. La ventilaci6n REFERENCES.- pulmonar durante el ejercicio . En L6pez Chicharro J. Fern-ndez Vaquero AX(eds.). 1...las pruebas de funci6n KK. Relation of alveolar size to forced vital pulmonar a la medicina del deporte. Tesis capacity in professional divers. Doctoral
Trombose venosa profunda e vírus chicungunha
Marques, Marcos Arêas; Adami de Sá, Fernanda Penza; Lupi, Otília; Brasil, Patricia; von Ristow, Arno
2017-01-01
Resumo Algumas infecções virais sistêmicas podem estar relacionadas ao desenvolvimento de trombose venosa profunda e/ou embolia pulmonar. Essa associação já está bem descrita em pacientes com infeções pelo vírus da imunodeficiência humana (HIV), hepatite C ou influenza. Recentemente introduzido no continente americano, o vírus chicungunha, agente etiológico da febre de chicungunha, ainda não tem essa relação bem sedimentada, mas com o aumento progressivo de sua incidência e pelo fato dessa infecção causar, muitas vezes, uma restrição severa da locomoção por poliartralgia e uma possível lesão endotelial direta, casos de tromboembolismo venoso podem começar a ser descritos. Neste relato de caso, descrevemos um paciente que desenvolveu trombose de veia poplítea direita durante internação para tratamento de febre por infecção por vírus chicungunha e poliartralgia severa. PMID:29930626
Educational intervention for collecting sputum for tuberculosis: a quasi-experimental study.
Sicsú, Amélia Nunes; Salem, Julia Ignez; Fujimoto, Luciana Botinelly Mendonça; Gonzales, Roxana Isabel Cardozo; Cardoso, Maria do Socorro de Lucena; Palha, Pedro Fredemir
2016-06-07
to evaluate the quality of the sputum sample before and after the Nursing guidance to patients. this is a quasi-experimental research design, single group type, before and after, non-randomized study. The study enrolled patients with suspected pulmonary tuberculosis, respiratory symptomatic patients for over three weeks, aged over 18 years, of both genders and without tuberculosis history in the last two years. The educational intervention consisted of individualized guidance on the collection of sputum sample, which was based on the guidelines of the Ministry of Health of Brazil and on the explanatory folder delivery. in this study participated 138 patients with suspected pulmonary tuberculosis. The results showed significant increase of the samples with purulent particles, volume greater than 5 mL and increased rate of patients diagnosed with tuberculosis, after the educational intervention. it was shown that after the educational intervention, it was observed sputum samples with better quality, with satisfactory aspect and volume for the effectiveness of the bacilloscopic examination. avaliar a qualidade da amostra de escarro antes e após as orientações de Enfermagem ao paciente. estudo com delineamento de pesquisa quase experimental, do tipo grupo único, antes e depois, não randomizado. Participaram do estudo pacientes com suspeita de tuberculose pulmonar, sintomáticos respiratórios por mais de três semanas, maiores de 18 anos, de ambos os sexos e sem antecedente de tuberculose nos últimos dois anos. A intervenção educativa consistiu em orientações individualizadas sobre a coleta da amostra de escarro, fundamentadas nas diretrizes do Ministério da Saúde do Brasil e na entrega de folder explicativo. participaram 138 pacientes com suspeita de tuberculose pulmonar. Os resultados evidenciaram importante acréscimo das amostras com partículas purulentas, volume maior que 5mL e aumento na taxa de pacientes diagnosticados com tuberculose, após a intervenção educativa. comprovou-se que, após a intervenção educativa, obtiveram-se amostras de escarro com maior qualidade, com aspecto e volume satisfatórios para efetividade do exame baciloscópico. evaluar la calidad de la muestra de esputo antes y después de las orientaciones de Enfermería al paciente. de estudio con diseño de investigación casi experimental, del tipo grupo único, antes y después, no aleatorio. Participaron del estudio pacientes con sospecha de tuberculosis pulmonar, sintomáticos respiratorios por más de 3 semanas, mayores de 18 años, de los dos sexos y sin antecedente de tuberculosis en los últimos dos años. La intervención educativa consistió en orientaciones individualizadas sobre la recolección de la muestra de esputo, fundamentadas en las directrices del Ministerio de la Salud de Brasil y en la entrega de folder explicativo. participaron 138 pacientes con sospecha de tuberculosis pulmonar. Los resultados evidenciaron un importante aumento de las muestras con partículas purulentas, volumen mayor que 5mL y aumento en la tasa de pacientes diagnosticados con tuberculosis, después de la intervención educativa. se comprobó que, después de la intervención educativa, se obtuvieron muestras de esputo con mejor calidad, con aspecto y volumen satisfactorios para efectividad del examen de baciloscopía.
Tuberculosis recurrence in a priority city in the state of São Paulo, Brazil.
Vieira, Amadeu Antonio; Leite, Danila Torres; Adreoni, Solange
2017-01-01
To describe cases of tuberculosis recurrence (TBR), stratified by temporal classification (early or late TBR), and to identify possible predictors of such recurrence. This was an analytical retrospective observational epidemiological study involving a cohort of 963 new cases of pulmonary tuberculosis, reported and treated via the Tuberculosis Control Program in the city of Carapicuíba, Brazil. The study period was from 2000 to 2010. All of the pulmonary tuberculosis patients who successfully completed the treatment (with or without confirmation of cure) were selected and followed until December 31, 2012. Of the 963 cases, TBR occurred in 47 (4.88%). The mean time between the first and second tuberculosis episodes was 36.12 months. Of the 47 TBR cases, 16 (34.04%) occurred within the first 18 months after the completion of the initial treatment (early TBR) and 31 (65.96%) occurred thereafter (late TBR). There were statistically significant differences between the early and late TBR groups only regarding level of education (≤ 3 vs. > 3 years of schooling; p < 0.004) and weight gain at completion of the initial treatment (1.78 kg vs. 5.31 kg; p < 0.045)-not regarding any of the other variables studied. A low level of education might translate to poor treatment adherence, which impedes the killing of bacilli and facilitates their survival in a latent state, making it appear as if the treatment was effective. Minimal or no weight gain at completion of the initial treatment might be a reliable biomarker to be used by health care facilities that provide tuberculosis treatment. Descrever os casos de recorrência de tuberculose (RTB) e identificar possíveis preditores segundo a classificação RTB recente ou tardia. Estudo epidemiológico observacional analítico retrospectivo a partir de uma coorte de 963 casos novos de tuberculose pulmonar notificados e tratados no Programa de Controle de Tuberculose de Carapicuíba (SP). O período de estudo foi de 2000 a 2010. Todos os casos novos de tuberculose pulmonar que completaram com sucesso o tratamento (com ou sem cura confirmada) foram selecionados e seguidos até 31 de dezembro de 2012. Dos 963 casos, RTB ocorreu em 47 (4,88%). O tempo médio transcorrido até o segundo episódio foi de 36,12 meses. Dos 47 casos de RTB, 16 (34,04%) ocorreram em até 18 meses da alta do primeiro tratamento (RTB recente), e 31 (65,96%) ocorreram após 18 meses (RTB tardia). Entre as variáveis investigadas, somente houve diferenças significativas entre os grupos RTB recente e tardia em relação ao ganho de peso na alta do primeiro tratamento (1,78 kg vs. 5,31 kg; p < 0,045) e nível de escolaridade (≤ 3 vs. > 3 anos de estudo; p < 0,004). A baixa escolaridade pode indicar uma menor adesão ao tratamento, dificultando a esterilização dos bacilos e facilitando sua sobrevivência em forma dormente, o que mascara a efetividade do tratamento. A ausência ou um reduzido aumento de peso na alta do tratamento poderá servir como um marcador biológico que pode ser utilizado pelos serviços de saúde que realizam o tratamento de tuberculose.
Berton, Danilo Cortozi; Santos, Álvaro Huber Dos; Bohn, Ivo; Lima, Rodrigo Quevedo de; Breda, Vanderléia; Teixeira, Paulo José Zimermann
2016-01-01
To compare a once-daily long-acting β2 agonist (indacaterol 150 µg) with a once-daily long-acting anticholinergic (tiotropium 5 µg) in terms of their effects on exercise endurance (limit of tolerance, Tlim) in patients with moderate COPD. Secondary endpoints were their effects on lung hyperinflation, exercise-related dyspnea, and daily-life dyspnea. This was a randomized, single-blind, crossover pilot study involving 20 patients (mean age, 60.9 ± 10.0 years; mean FEV1, 69 ± 7% of predicted). Spirometric parameters, Transition Dyspnea Index scores, Tlim, and exertional dyspnea were compared after three weeks of each treatment (with a one-week washout period between treatments). Nineteen patients completed the study (one having been excluded because of COPD exacerbation). Improvement in Tlim from baseline tended to be greater after treatment with tiotropium than after treatment with indacaterol (96 ± 163 s vs. 8 ± 82 s; p = 0.06). Tlim significantly improved from baseline after treatment with tiotropium (having increased from 396 ± 319 s to 493 ± 347 s; p = 0.010) but not after treatment with indacaterol (having increased from 393 ± 246 to 401 ± 254 s; p = 0.678). There were no differences between the two treatments regarding improvements in Borg dyspnea scores and lung hyperinflation at "isotime" and peak exercise. There were also no significant differences between treatments regarding Transition Dyspnea Index scores (1.5 ± 2.1 vs. 0.9 ± 2.3; p = 0.39). In patients with moderate COPD, tiotropium tends to improve Tlim in comparison with indacaterol. No significant differences were observed between the two treatments regarding their effects on lung hyperinflation, exercise-related dyspnea, and daily-life dyspnea. Future studies, including a larger number of patients, are required in order to confirm our findings and explore mechanistic explanations. (ClinicalTrials.gov identifier: NCT01693003 [http://www.clinicaltrials.gov/]). Comparar um β2-agonista de longa duração administrado uma vez por dia (indacaterol 150 µg) a um anticolinérgico de longa duração administrado uma vez por dia (tiotrópio 5 µg) quanto a seus efeitos na resistência ao exercício (limite de tolerância, Tlim) em pacientes com DPOC moderada. Os desfechos secundários foram seus efeitos na hiperinsuflação pulmonar, na dispneia causada pelo exercício e na dispneia na vida diária. Estudo piloto randomizado cruzado e simples cego com 20 pacientes (média de idade: 60,9 ± 10,0 anos; média do VEF1: 69 ± 7% do previsto). Parâmetros espirométricos, pontuação no Transition Dyspnea Index, Tlim e dispneia aos esforços foram comparados após três semanas de cada tratamento (com uma semana de intervalo entre os tratamentos). Dezenove pacientes completaram o estudo - um foi excluído por causa de exacerbação da DPOC. A melhora no Tlim tendeu a ser maior com tiotrópio do que com indacaterol (96 ± 163 s vs. 8 ± 82 s; p = 0,06). Em comparação com os valores basais, o Tlim melhorou significativamente com tiotrópio (aumentando de 396 ± 319 s para 493 ± 347 s; p = 0,010), mas não com indacaterol (aumentando de 393 ± 246 para 401 ± 254 s; p = 0,678). Não houve diferença entre os tratamentos quanto à melhora na pontuação na escala de dispneia de Borg e na insuflação pulmonar no "isotempo" e no pico do exercício. Também não houve diferenças significativas entre os tratamentos quanto à pontuação no Transition Dyspnea Index (1,5 ± 2,1 vs. 0,9 ± 2,3; p = 0,39). Em pacientes com DPOC moderada, o tiotrópio tende a melhorar o Tlim em comparação com o indacaterol. Não houve diferenças significativas entre os tratamentos quanto a seus efeitos na insuflação pulmonar, na dispneia durante o exercício e na dispneia na vida diária. São necessários mais estudos, com um número maior de pacientes, para confirmar nossos achados e explorar explicações mecanicistas. (ClinicalTrials.gov identifier: NCT01693003 [http://www.clinicaltrials.gov/]).
Terra, Ricardo Mingarini; Kazantzis, Thamara; Pinto-Filho, Darcy Ribeiro; Camargo, Spencer Marcantonio; Martins-Neto, Francisco; Guimarães, Anderson Nassar; Araújo, Carlos Alberto; Losso, Luis Carlos; Ghefter, Mario Claudio; Lima, Nuno Ferreira de; Gomes-Neto, Antero; Brito-Filho, Flávio; Haddad, Rui; Saueressig, Maurício Guidi; Lima, Alexandre Marcelo Rodrigues; Siqueira, Rafael Pontes de; Pinho, Astunaldo Júnior de Macedo E; Vannucci, Fernando
2016-01-01
The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil. Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy. Demographic, surgical, and postoperative data were collected with a standardized instrument, after which they were compiled and analyzed. The surgeons provided data related to a collective total of 786 patients (mean number of resections per surgeon, 43.6). However, 137 patients were excluded because some data were missing. Therefore, the study sample comprised 649 patients. The mean age of the patients was 61.7 years. Of the 649 patients, 295 (45.5%) were male. The majority-521 (89.8%)-had undergone surgery for neoplasia, which was most often classified as stage IA. The median duration of pleural drainage was 3 days, and the median hospital stay was 4 days. Of the 649 procedures evaluated, 598 (91.2%) were lobectomies. Conversion to thoracotomy was necessary in 30 cases (4.6%). Postoperative complications occurred in 124 patients (19.1%), the most common complications being pneumonia, prolonged air leaks, and atelectasis. The 30-day mortality rate was 2.0%, advanced age and diabetes being found to be predictors of mortality. Our analysis of this representative sample of patients undergoing pulmonary resection by video-assisted thoracoscopy in Brazil showed that the procedure is practicable and safe, as well as being comparable to those performed in other countries. O objetivo deste estudo foi descrever os resultados de ressecções pulmonares anatômicas por videotoracoscopia no Brasil. Cirurgiões torácicos (membros da Sociedade Brasileira de Cirurgia Torácica) foram convidados, por correio eletrônico, a participar do estudo. Dezoito cirurgiões participaram do projeto enviando seus bancos de dados retrospectivos referentes a ressecções anatômicas de pulmão por videotoracoscopia. Dados demográficos, cirúrgicos e pós-operatórios foram coletados em um instrumento padronizado e posteriormente compilados e analisados. Dados referentes a 786 pacientes foram encaminhados (média de 43,6 ressecções por cirurgião), sendo 137 excluídos por informações incompletas. Logo, 649 pacientes constituíram nossa população estudada. A média de idade dos pacientes foi de 61,7 anos, 295 eram homens (45,5%), e a maioria - 521 (89,8%) - foi submetida à cirurgia por neoplasia, mais frequentemente classificada como estádio IA. A mediana do tempo de drenagem pleural foi de 3 dias, e a do tempo de internação, 4 dias. Dos 649 procedimentos realizados, 598 (91,2%) foram lobectomias. A taxa de conversão para toracotomia foi de 4,6% (30 casos). Complicações pós-operatórias ocorreram em 124 pacientes (19,1%), sendo pneumonia, escape aéreo prolongado e atelectasia as mais frequentes. A mortalidade em 30 dias foi de 2,0%, tendo como preditores idade avançada e diabetes. A casuística brasileira mostra que as ressecções pulmonares por cirurgia torácica videoassistida são factíveis e seguras, além de comparáveis àquelas de registros internacionais.
Navarro, Carmen
2006-11-01
Pulmonary involvement in systemic sclerosis. Alveolitis, fibrosis and pulmonar arterial hypertension Lung disease is present in most of the patients with systemic sclerosis and is now the most important cause of mortality. Interstitial lung disease and pulmonary hypertension are, so far, the main disorders found and both are difficult to detect at the earliest stages. However, diagnostic tools such as immunological test, lung function test, high resolution CT, bronchoalveolar lavage, echocardiography, right-side cardiac catheterization, or lung biopsy are necessary to accurately evaluate the clinical status and allow to improve the management organ-specific ad hoc. Progress in immunological and vascular therapies as well as other emergence drugs offer new expectations to scleroderma patients. Copyright © 2006 Elsevier España S.L. Barcelona. Published by Elsevier Espana. All rights reserved.
Multiple Myeloma: Patient Handbook
... incidence of deep vein thrombosis and pulmonar y embolism. • Patients must be pre-medicated with dexamethasone, antihistamine, ... foods that include processed sugars and artificial trans fats. Caution should be used in two areas: • Vitamin ...
[Management of pulmonary stenosis in the correction of the tetralogy of Fallot].
López Soriano, F; Pérez Molina, J; Attie, F
1980-01-01
Successful surgical correction of (la estenosis pulmonar en la tetralogía de Fallot), requires that the postoperative ratio between the (right ventricular pressure) and (left ventricular pressure) (PVD/PVI) be less than 0.70. By measuring the ring diameter and pulmonary branch on relation to the (superficie corporal) it is possible to predict the outcome of this ratio and therefore indicate whether or not it is necessary to increase (AP). This paper presents our experience with 24 patients subjected to total correction of (tetralogía de Fallot) from March of 1975 to the present using the above criteria. The average age was 7 years (ranging from 2 to 20). In all cases the (cresta supraventricular) was (resected). In 14 (58%) a (valvultomia pulmonar) was performed and in 9 patients (37) it was necessary to increase the ring and pulmonary branch of the pulmonary artery according to measurements taken. The post-operative relationship PVD/PVI was 0.2-0.3: 15%, 0.4-0.5: 60%, 0.6-0.7: 25% In no case was the ratio greater than 0.70. No significant difference was found between those cases requiring... (parche transanular) and those where such treatment was not necessary. Three patients (12%) died immediately following the operation. It is concluded that measurement of the diameter of the pulmonary ring in comparison to the (superficie corporal) is extremely useful in management during surgery of (estenosis pulmonar) in patients with (tetralogía de Fallot).
Lavôr, Débora Cristina Brasil da Silva; Pinheiro, Jair Dos Santos; Gonçalves, Maria Jacirema Ferreira
2016-04-01
To assess the degree of implementation of the Directly Observed Treatment, Short-course - DOTS for tuberculosis (TB) in a large city. Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program. Avaliar o grau de implantação da estratégia de tratamento diretamente observado (Directly Observed Treatment, Short-course - DOTS) para tuberculose (TB) em um município de grande porte. Avaliação de implantação por meio de modelo lógico, cujos casos novos de TB pulmonar bacilífera foram recrutados em ambulatórios especializados e acompanhados nas unidades básicas de saúde. Utilizou-se matriz de julgamento que abrange os cinco componentes da estratégia DOTS. O resultado do modelo lógico indica DOTS implantada parcialmente. Nos contextos externo, organizacional e de implantação, a estratégia DOTS está implantada parcialmente; e, na efetividade não está implantada. A implantação parcial da estratégia DOTS, na cidade de Manaus, reflete na não conformidade do controle da TB, levando à baixa efetividade do programa.
El humo de los incendios puede tener un efecto adverso en la salud de las personas, especialmente en aquellas que padecen de enfermedades cardíacas y pulmonares. Vea cómo minimizar su exposición al humo.
A TRIBUTE TO DR. WILLIAM PENN WATKINSON
Dr. William Penn Watkinson (known to colleagues as "Penn") of EPA¿s health research lab (National Health and Environmental Research Laboratory) of Research Triangle Park, North Carolina, died Wednesday, December 13 after a battle with lung cancer. He was a member of the Pulmonar...
Silva, Vangie Dias da; Mello, Fernanda Carvalho de Queiroz; Figueiredo, Sonia Catarina de Abreu
2017-01-01
To estimate the rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination (FDC) regimen, as well as to evaluate possible associated factors. This was a retrospective observational study involving 208 patients with a confirmed diagnosis of pulmonary tuberculosis enrolled in the Hospital Tuberculosis Control Program at the Institute for Thoracic Diseases, located in the city of Rio de Janeiro, Brazil. Between January of 2007 and October of 2010, the patients were treated with the rifampin-isoniazid-pyrazinamide (RHZ) regimen, whereas, between November of 2010 and June of 2013, the patients were treated with the rifampin-isoniazid-pyrazinamide-ethambutol FDC (RHZE/FDC) regimen. Data regarding tuberculosis recurrence and mortality in the patients studied were retrieved from the Brazilian Case Registry Database and the Brazilian Mortality Database, respectively. The follow-up period comprised two years after treatment completion. The rates of cure, treatment abandonment, and death were 90.4%, 4.8%, and 4.8%, respectively. There were 7 cases of recurrence during the follow-up period. No significant differences in the recurrence rate were found between the RHZ and RHZE/FDC regimen groups (p = 0.13). We identified no factors associated with the occurrence of recurrence; nor were there any statistically significant differences between the treatment groups regarding adverse effects or rates of cure, treatment abandonment, or death. The adoption of the RHZE/FDC regimen produced no statistically significant differences in the rates of recurrence, cure, or treatment abandonment; nor did it have any effect on the occurrence of adverse effects, in comparison with the use of the RHZ regimen. Estimar as taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com o esquema de dose fixa combinada (DFC) de quatro drogas e avaliar possíveis fatores associados. Estudo observacional retrospectivo com 208 pacientes com diagnóstico confirmado de tuberculose pulmonar registrados no Programa de Controle da Tuberculose Hospitalar do Instituto de Doenças do Tórax, localizado na cidade do Rio de Janeiro. Os pacientes tratados entre janeiro de 2007 e outubro de 2010 receberam o esquema rifampicina-isoniazida-pirazinamida (RHZ), e aqueles tratados entre novembro de 2010 e junho de 2013 receberam o esquema rifampicina-isoniazida-pirazinamida-etambutol em DFC (RHZE/DFC). Os dados dos pacientes sobre recidiva e óbito foram obtidos no Sistema de Informação de Agravos de Notificação e no Sistema de Informação de Mortalidade, respectivamente. O período de acompanhamento foi de dois anos após o encerramento do tratamento. As taxas de cura, abandono e óbito foram de 90,4%, 4,8% e 4,8%, respectivamente. Houve 7 casos de recidivas durante o período de acompanhamento. Não houve diferenças significativas na taxa de recidiva entre os grupos de tratamento RHZ e RHZE/DFC (p = 0,13). Não foram identificados fatores associados com a ocorrência de recidiva, nem houve diferenças estatisticamente significativas na ocorrência dos efeitos adversos ou nas taxas de cura, abandono e óbito entre os grupos de tratamento. A adoção do esquema de tratamento RHZE/DFC não produziu diferenças estatisticamente significativas nas taxas de recidiva, cura e abandono nem na ocorrência de efeitos adversos em comparação com o esquema RHZ.
Estimated exposures to ambient respirable particulate matter (PM) and related co-pollutants have been statistically associated with mortality and morbidity in epidemiological studies conducted throughout the world. Although some subpopulations (e.g., asthmatics; elderly, pulmonar...
The microtechnology of the second half of the 20th century has produced a technical revolution that has lead to the production of computers, the Internet and taken us into a new emerging era of nanotechnology. This issue of Toxicological Sciences includes two articles, "Pulmonar...
Load Carriage Induced Alterations of Pulmonary Function
1989-01-01
pulmonar , function reductions are directh’ related to the backpack load carried due to the mechanical constraint it imposes on the thoracic cage.2 To...and Fish- man. A.P.. 1965. The regulation of venttlation in diffuse Agostor. E.. D’Angelc, E. and Piolini, M., 1978. Breathing pulmonary fibrosis . J
Extracorporeal respiratory support in adult patients.
Romano, Thiago Gomes; Mendes, Pedro Vitale; Park, Marcelo; Costa, Eduardo Leite Vieira
2017-01-01
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support. We discuss the history of respiratory support using ECMO in adults, as well as the clinical evidence; costs; indications; installation of the equipment; ventilator settings; daily care of the patient and the system; common troubleshooting; weaning; and discontinuation. RESUMO Em pacientes com insuficiência respiratória grave (hipoxêmica ou hipercápnica), o suporte somente com ventilação mecânica pode ser insuficiente para suas necessidades, especialmente quando se tenta evitar o uso de parâmetros ventilatórios que possam causar danos aos pulmões. Nesses pacientes, extracorporeal membrane oxygenation (ECMO, oxigenação extracorpórea por membrana), que também é muito eficaz na remoção de dióxido de carbono do sangue, pode manter a vida, permitindo o uso de ventilação pulmonar protetora. No presente artigo de revisão, objetivamos explorar alguns dos aspectos mais relevantes do suporte respiratório por ECMO. Discutimos a história do suporte respiratório por ECMO em adultos; evidências clínicas; custos; indicações; instalação do equipamento; parâmetros ventilatórios; cuidado diário do paciente e do sistema; solução de problemas comuns; desmame e descontinuação.
Cardiopulmonary Exercise Test: Background, Applicability and Interpretation.
Herdy, Artur Haddad; Ritt, Luiz Eduardo Fonteles; Stein, Ricardo; Araújo, Claudio Gil Soares de; Milani, Mauricio; Meneghelo, Romeu Sérgio; Ferraz, Almir Sérgio; Hossri, Carlos; Almeida, Antonio Eduardo Monteiro de; Fernandes-Silva, Miguel Morita; Serra, Salvador Manoel
2016-11-01
Cardiopulmonary exercise test (CPET) has been gaining importance as a method of functional assessment in Brazil and worldwide. In its most frequent applications, CPET consists in applying a gradually increasing intensity exercise until exhaustion or until the appearance of limiting symptoms and/or signs. The following parameters are measured: ventilation; oxygen consumption (VO2); carbon dioxide production (VCO2); and the other variables of conventional exercise testing. In addition, in specific situations, pulse oximetry and flow-volume loops during and after exertion are measured. The CPET provides joint data analysis that allows complete assessment of the cardiovascular, respiratory, muscular and metabolic systems during exertion, being considered gold standard for cardiorespiratory functional assessment.1-6 The CPET allows defining mechanisms related to low functional capacity that can cause symptoms, such as dyspnea, and correlate them with changes in the cardiovascular, pulmonary and skeletal muscle systems. Furthermore, it can be used to provide the prognostic assessment of patients with heart or lung diseases, and in the preoperative period, in addition to aiding in a more careful exercise prescription to healthy subjects, athletes and patients with heart or lung diseases. Similarly to CPET clinical use, its research also increases, with the publication of several scientific contributions from Brazilian researchers in high-impact journals. Therefore, this study aimed at providing a comprehensive review on the applicability of CPET to different clinical situations, in addition to serving as a practical guide for the interpretation of that test. Resumo O teste cardiopulmonar de exercício (TCPE) vem ganhando importância crescente como método de avaliação funcional tanto no Brasil quanto no Mundo. Nas suas aplicações mais frequentes, o teste consiste em submeter o indivíduo a um exercício de intensidade gradativamente crescente até a exaustão ou o surgimento de sintomas e/ou sinais limitantes. Neste exame se mensura a ventilação (VE), o consumo de oxigênio (VO2), a produção de gás carbônico (VCO2) e as demais variáveis de um teste de exercício convencional. Adicionalmente, podem ser verificadas, em situações específicas, a oximetria de pulso e as alças fluxo-volume antes, durante e após o esforço. A análise integrada dos dados permite a completa avaliação dos sistemas cardiovascular, respiratório, muscular e metabólico no esforço, sendo considerado padrão-ouro na avaliação funcional cardiorrespiratória.1-6 O TCPE permite definir mecanismos relacionados à baixa capacidade funcional, os quais podem ser causadores de sintomas como a dispneia, correlacionando-os com alterações dos sistemas cardiovascular, pulmonar e musculoesquelético. Também pode ser de grande aplicabilidade na avaliação prognóstica em cardiopatas, pneumopatas e em pré-operatório, além de auxiliar na prescrição mais criteriosa do exercício em sujeitos normais, em atletas, em cardiopatas e em pneumopatas. Assim como ocorre com o uso clínico, a pesquisa nesse campo também cresce e várias contribuições científicas de pesquisadores nacionais são publicadas em periódicos de alto fator de impacto. Sendo assim, o objetivo deste documento é fornecer uma revisão ampla da aplicabilidade do TCPE nas diferentes situações clínicas, bem como servir como guia prático na interpretação desse teste propedêutico.
Terra, Ricardo Mingarini; Araujo, Pedro Henrique Xavier Nabuco de; Lauricella, Leticia Leone; Campos, José Ribas Milanez de; Costa, Herbert Felix; Pego-Fernandes, Paulo Manuel
2016-01-01
To describe the implementation of a robotic thoracic surgery program at a public tertiary teaching hospital and to analyze its initial results. This was a planned interim analysis of a randomized clinical trial aimed at comparing video-assisted thoracoscopic surgery and robotic surgery in terms of the results obtained after pulmonary lobectomy. The robotic surgery program developed at the Instituto do Câncer do Estado de São Paulo, in the city of São Paulo, Brazil, is a multidisciplinary initiative involving various surgical specialties, as well as anesthesiology, nursing, and clinical engineering teams. In this analysis, we evaluated the patients included in the robotic lobectomy arm of the trial during its first three months (from April to June of 2015). Ten patients were included in this analysis. There were eight women and two men. The mean age was 65.1 years. All of the patients presented with peripheral tumors. We performed right upper lobectomy in four patients, right lower lobectomy in four, and left upper lobectomy in two. Surgical time varied considerably (range, 135-435 min). Conversion to open surgery or video-assisted thoracoscopic surgery was not necessary in any of the cases. Intraoperative complications were not found. Only the first patient required postoperative transfer to the ICU. There were no deaths or readmissions within the first 30 days after discharge. The only postoperative complication was chest pain (grade 3), in two patients. Pathological examination revealed complete tumor resection in all cases. When there is integration and proper training of all of the teams involved, the implementation of a robotic thoracic surgery program is feasible and can reduce morbidity and mortality. Descrever a implantação de um programa de cirurgia torácica robótica em um hospital terciário público universitário e analisar seus resultados iniciais. Este estudo é uma análise interina planejada de um ensaio clínico aleatorizado cujo objetivo é comparar resultados da lobectomia pulmonar por videotoracoscopia com a robótica. O programa de cirurgia robótica do Instituto do Câncer do Estado de São Paulo, localizado na cidade de São Paulo (SP), foi uma iniciativa multidisciplinar que envolveu diversas especialidades cirúrgicas e equipes de anestesia, enfermagem e engenharia clínica. Nesta análise, avaliamos os pacientes incluídos no braço lobectomia robótica durante os primeiros três meses do estudo (de abril a junho de 2015). Dez pacientes foram incluídos nesta análise. Eram oito mulheres e dois homens. A média de idade foi de 65,1 anos. Todos apresentavam tumores periféricos. Foram realizadas lobectomia superior direita, em quatro pacientes; lobectomia inferior direita, em quatro; e lobectomia superior esquerda, em dois. Os tempos cirúrgicos variaram bastante (variação, 135-435 min). Não foi necessária a conversão para técnica aberta ou videotoracoscópica em nenhum paciente. Não foram observadas complicações intraoperatórias. Apenas o primeiro paciente foi encaminhado à UTI no pós-operatório. Não houve mortalidade nem reinternações em 30 dias após a alta. A única complicação pós-operatória observada foi dor torácica (grau 3), em dois pacientes. O exame anatomopatológico revelou a ressecção completa do tumor em todos os casos. A implantação de um programa de cirurgia torácica robótica, quando há integração e treinamento adequado de todas as equipes envolvidas, é factível e pode reduzir a morbidade e a mortalidade.
Spatial distribution of tuberculosis in a municipality in the interior of São Paulo, 2008-2013.
Fusco, Alcione Pereira Biffi; Arcêncio, Ricardo Alexandre; Yamamura, Mellina; Palha, Pedro Fredemir; Reis, Amanda Alessandra Dos; Alecrim, Tatiana Ferraz de Araújo; Protti, Simone Teresinha
2017-06-05
to describe the epidemiological clinical profile of tuberculosis and analyze the spatial distribution of cases in a municipality in the state of São Paulo. descriptive and ecological study of cases of tuberculosis through the records in an information system. Descriptive statistics were used to calculate central tendency (mean) and chi-square test, with Yates correction or Fisher exact test, when necessary. The Kernel technique was also used to calculate the occurrence densities of tuberculosis cases, using a radius of 1000 meters. Type I error was set at 5%. 299 cases of tuberculosis were identified, with 290 (96.98%) being geocoded. The majority of these were male (n = 212; 70.91%), median age 40 years, and the pulmonary clinical form was predominant (n = 244, 81.60%). The distribution occurred in a non-random manner, observing important areas of the municipality with a higher density of cases of the disease. the study evidenced an epidemiological profile of tuberculosis cases similar to those in the literature; however, their distribution does not occur in a random manner, pointing to specific population groups that require greater management and planning of health services for the control of tuberculosis. caracterizar o perfil clínico epidemiológico da tuberculose (TB) e analisar a distribuição espacial dos casos em município paulista. estudo descritivo e ecológico dos casos de tuberculose registrados em um sistema de informação. Recorreu-se à estatística descritiva com cálculo de medidas de tendência central (média) e aplicação do teste qui-quadrado, com correção de Yates ou teste exato de Fisher, quando necessários. Aplicou-se ainda a técnica de Kernel para o cálculo das densidades de ocorrência dos casos da TB, utilizando um raio de 1000 metros. Fixou-se o erro tipo I em 5%. identificou-se 299 casos de TB, sendo geocodificados 290 (96,98%). A maioria destes foi do sexo masculino (n=212; 70,91%), idade mediana 40 anos, sendo a forma clínica pulmonar predominante (n=244; 81,60%). A distribuição ocorreu de forma não aleatória, observando-se áreas importantes do município com maior densidade de casos da doença. o estudo evidenciou perfil epidemiológico dos casos de tuberculose semelhante ao da literatura, no entanto, a distribuição dos mesmos não ocorre de forma aleatória, apontando grupos específicos da população que necessitam de maior gestão e planejamento dos serviços de saúde para o controle da tuberculose. caracterizar el perfil epidemiológico clínico de tuberculosis y analizar la distribución espacial de casos en un municipio paulista. Estudio descriptivo y ecológico de casos de tuberculosis registrados en un sistema de información. Se utilizó estadística descriptiva con medidas de tendencia central (media) y aplicación de chi-cuadrado, con correlación de Yates o prueba exacta de Fisher según necesidad. Para el calcular la densidad en la ocurrencia de casos de tuberculosis, se aplicó la técnica uniforme Kernel utilizando una distancia de 1000 metros. El error de tipo I fue fijado en 5%. Se identificaron 299 casos de tuberculosis, siendo geocodificados 290 (96.98%). La mayoría de los casos fueron de sexo masculino (n=212; 70,91%), con edad mediana de 40 años, siendo la forma pulmonar la más predominante (n=244; 81,60%). La distribución de casos fue forma no aleatoria, identificando áreas del municipio con mayor densidad de casos con esta patología. el perfil epidemiológico de casos de tuberculosis observado fue similar a lo observado en la literatura, aunque la distribución de estos no ocurre de manera aleatoria, identificando grupos específicos de la población los cuales requieren de mayores gestión y planificación en los servicios de salud para el control de la tuberculosis.
2003-01-01
dysp = Dyspnea euph = euphoria excitement = excited fib = fibrosis flush face = flush face ftg = fatigue Head = Headache Gidd = giddiness inco...nausea Neck = neck ache nose = irritated nose Pallor Pulm edema= pulmonar y edema Resp sys = Respiratory System skin = irritated skin som = somnolence
Brogly, Nicolas; Schiraldi, Renato; Puertas, Laura; Maggi, Genaro; Yanci, Eduardo Alonso; Maldonado, Ever Hugo Martinez; Arévalo, Emilia Guasch; Rodríguez, Fernando Gilsanz
2016-01-01
The delivery of cardiac patients is a challenge for the anaesthesiologist, to whom the welfare of both the mother and the foetus is a main issue. In case of caesarean section, advanced monitoring allows to optimize haemodynamic condition and to improve morbidity and mortality. To describe the use of pulse contour analysis calibrated by Trans-pulmonar thermodilution (Picco Plus(®)) for the perioperative management of a caesarean section in a patient with severe cardiomyopathy. We describe the case of a 28-year-old woman with a congenital heart disease who was submitted to a caesarean section under general anaesthesia for maternal pathology and foetal breech presentation. Intra- and post-operative management was optimized by advanced haemodynamic monitorization obtained by pulse contour wave analysis and thermodilution calibration (Picco Plus(®) monitor). The information about preload, myocardial contractility and postcharge was useful in guiding the fluid therapy and the use of vasoactive drugs. This case report illustrates the importance of advanced haemodynamic monitoring with an acceptably invasive device in obstetric patients with high cardiac risk. The increasing experience in advanced haemodynamic management will probably permit to decrease morbidity and mortality of obstetric patients in the future. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
Brogly, Nicolas; Schiraldi, Renato; Puertas, Laura; Maggi, Genaro; Yanci, Eduardo Alonso; Maldonado, Ever Hugo Martinez; Arévalo, Emilia Guasch; Rodríguez, Fernando Gilsanz
2016-01-01
The delivery of cardiac patients is a challenge for the anaesthesiologist, to whom the welfare of both the mother and the foetus is a main issue. In case of caesarean section, advanced monitoring allows to optimize haemodynamic condition and to improve morbidity and mortality. To describe the use of pulse contour analysis calibrated by Trans-pulmonar thermodilution (Picco Plus(®)) for the perioperative management of a caesarean section in a patient with severe cardiomyopathy. We describe the case of a 28-year-old woman with a congenital heart disease who was submitted to a caesarean section under general anaesthesia for maternal pathology and foetal breech presentation. Intra- and post-operative management was optimized by advanced haemodynamic monitorization obtained by pulse contour wave analysis and thermodilution calibration (Picco Plus(®) monitor). The information about preload, myocardial contractility and postcharge was useful in guiding the fluid therapy and the use of vasoactive drugs. This case report illustrates the importance of advanced haemodynamic monitoring with an acceptably invasive device in obstetric patients with high cardiac risk. The increasing experience in advanced haemodynamic management will probably permit to decrease morbidity and mortality of obstetric patients in the future. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.
Barreto, Maynara Fernanda Carvalho; Dellaroza, Mara Solange Gomes; Kerbauy, Gilselena; Grion, Cintia Magalhães Carvalho
2016-04-01
To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Estimar o custo da internação de pacientes com sepse grave ou choque séptico admitidos ou diagnosticados no setor de Urgências e Emergências de um hospital universitário e seguidos até o desfecho clínico. Estudo epidemiológico, prospectivo e observacional, realizado em um hospital público do sul do Brasil, no período de 1 ano (agosto de 2013 a agosto de 2014). A coleta dos dados clínico-epidemiológicos utilizou fichas de notificação de sepse, prontuários e dados do setor de custos. Foi realizada análise de tendência central, dispersão e quartis dos custos das internações. Amostra composta por 95 pacientes que totalizaram elevado custo da internação (R$ 3.692.421,00), com média de R$ 38.867,60 por paciente. Mais da metade do valor total do tratamento da sepse (R$ 2.215.773,50) destinou-se a pacientes que evoluíram a óbito (59,0%). Os maiores custos foram relacionados à alta, ao diagnóstico de sepse grave, ao foco infeccioso pulmonar e à faixa etária até os 59 anos. O elevado custo com o tratamento da sepse justificam investimentos em ações de capacitação e instituição de protocolos que possam direcionar ações preventivas, otimizar o diagnóstico e a terapêutica em pacientes infectados e séptico.
Association of tuberculosis with multimorbidity and social networks.
Valenzuela-Jiménez, Hiram; Manrique-Hernández, Edgar Fabian; Idrovo, Alvaro Javier
2017-01-01
The combination of tuberculosis with other diseases can affect tuberculosis treatment within populations. In the present study, social network analysis of data retrieved from the Mexican National Epidemiological Surveillance System was used in order to explore associations between the number of contacts and multimorbidity. The node degree was calculated for each individual with tuberculosis and included information from 242 contacts without tuberculosis. Multimorbidity was identified in 49.89% of individuals. The node degrees were highest for individuals with tuberculosis + HIV infection (p < 0.04) and lowest for those with tuberculosis + pulmonary edema (p < 0.07). Social network analysis should be used as a standard method for monitoring tuberculosis and tuberculosis-related syndemics. RESUMO A combinação de tuberculose e outras doenças pode afetar o tratamento da tuberculose nas populações. No presente estudo, a análise de redes sociais de dados extraídos do Sistema Nacional de Vigilância Epidemiológica do México foi usada para explorar as relações entre o número de contatos e a multimorbidade. O grau do nó foi calculado para cada indivíduo com tuberculose e incluiu informações a respeito de 242 contatos sem tuberculose. A multimorbidade foi identificada em 49,89% dos indivíduos. Os maiores graus dos nós foram os referentes a indivíduos com tuberculose + infecção pelo HIV (p < 0,04), e os menores foram os referentes a indivíduos com tuberculose + edema pulmonar (p < 0,07). A análise de redes sociais deve ser usada como método-padrão para monitorar a tuberculose e a sindemia relacionada com a tuberculose.
1991-07-01
muscle k142), heart muscle (80), bo- are released. In recent years much has been learned vine pulmonar arter endothelial cells (251), and rat about the...b3 Zn or cytes from cystic fibrosis patients lack a Cl current that Ni (1 mM)-added to the cytoplasmic side of the mem- can be acti% ated b3 the...that at37’C hu- to be defectiv.- in cystic fibrosis (55, 277), and Chen et al. man T-cell CiL channels are active at rest, implies that (25) have shown
Beliefs About Children’s Illness Among Rural Guatemalan Women.
1996-07-01
a neighboring community. "The question was: "i,Por que cree que le dio esta enfermedad a su hijo(a)?" or "Why do you think your child got sick...began: "Ya hablamos de los asientos. Ahora quisiera que me dijera ^que enfermedades del pecho o los pulmones les dan a los ninos aquf en (la communidad...Bronchitis {Bronquitisl Enfermedad de bronquios) 3 0 8 11 22 Cough (Jos) 13 20 6 6 45 Cold/pulmonary cold (catarrol catarro pulmonar) 1 3 4
Vasconcelos, Thiago Brasileiro de; Araújo, Fernanda Yvelize Ramos de; Pinho, João Paulo Melo de; Soares, Pedro Marcos Gomes; Bastos, Vasco Pinheiro Diógenes
2016-01-01
To evaluate the effects of passive inhalation of cigarette smoke on the respiratory system of guinea pigs. Male guinea pigs were divided into two groups: control and passive smoking, the latter being exposed to the smoke of ten cigarettes for 20 min in the morning, afternoon and evening (30 cigarettes/day) for five days. After that period, inflammatory parameters were studied by quantifying mesenteric mast cell degranulation, as well as oxidative stress, in BAL fluid. In addition, we determined MIP, MEP, and mucociliary transport (in vivo), as well as tracheal contractility response (in vitro). In comparison with the control group, the passive smoking group showed a significant increase in mast cell degranulation (19.75 ± 3.77% vs. 42.53 ± 0.42%; p < 0.001) and in the levels of reduced glutathione (293.9 ± 19.21 vs. 723.7 ± 67.43 nM/g of tissue; p < 0.05); as well as a significant reduction in mucociliary clearance (p < 0.05), which caused significant changes in pulmonary function (in MIP and MEP; p < 0.05 for both) and airway hyperreactivity. Passive inhalation of cigarette smoke caused significant increases in mast cell degranulation and oxidative stress. This inflammatory process seems to influence the decrease in mucociliary transport and to cause changes in pulmonary function, leading to tracheal hyperreactivity. Avaliar os efeitos da inalação passiva da fumaça de cigarro no sistema respiratório de cobaias. Foram utilizadas cobaias machos, divididas em dois grupos: controle e tabagismo passivo, esse último exposto à fumaça de dez cigarros por 20 min pela manhã, tarde e noite (30 cigarros/dia) por 5 dias. Após esse período, parâmetros inflamatórios foram estudados através da contagem de degranulação de mastócitos no mesentério e de estresse oxidativo a partir do LBA. Adicionalmente, foram verificadas PImáx, PEmáx, transporte mucociliar (in vivo) e contratilidade traqueal (in vitro). Na comparação com o grupo controle, o grupo tabagismo passivo apresentou um aumento significativo na degranulação de mastócitos (19,75 ± 3,77% vs. 42,53 ± 0,42%; p < 0,001), nos níveis de glutationa reduzida (293,9 ± 19,21 vs. 723,7 ± 67,43 nM/g de tecido; p < 0,05) e uma redução significativa no transporte mucociliar (p < 0,05), provocando alterações significativas na função pulmonar, tanto na PImáx como na PEmáx (p < 0,05 para ambas), e hiper-reatividade nas vias aéreas. A inalação passiva da fumaça de cigarro ocasionou aumentos significativos na degranulação de mastócitos e no estresse oxidativo. Esse processo inflamatório parece ter influenciado a diminuição do transporte mucociliar e causado alterações na função pulmonar, proporcionando um quadro de hiper-reatividade traqueal.
Silva, Rose Mary Ferreira Lisboa da; Silva, Pollyana Ardavicius E; Lima, Marcos Correia; Sant'Anna, Lívia Tanure; Silva, Túlio Corrêa; Moreira, Pedro Henrique Vilela; Gandra, Robert Moreira; Cavalcanti, Túlio Ramos; Mourão, Plínio Henrique Vaz
2017-07-01
Atrial fibrillation (AF) is a common arrhythmia, with risk of systemic embolism and death. It presents rheumatic etiology in up to 32% of developing countries, whose anticoagulation and evolution data are scarce. to determine the predictors of cardiac death considering the clinical profile, thromboembolism and bleeding scores of patients with AF of a single center, with high prevalence of rheumatic heart disease. 302 patients with AF were studied, mean age 58.1 years; 161 women; 96 pts with rheumatic etiology. Patients underwent clinical and laboratory evaluation, measurement of risk scores and the mean follow-up of 12.8 months. 174 were using warfarin. The averages of the HAS-BLED and ATRIA scores were 1.4 and 1.2, respectively. Percent time in therapeutic range of international normalized ratio was 45.8%. Thirty patients (9.9%) had cardiac death and 41 had some type of bleeding due to warfarin. By univariate analysis, there was statistical significance between cardiac death and permanent AF, blood pressure, systolic dysfunction, R2CHADS2, CCS, EHRA and HAS-BLED. There was no association with valvular AF. By multivariate analysis, systemic arterial and pulmonary artery pressures, classification CCS and systolic dysfunction showed statistical significance. There was no association between cardiac death and valvular AF. Independent predictors of cardiac death were low measures of blood pressure, higher score CCS classification and the presence of systolic ventricular dysfunction. A fibrilação atrial (FA) é uma arritmia comum, com risco de embolia sistêmica e morte. Apresenta etiologia reumática em até 32% dos países em desenvolvimento, cujos dados de anticoagulação e evolução são escassos. Verificar as variáveis preditoras de morte cardíaca (MC) conforme o perfil clínico, os escores de tromboembolismo e de sangramento dos pacientes com FA de uma única instituição universitária, com alta prevalência de cardiopatia reumática. Foram estudados 302 pts com FA, média de idade 58,1 anos; 161 mulheres; 96 pts com etiologia reumática. Os pts foram submetidos à avaliação clínica e laboratorial, ao cálculo dos escores de risco e ao seguimento clínico médio de 12,8 meses. 174 pts estavam em uso de varfarina. As médias dos escores HAS-BLED e ATRIA foram de 1,4 e de 1,2, respectivamente. O cálculo da fração dos valores da razão normalizada internacional dentro do intervalo terapêutico foi de 45,8%. Houve MC em 30 pts (9,9%) e 41 apresentaram algum tipo de hemorragia em decorrência do uso de varfarina. Pela análise univariada, houve significância estatística entre MC e FA permanente, pressões arteriais, disfunção sistólica, R2CHADS2, CCS, EHRA e HAS-BLED. Não houve associação com FA valvar. Por meio da análise multivariada, a pressão arterial sistêmica e da artéria pulmonar, a classificação CCS e a disfunção sistólica apresentavam significância estatística. Não houve associação entre MC e FA valvar. Os preditores independentes de MC foram medidas baixas de pressão arterial, escores mais elevados da classificação CCS e a presença de disfunção ventricular sistólica.
Morais, António; Moura, M Conceição Souto; Cruz, M Rosa; Gomes, Isabel
2004-01-01
Nonspecific interstitial pneumonitis (NSIP) initially described by Katzenstein and Fiorelli in 1994, seems to be a distinct clinicopathologic entity among idiopathic interstitial pneumonitis (IIP). Besides different histologic features from other IIP, NSIP is characterized by a better long-term outcome, associated with a better steroids responsiveness than idiopathic pulmonar fibrosis (IPF), where usually were included. Thus, differentiating NSIP from other IIP, namely IPF is very significant, since it has important therapeutic and prognostic implications. NSIP encloses different pathologies, namely those with inflammatory predominance (cellular subtype) or fibrous predominance (fibrosing subtype). NSIP is reviewed and discussed by the authors, after two clinical cases description.
Postinfectious bronchiolitis obliterans
2018-06-01
La bronquiolitis obliterante es una enfermedad pulmonar crónica infrecuente y grave producto de una lesión del tracto respiratorio inferior. En nuestro país, es más frecuente observarla secundaria a una lesión viral grave, en especial, por adenovirus. La bronquiolitis obliterante se caracteriza por la oclusión parcial o total del lumen de los bronquiolos respiratorios y terminales por tejido inflamatorio y fibrosis, que produce la obstrucción crónica de la vía aérea. Este consenso discute el estado actual del conocimiento en las diferentes áreas de la bronquiolitis obliterante secundaria a una lesión infecciosa.
[Corneal manifestations in systemic diseases].
Zarranz Ventura, J; De Nova, E; Moreno-Montañés, J
2008-01-01
Systemic diseases affecting the cornea have a wide range of manifestations. The detailed study of all pathologies that cause corneal alteration is unapproachable, so we have centered our interest in the most prevalent or characteristic of them. In this paper we have divided these pathologies in sections to facilitate their study. Pulmonar and conective tissue (like colagen, rheumatologic and idiopathic inflamatory diseases), dermatologic, cardiovascular, hematologic, digestive and hepatopancreatic diseases with corneal alteration are described. Endocrine and metabolic diseases, malnutrition and carential states are also studied, as well as some otorhinolaryngologic and genetic diseases that affect the cornea. Finally, a brief report of ocular toxicity induced by drugs is referred.
Bayaroğullari, Hanifi; Davran, Ramazan; Cavuş, Yeliz; Yetim, Tülin Durgun; Evirgen, Ömer
2013-01-01
Hydatid disease (HD) is a worldwide parasitic disease. Echinococcosis may involve many organs but affect most commonly liver and lungs. The location of echinococcal cysts inside pulmonary artery is extremely rare. Radiologic findings range from purely cystic lesions to a completely solid appearance. Hydatid cysts (HC) can be solitary or multiple and varies size. Pulmonary artery embolism of HC can be symptomatic or asymptomatic. When symptomatic, we see the chest pain, dyspnea, cough, hemoptysis and sometimes acute cor pulmonale or sudden death secondary to massive giant pulmonary artery embolism of HC. Copyright © 2013 Elsevier Inc. All rights reserved.
Moreira, Graciane Laender; Manzano, Beatriz Martins; Gazzotti, Mariana Rodrigues; Nascimento, Oliver Augusto; Perez-Padilla, Rogelio; Menezes, Ana Maria Baptista; Jardim, José Roberto
2014-01-01
OBJECTIVE: To determine the underdiagnosis rate in new COPD cases at the end of a nine-year follow-up period-in the study designated "Projeto Latino-Americano de Investigação em Obstrução Pulmonar" (PLATINO, Latin-American Pulmonary Obstruction Investigation Project)-and compare that with the underdiagnosis rate during the initial phase of the study, as well as to identify the clinical features exhibited by the subjects who were not diagnosed until the end of the follow-up phase. METHODS: The study population comprised the 1,000 residents of the city of São Paulo, Brazil, who took part in the PLATINO study. Of those, 613 participated in the follow-up phase, during which the subjects were assessed with the same instruments and equipment employed in the initial phase of the study. We used the chi-square test or the independent sample t-test to analyze the underdiagnosis rate and to identify the characteristics of the subjects who were not diagnosed until the end of the follow-up phase. RESULTS: The underdiagnosis rate for new COPD cases at the end of the nine-year follow-up period was 70.0%. The underdiagnosis rate during the follow-up phase was 17.5% lower than that reported for the initial phase of the study. The subjects who were not diagnosed until the end of the follow-up phase presented with fewer respiratory symptoms, better pulmonary function, and less severe disease than did those previously diagnosed with COPD. CONCLUSIONS: The underdiagnosis rate for new COPD cases was lower in the follow-up phase of the study than in the initial phase. The subjects who were not diagnosed until the end of the follow-up phase of the PLATINO study presented with the same clinical profile as did those who were not diagnosed in the initial phase. These findings underscore the need for spirometry in order to confirm the diagnosis of COPD and provide early intervention. PMID:24626267
Influence of heart failure on resting lung volumes in patients with COPD.
Souza, Aline Soares de; Sperandio, Priscila Abreu; Mazzuco, Adriana; Alencar, Maria Clara; Arbex, Flávio Ferlin; Oliveira, Mayron Faria de; O'Donnell, Denis Eunan; Neder, José Alberto
2016-01-01
To evaluate the influence of chronic heart failure (CHF) on resting lung volumes in patients with COPD, i.e., inspiratory fraction-inspiratory capacity (IC)/TLC-and relative inspiratory reserve-[1 - (end-inspiratory lung volume/TLC)]. This was a prospective study involving 56 patients with COPD-24 (23 males/1 female) with COPD+CHF and 32 (28 males/4 females) with COPD only-who, after careful clinical stabilization, underwent spirometry (with forced and slow maneuvers) and whole-body plethysmography. Although FEV1, as well as the FEV1/FVC and FEV1/slow vital capacity ratios, were higher in the COPD+CHF group than in the COPD group, all major "static" volumes-RV, functional residual capacity (FRC), and TLC-were lower in the former group (p < 0.05). There was a greater reduction in FRC than in RV, resulting in the expiratory reserve volume being lower in the COPD+CHF group than in the COPD group. There were relatively proportional reductions in FRC and TLC in the two groups; therefore, IC was also comparable. Consequently, the inspiratory fraction was higher in the COPD+CHF group than in the COPD group (0.42 ± 0.10 vs. 0.36 ± 0.10; p < 0.05). Although the tidal volume/IC ratio was higher in the COPD+CHF group, the relative inspiratory reserve was remarkably similar between the two groups (0.35 ± 0.09 vs. 0.44 ± 0.14; p < 0.05). Despite the restrictive effects of CHF, patients with COPD+CHF have relatively higher inspiratory limits (a greater inspiratory fraction). However, those patients use only a part of those limits, probably in order to avoid critical reductions in inspiratory reserve and increases in elastic recoil. Avaliar a influência da insuficiência cardíaca crônica (ICC) nos volumes pulmonares de repouso em pacientes com DPOC, ou seja, fração inspiratória -capacidade inspiratória (CI)/CPT - e reserva inspiratória relativa - [1 - (volume pulmonar inspiratório final/CPT)]. Após cuidadosa estabilização clínica, 56 pacientes com DPOC (24 alocados no grupo DPOC+ICC; 23 homens/1 mulher) e 32 (28 homens/4 mulheres) com DPOC isolada foram submetidos à espirometria forçada e lenta e pletismografia de corpo inteiro. Os pacientes do grupo DPOC+ICC apresentaram maior VEF1, VEF1/CVF e VEF1/capacidade vital lenta; porém, todos os principais volumes "estáticos" - VR, capacidade residual funcional (CRF) e CPT - foram menores que aqueles do grupo DPOC (p < 0,05). A CRF diminuiu mais do que o VR, determinando assim menor volume de reserva expiratória no grupo DPOC+ICC que no grupo DPOC. Houve redução relativamente proporcional da CRF e da CPT nos dois grupos; logo, a CI também foi similar. Consequentemente, a fração inspiratória no grupo DPOC+ICC foi maior que no grupo DPOC (0,42 ± 0,10 vs. 0,36 ± 0,10; p < 0,05). Embora a razão volume corrente/CI fosse maior no grupo DPOC+ICC, a reserva inspiratória relativa foi notadamente similar entre os grupos (0,35 ± 0,09 vs. 0,44 ± 0,14; p < 0,05). Apesar dos efeitos restritivos da ICC, pacientes com DPOC+ICC apresentam elevações relativas dos limites inspiratórios (maior fração inspiratória). Entretanto, esses pacientes utilizam apenas parte desses limites, com o provável intuito de evitar reduções críticas da reserva inspiratória e maior trabalho elástico.
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, Communication Specialist talks about the Periodic Table of Elements 7/17/17 Back to Elements List Fermium is process, but the identification of Pu-244 raised the possibility that still more neutrons could have been discovery of the new elements, and the new data on neutron capture, was kept secret on the orders of the U.S
Staff - Trystan M. Herriott | Alaska Division of Geological & Geophysical
sandstone interval in outcrop of the Tonnie Siltstone Member, Chinitna Formation, lower Cook Inlet, south Paveloff Siltstone Member of the Chinitna Formation: Exploring the potential role of facies variations in member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska, in Wartes, M.A., ed
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Staff - Nina T. Harun | Alaska Division of Geological & Geophysical Surveys
mapping of the Upper Jurassic Naknek Formation in a footwall syncline associated with the Bruin Bay fault Ivishak Formation in the northeastern Brooks Range, Alaska: University of Alaska Fairbanks, M.S. thesis Triassic Ivishak Formation in the Sadlerochit Mountains, northeastern Alaska: Alaska Division of Geological
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Conversion Factors Periodic Table of the Elements Chart of the Nuclides Map of the Nuclides Computer Index of (Atominstitut der Ãsterreichischen Universitäten) Neutron Activation Table of Elements Neutron Scattering at neutronsources.org. The information contained here in the Neutron Scattering Web has been
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. ___________________________________________________________________________________ What do the different colors on the map of the CMB represent? Although the temperature of the CMB is The most conclusive and carefully examined evidence for The Big Bang is the existence of an isotropic radiation bath that permeates the entirety of the universe known as the cosmic microwave
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X-RAY DATA BOOKLET Center for X-ray Optics and Advanced Light Source Lawrence Berkeley National Laboratory Introduction X-Ray Properties of Elements Electron Binding Energies X-Ray Energy Emission Energies Table of X-Ray Properties Synchrotron Radiation Characteristics of Synchrotron Radiation History of X
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all forces show that they are the same basic force, and have frozen out to different forces in the . What do the different colors on the map of the CMB represent? Although the temperature of the CMB is Implications of the COBE DMR Map of the Early Universe What COBE DMR saw: The COBE DMR (Cosmic
What about using pesticides if I am pregnant or have a baby?
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Mineral Resources | Alaska Division of Geological & Geophysical Surveys
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Emergencia (EAS) de la Comisión Federal de Comunicaciones, Radio NOAA es una red para todo tipo de peligros . De este modo, es la fuente más comprensiva de información del tiempo y emergencias que està quÃmicos o derramamientos de petróleo). Conocida como "La Voz del Servicio Nacional de MeteorologÃa
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Publications - GMC 395 | Alaska Division of Geological & Geophysical
investigations of the diatom stratigraphy of Borehole TA8, Portage Alaska: Alaska Division of Geological & Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical DGGS GMC 395 Publication Details Title: Preliminary investigations of the diatom stratigraphy of
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Solar Integration Data Sets | Grid Modernization | NREL
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para un condado depende de recepción de la seña fiable, que tÃpicamente se extiende en un radio de 40 millas del transmisor, asumiendo terreno plano. Condados sin la cobertura de NWR o cobertura obstáculos de la seña y/o la distancia excesiva del transmisor. Usted puede referirse directamente a
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Publications - PIR 2008-1 | Alaska Division of Geological & Geophysical
investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Division of Geological & interpretations of the Nanushuk Formation exposed along the Colville River near the confluences with the Awuna and Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska
Periodic Table of Elements: Los Alamos National Laboratory
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Operating the Western Interconnection with 80%-90% Renewables - Text
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atomic layer deposition for applications. He also manages the majority of X-ray characterization equipment at NREL, specifically X-ray diffraction and X-ray fluorescence instrumentation. Additionally, he for EERE's Hydrogen Storage program. He is also an expert in X-ray diffraction and X-ray fluorescence
Energy Analysis Publications | Energy Analysis | NREL
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NREL's Advanced Atomic Layer Deposition Enables Lithium-Ion Battery
Battery Technology News Release: NREL's Advanced Atomic Layer Deposition Enables Lithium-Ion Battery increasingly demanding needs of any battery application. These lithium-ion batteries feature a hybrid solid further customized lithium-ion battery materials for high performance devices by utilizing our patented
degradation in silicon nanowires for lithium ion battery," ACS Nano, 2015, 9(5), pp 5559-5566, DOI molecular layer deposited coating on silicon nanoparticles for lithium ion battery anodes," ACS Nano lithium-ion batteries, lithium-air batteries, organic radical batteries, and magnesium-ion batteries. The
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Engineering has yielded new insights for lithium-ion (Li-ion) battery electrodes at the microstructural level -Phase Stochastics in Lithium-Ion Battery Electrodes" detailing the research and resulting revolutionizes the way lithium-ion (Li-ion) batteries are evaluated so designs can be improved before batteries
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DIY Solar Market Analysis Webinar Series: PVWatts® | State, Local, and
, and updates the energy prediction algorithms to be in line with the actual performance of modern the latest update." In this webinar, one of the tool's developers explains how the new version of ® Wednesday, July 9, 2014 As part of a Do-It-Yourself Solar Market Analysis summer series, NREL's Solar
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Carlo, F. De Carlo, Francesco De Graef, Marc de Jalon, Garcia De La Rosa, K. de Leon, P.A. Ignacio- de . Degenkolb, E. DeJongh, M. DeLisi, M. Delmont, T. O. DeLuca, C. Demas, N. Demchenko, Y. Demeshko, I. Demiguel , N. Kyrpides, Nikos La Joie, C. Labarta, J. LaBissoniere, D. Lacinski, L. Lacour, S. Laguna, I. Lai
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has the ability to view various parts of a frog from many different angles, and with the different here - the Virtual Dissection Kit - has been accessed by 50,000 different sites, in over 50 different form document that is a translation of the user interface into a different language (the Virtual Frog
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NCEP Operational HWRF Forecasting System
2010 Basin: North Atlantic Eastern North Pacific Central North Pacific Western North Pacific North ALBERTO01L North Atlantic: (1) active ALBERTO01L Eastern North Pacific: (0) active Central North Pacific: (0 ) active Western North Pacific: (0) active North Indian Ocean: (0) active Southern Hemisphere: (0) active Â
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Turbine Control Systems Wind Turbine Control Systems Advanced wind turbine controls can reduce the loads on wind turbine components while capturing more wind energy and converting it into electricity turbines. A photo of a wind turbine against blue sky with white blades on their sides in the foreground
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Wind Energy Modeling and Simulation Wind Turbine Modeling and Simulation Wind turbines are unique wind turbines. It enables the analysis of a range of wind turbine configurations, including: Two- or (SOWFA) employs computational fluid dynamics to allow users to investigate wind turbine and wind power
Systems Engineering Workshop 2017 | Wind | NREL
Energy for Wind Systems Today Cost and Value of Wind Power-Implications of Wind Turbine Design, János Aaron Smith, PPI Session II: Uncertainty Impacts on Wind Turbine Design and Performance Mitigation of Wind Turbine Design Load Uncertainties, Anand Natarajan, DTU Wind Energy Uncertainty in the Wind
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DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE NAM CONUS NEST? (04 Nov 2011, updated 13 April 2017 . Back to Table of Contents WHY IS THE QPF DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE NAM different QPF fields between the 12km NAM parent and the NAM nests. 13 April 2017 update: In the 12 August
NOAA Weather Radio - Using NWR SAME
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The Sky This Week, 2016 April 26 - May 3 - Naval Oceanography Portal
the week coursing through the summer Milky Way, skirting the southern reaches of the ecliptic in the morning sky. Last Quarter occurs on the 29th at 11:29 pm Eastern Daylight Time. As Luna wanes through her begins on the 29th and lasts through May 8th. This month's target constellation is Leo, the Lion, which
The Evolving Search for the Nature of Dark Energy | Berkeley Lab
percent of its contents is ordinary matter, 24 percent is dark matter, and all the rest is dark energy ordinary matter, 24 percent is dark matter, and all the rest is dark energy - unless there's a flaw in our Universe, and it's pushing all the rest - ordinary matter and dark matter - farther apart at an ever
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Defense.gov - Special Report - Progress Report: Department of Defense
the need to re-shape and re-balance the direction of the Department and an increasingly challenging capabilities, requirements, risks and needs for the purpose of shifting the Department toward a different , the Landing Platform Dock ship and Mobile Landing Platform ship; and Completing production of the C-17
Publications - PIR 2015-5 | Alaska Division of Geological & Geophysical
superposition of strike-slip and reverse-slip faults in the Bruin Bay fault system, Ursus Head, lower Cook Inlet , Preliminary investigation of fracture populations in Mesozoic strata of the Cook Inlet forearc basin: Iniskin observations: Continued facies analysis of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska
Publications - GMC 329 | Alaska Division of Geological & Geophysical
Bee Creek 1976 holes of Chignik C2 Quadrangle (B-1, 265'; B-2, 500'; B-3, 500'; B-4, 300' and B-5, 300 the Bee Creek 1976 holes of Chignik C2 Quadrangle (B-1, 265'; B-2, 500'; B-3, 500'; B-4, 300' and B-5
Search For Go NWS All NOAA NWR Recepción El área de la recepción nominal para un receptor de Radio cosas afectan la recepción de señas de la radio. Por ejemplo, las extensiones grandes de agua de sal de NWR. Siga leyendo si está dentro del área pero tiene dificultad con recepción. Su seña de la
Research | Photovoltaic Research | NREL
-V cells Hybrid tandems Polycrystalline Thin-Film PV CdTe solar cells CIGS solar cells Perovskites and Organic PV Perovskite solar cells Organic PV solar cells Advanced Materials, Devices, and Science Interfacial and Surface Science Reliability and Engineering Real-Time PV and Solar Resource
transfer and materials science to the development of high-performance building components. He is member of the Building Energy Science Group, his research focuses on the application of fundamental heat particularly interested in the development of novel opaque insulation and window frame materials using nano
Water Power Research | Water Power | NREL
Water Power Research Water Power Research NREL conducts water power research; develops design tools Columbia River, Washington. Hydropower Research Hydropower technologies convert the energy of water moving ; and evaluates, validates, and supports the demonstration of innovative water power technologies. Photo
on the formation of higher efficiency formamidinium lead triiodide-based solar cells," Chem -0003-2019-4298 Dr. Mengjin Yang received his Ph.D. in Materials Science from the University of Pittsburgh, where he investigated nanomaterials for solar energy conversion under the supervision of Prof
Geothermal Energy | Climate Neutral Research Campuses | NREL
Geothermal Energy Geothermal Energy Research campuses can take advantage of geothermal resources sections that describe how examining geothermal energy may fit into your climate action plans. Campus Options Considerations Sample Project Related Links Campus Geothermal Energy Options Campuses can use
Battery Control Algorithms | Transportation Research | NREL
publications. Accounting for Lithium-Ion Battery Degradation in Electric Vehicle Charging Optimization Advanced Reformulation of Lithium-Ion Battery Models for Enabling Electric Transportation Fail-Safe Design for Large Capacity Lithium-Ion Battery Systems Contact Ying Shi Email | 303-275-4240
NREL: News - Winner of Solar Decathlon to be Announced
Winner of Solar Decathlon to be Announced Friday, October 4, 2002 Washington, D.C.- The winner of National Gallery of Art Note: All houses competing in the Solar Decathlon will be open to the public from 9 the U.S. Department of Energy's first Solar Decathlon will be announced noon, Saturday, October 6 in
Preserving the Dark Skies La Oficina de Protección de la Calidad del Cielo del Norte de Chile - OPCC Light view Cerro Pachón CTIO/AURA La Serena Facilities The "El Totoral" Reserve, Cerro Tololo and . back to top Sky Brightness over Cerro Pachón and Cerro Tololo Light pollution from nearby cities (La
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National Wind Technology Center | NREL
. Wind Energy Research Wind turbine blade Wind energy research at the NWTC allows for validation and verification of large and small components and wind turbine systems. Photo by Dennis Schroeder / NREL 40935 Wind energy research at the NWTC has pioneered wind turbine components, systems, and modeling methods
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section Advanced Search... Sections Home Time Earth Orientation Astronomy Meteorology Oceanography Ice You the Moon Illuminated Time Universal Time and Greenwich Mean Time What is Terrestrial Time? Computing Greenwich Apparent Sidereal Time What are the U.S. Time Zones? World Time Zone Map When Does Daylight Time
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Home Page, Alaska Department of Fish and Game
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CAEBAT Model Featured on American Chemical Society Journal Tenth
University's School of Mechanical Engineering has yielded new insights for lithium-ion (Li-ion) battery corresponding article, "Secondary-Phase Stochastics in Lithium-Ion Battery Electrodes" detailing the microstructural modifications can greatly improve overall Li-ion battery performance. The value of this work is
Energy Storage News | Transportation | Transportation Research | NREL
NREL/Purdue team's corresponding article, "Secondary-Phase Stochastics in Lithium-Ion Battery by NREL and NASA, the Battery ISC Device revolutionizes the way lithium-ion (Li-ion) batteries are collaboration with Purdue University's School of Mechanical Engineering has yielded new insights for lithium-ion
News and Feature Stories | NREL
insights for lithium-ion (Li-ion) battery electrodes at the microstructural level, that can lead to Lithium-Ion Battery Electrodes" detailing the research and resulting discoveries, is showcased inside 19th annual Middle School Electric Car Competition, where students raced solar and lithium-ion powered
Publications - GMC 73 | Alaska Division of Geological & Geophysical Surveys
following seven NPRA wells: Fish Creek test well #1; Oumalik test well #1; Peard test well #1; Tunalik #1 ; Umiat test well #11; Wolf Creek test well #3; and Walapka test well #1 Authors: Unknown Publication Date wells: Fish Creek test well #1; Oumalik test well #1; Peard test well #1; Tunalik #1; Umiat test well
Nolan Wilson Nolan Wilson Postdoctoral Researcher-Chemical Engineering Nolan.Wilson@nrel.gov | 303 Ph.D., Chemical and Biomolecular Engineering, Clemson University, 2014 M.S., Chemical and Biomolecular Engineering, Clemson University, 2012 B.S., Chemical Engineering, Auburn University, 2007 Professional
information on the ecology of the species, its impacts and management, a comprehensive bibliography and a list ) General Impact information Management information Distribution The Distribution page presents the global page collates management information from the profile narrative page plus location-specific management
Staff - Trent D. Hubbard | Alaska Division of Geological & Geophysical
, R.P., Darrow, M.M., and Hubbard, T.D., 2015, Influence of catchment properties on stability of frozen : Evaluating geologic hazards and the distribution and character of geologic materials on Alaska's North Slope Professor, Department of Biology and Earth Sciences, University of Central Missouri, Warrensburg, MO 2003
Standard Terms and Conditions | NREL
and Technical Services Subcontracts, Cost-Type (1) Cost Sharing (2) Cost Reimbursement (3) Cost Plus Than Foreign) (1) Cost Sharing (2) Cost Reimbursement (2) Cost Plus Fixed Fee. Appendix B-10 (12/15/16 /15/16) Standard Terms and Conditions for Travel Requirements (1) Cost Sharing (2) Cost Reimbursement
Publications - PIR 2015-5-8 | Alaska Division of Geological & Geophysical
lower sandstone member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska, in Wartes member of the Upper Jurassic Naknek Formation, northern Chinitna Bay, Alaska Authors: Wartes, M.A Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska
Publications - PIR 2015-5-4 | Alaska Division of Geological & Geophysical
facies analysis of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska, in Wartes, M.A of the Lower Jurassic Talkeetna Formation, north Chinitna Bay, Alaska Authors: Bull, K.F. Publication Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska
Presentations - Herriott, T.M. and others, 2011 | Alaska Division of
Details Title: Detailed geologic mapping and overview of structural and stratigraphic studies in the east Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of in the east-central North Slope foothills, Alaska (poster): 3P Arctic, The Polar Petroleum Potential
Idaho Water Resources Research Institute
Students Parents Alumni Faculty & Staff students walk on University of Idaho campus Visit U of I Learn Visit Students on Campus Title IX Helping to ensure U of I is a safe and engaging place for students to Diversity Athletics Events News Directory A - Z Prospective Students Current Students Parents Alumni Faculty
First International Workshop on Grid Simulator Testing of Wind Turbine
of Wind Turbine Drivetrains First International Workshop on Grid Simulator Testing of Wind Turbine Wind Turbine Drivetrains June 13-14, 2013, at the National Wind Technology Center near Boulder apparatuses involved in grid compliance testing of utility-scale wind turbine generators. This includes both
Community Solar | State, Local, and Tribal Governments | NREL
distributed generation owners for the power that their systems contribute to the grid. Community solar generation from an offsite solar system. Some form of VNM must exist for community solar to work properly so Electric Power Association. Community Solar: NREL's Working Group on Community Solar Gardens meeting
NREL Projects Awarded More Than $3 Million to Advance Novel Solar
in Grid Operations," evaluating a research solution to better integrate solar power generation funding program, which advances state-of-the-art techniques for predicting solar power generation to Office to advance predictive modeling of solar power as part of its Solar Forecasting 2 funding program
Scanning Defect Mapping | Photovoltaic Research | NREL
SDMS moves the treated wafer across a stationary laser beam and maps the defects for each location on the wafer. The amount of light reflected from an area is proportional to the dislocation density for that area and provides a direct statistical count of the number of dislocations. PV Research Other
Climate Prediction Center - Seasonal Outlook
ACCOUNT FOR THE LATEST DYNAMICAL AND STATISTICAL GUIDANCE. LONG TERM TRENDS ACCOUNT FOR THE FAMILIAR U Time. Please consult the schedule of 30 & 90-day outlooks for exact release dates. Text Discussions COLLEGE PARK MD 830 AM EDT THU MAY 17 2018 SUMMARY OF THE OUTLOOK FOR NON-TECHNICAL USERS ENSO NEUTRAL
Project Development Model | Integrated Energy Solutions | NREL
. The five elements of project fundamentals are: Baseline: Analyze the current situation for the site . The two-phase iterative model includes elements in project fundamentals and project development based State and Local Energy Data (SLED) tool, developed by NREL for the U.S. Department of Energy, to get
Rare Earth Elements | Alaska Division of Geological & Geophysical Surveys
- Mineral Resources main content Rare Earth Elements Rare earth elements and the supply and demand of these deposits containing rare earth elements to meet the perceived future demand. High prices for rare earth earth element occurrences in the DGGS publications catalog. Department of Natural Resources, Division of
John B. Goodenough, Cathode Materials, and Rechargeable Lithium-ion
cathode materials for the lithium-ion rechargeable battery that is ubiquitous in todayÂs portable conductors has enabled realization of the rechargeable lithium-ion battery used in cellular telephones and Goodenough, the rechargeable lithium ion battery, and related research is available in electronic documents
La Aventura de las PartÃculas
ciertas formas fundamentales. Explore las siguientes rutas que le explicarán la materia del universo! La grande del logo de la Ruta SM) La ruta de las evidencias experimentales : aprenda como los fÃsicos diseà explicación de los "por qué" de las interacciones fÃsicas hay todavÃa muchos misterios por
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logo La Radio de Canada NWR receiver logo recepción COVERAGE County Coverage Listings State Coverage Programación Español Listado de estación Explicacion de SAME Coverage Station Listing County Listing Search For Go NWS All NOAA Información General NWR receiver logo Información de Fondo (incluyendo
Search GO Special Result of the Week Toward a high-intensity muon source Impact of a single pulse of 12 x moment of impact (T=0); b) 9ms after impact; c) 15ms after impact. To solve the mysteries of nature 1012 protons at 14 GeV on a 1cm-wide jet of mercury flowing at 15m/s in a 10T solenoid field: a) at the
Xiaowen Chen Photo of Xiaowen Chen Xiaowen Chen Researcher IV-Chemical Engineering Xiaowen.Chen Education Ph.D., Chemical Engineering, University of Maine, 2009 M.S., Chemical Engineering, University of Maine, 2005 B.S., Chemical Engineering in Polymer Science and Technology, Nanjing University of Science
Sandia National Laboratories: Research: R&D 100 Awards
high radiation environments such as space. Watch the video. control system for active damping of inter first commercially available, high-voltage, high-frequency, high-current, high-temperature, single-chip Materials Science Nanodevices & Microsystems Radiation Effects & High Energy Density Science
logo and clouds NSSL is one of the National Oceanic and Atmospheric Administration's internationally of tornado Tornadoes picture of vintage doppler radar Instruments picture of clouds Sky Scenes -known Environmental Research Laboratories, leading the way in investigations of all aspects of severe
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Tuberculosis Tuberculosis Reports Tuberculosis Reports Tuberculosis Utah Reports Tuberculosis in Utah - Five (IBIS-PH) Tuberculosis 2015 Monthy Reports January February March April May June Tuberculosis National Reports National TB Data and Statistics Tuberculosis Global Reports TB Incidence Map by country TB
of residential solar PV markets. Eric leads the lab's solar data partnerships program. Eric's current green power market research. Research Interests Economic analysis, econometrics, distributed solar PV . Ardani, R. Margolis. 2018. Solar plus: Optimization of distributed solar PV through battery storage and
Photovoltaics | Climate Neutral Research Campuses | NREL
Photovoltaics Photovoltaics Solar photovoltaics (PV) is a mature, commercially available technology arrays. Campus Solar Energy Options A PV system requires periodic maintenance, but upkeep averages two to undertaking a solar energy assessment or PV installation. Solar Energy Resources Solar energy production
University of Maryland MRSEC - Education: Resources
. University of Maryland Materials Research Science and Engineering Center Home About Us Leadership Moments in MSE The Materials Science and Engineering Career Resources Center Materials Research Society Central Super Science Fair Projects: Ideas, Topics, & Experiments All Science Fair Projects Science
Pesticide Information for Veterinarians
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costs and benefits of pesticides to society. They try to identify the potential risks on human health ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure
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The Evolving Market Structure of the U.S. Residential Solar PV Installation
Solar PV Installation Industry, 2000-2016 The Evolving Market Structure of the U.S. Residential Solar PV residential solar photovoltaic (PV) system and that the residential PV installation industry has become more concentrated over time. From 2000 to 2016, the U.S. residential solar photovoltaic (PV) installation industry
DefenseLink.mil - Pentagon Memorial Dedication
Dept. photo by Army Staff Sgt. Michael J. Carden An entry stone at the Pentagon Memorial lists the their lives during the Sept. 11 terrorist attack on the Pentagon. Photo by Staff Sgt. Michael J. Carden Staff Sgt. Michael J. Carden A member of The United States Air Force Band practices before the start of
O, Canada: NREL Partnership Produces New Take on Alternative Fueling
Fueling Station Locator. The tool, which is part of a significant investment by the Canadian government to to develop a modern, bilingual web tool that makes it easier for drivers of alternative fuel vehicles Locator Tool March 5, 2018 Word of the National Renewable Energy Laboratory's (NREL) deep transportation
Publications - PIR 2015-5-9 | Alaska Division of Geological & Geophysical
content DGGS PIR 2015-5-9 Publication Details Title: Evidence of a submarine canyon in the Snug Harbor ., Decker, P.L., and Wartes, M.A., 2015, Evidence of a submarine canyon in the Snug Harbor Siltstone and Pomeroy Arkose Members, Naknek Formation, south-central Alaska: Implications for the distribution of
Visualization and Analytics Software Tools for Peregrine System |
R is a language and environment for statistical computing and graphics. Go to the R web site for System Visualization and Analytics Software Tools for Peregrine System Learn about the available visualization for OpenGL-based applications. For more information, please go to the FastX page. ParaView An open
Inventory of File gfs.t06z.smartguam00.tm00.grib2
boundary layer WDIR analysis Wind Direction (from which blowing) [degtrue] 013 planetary boundary layer WIND analysis Wind Speed [m/s] 014 planetary boundary layer RH analysis Relative Humidity [%] 015 planetary boundary layer DIST analysis Geometric Height [m] 016 surface 4LFTX analysis Best (4 layer) Lifted
Lewis John Lewis John Lewis Researcher IV-Chemical Engineering John.Lewis@nrel.gov | 303-275-3021 Education Ph.D. Chemical Engineering, California Institute of Technology, Pasadena, CA, 1996 M.S. Chemical Engineering, California Institute of Technology, Pasadena, CA, 1993 B.S. Chemical Engineering, Texas A&M
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services. Marine Modeling and Analysis Branch Logo Click here to go to the EMC/MMAB homepage MMAB Mission Statement The Marine Modeling and Analysis Branch is part of the Environmental Modeling Center, which is Environmental Prediction Environmental Modeling Center Marine Modeling and Analysis Branch 5830 University
Materials and Devices | Photovoltaic Research | NREL
Polycrystalline Thin-Film PV Cadmium telluride (CdTe) solar cells Copper indium gallium diselenide (CIGS) solar cells Perovskite and Organic PV Perovskite solar cells Perovskite Patent Portfolio Organic PV (OPV ) solar cells Advanced Materials, Devices, and Concepts We explore new PV materials using high-throughput
Silicon Materials and Devices R&D | Photovoltaic Research | NREL
" and "Si-based Tandem Solar Cells"), Next Generation Photovoltaics (NextGen PV III), and devices, especially for photovoltaic (PV) cell applications. PV Research Other Materials & Devices pages: High-Efficiency Crystalline PV Polycrystalline Thin-Film PV Perovskite and Organic PV Advanced PV
Water Resource Sustainability Conference 2015
| Honolulu, Hawaii Presented By Water Resources Research Center (WRRC), Hawaii and American Samoa Water and Environmental Research Institute (WERI), Guam Puerto Rico Water Resources and Environmental Research Institute (PRWRERI), Puerto Rico The Virgin Islands Water Resources Research Institute (VI-WRRI), U. S. Virgin
reached the mature stage of formation. Image ID: nssl0065, NOAA's National Severe Storms Laboratory (NSSL Available Publication of the U.S. Department of Commerce, National Oceanic & Atmospheric Adminstration NOAA Photo Library Banner Takes you to the Top Page Takes you to the About this Site page. Takes
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Wind Maps | Geospatial Data Science | NREL
Wind Maps Wind Maps Wind Prospector This GIS application supports resource assessment and data exploration for wind development. This collection of wind maps and assessments details the wind resource in Geospatial Data Science Team. National Wind Resource Assessment The national wind resource assessment was
in hard hats standing on top of a large wind turbine overlooking several other wind turbines in the Framework Transforms FAST Wind Turbine Modeling Tool NREL Assesses National Design Standards for Offshore Wind Resource NREL Identifies Investments for Wind Turbine Drivetrain Technologies Awards R&D 100
@NWTC Newsletter: Fall 2013 | Wind | NREL
Assessment of the U.S. Wind Industry in 2012 NREL Identifies Investments for Wind Turbine Drivetrain , medium-speed, medium-voltage wind turbine drivetrain design. Tapping into unparalleled expertise, the The drivetrain of a wind turbine converts the power of the wind into electrical energy. Now
Geothermal Maps | Geospatial Data Science | NREL
presented in these maps was aggregated from the Geothermal Energy Association 2014 Annual U.S. and Global Geothermal Maps Geothermal Maps Our geothermal map collection covers U.S. geothermal power plants , geothermal resource potential, and geothermal power generation. If you have difficulty accessing these maps
NREL: Renewable Resource Data Center - Geothermal Resource Information
Energy's Office of Energy Efficiency and Renewable Energy Geothermal Technologies Program. Its collection , and thermal springs. View NREL's Geothermal resource maps as well as maps for other renewable energy Geothermal Resource Information Geothermal Prospector Start exploring U.S. geothermal resources
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pesticides, the EPA works to protect human health and the environment. The EPA works cooperatively with state ; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure
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fueled for the fleet to be subject to the regulatory requirements. Under Standard Compliance, the AFVs that may be used toward compliance or banked once the fleet achieves compliance for investments in composition. For more information, visit the EPAct State and Alternative Fuel Provider Fleets website
Origin of the Chemical Elements and Their Discoveries [added 1/2007] National Laboratories and Other to the content of DOE R&D Accomplishments. Celebrating Einstein - series of articles about Albert Einstein and his work [added 3/2005] Compact Portable Electric Power Sources [added 1/2007] History of the
Fermilab | Science | Historic Results
quark since the discovery of the bottom quark at Fermilab through fixed-target experiments in 1977. Both cosmic rays. Researchers previously had assumed that cosmic rays approach the Earth uniformly from random impact the Earth generally come from the direction of active galactic nuclei. Many large galaxies
ACHP | Defense Department Compliance with NHPA
NHPA: Section 202(a)(6) Evaluation Report Defense Department Compliance with the National Historic )(6) Evaluation Report is a preliminary step in helping the Department of Defense marshall its Search skip specific nav links Home arrow Publications arrow Intro: Defense Department Compliance with
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of the Navy Chief Of Naval Operations Master Chief Petty Officer Of The Navy Chief Of Naval Personnel Pentagon Hall of Heroes On May 25, Medal of Honor recipient retired Master Chief Petty Officer (SEAL Of Naval Operations Master Chief Petty Officer Of The Navy Chief Of Naval Personnel Biographies SES
ACHP | News | President Bush Issues Executive Order on Preserve America
requirements of subsections 3(a)-(c) of this order. To assist agencies, the Council, in consultation with the Preservation Officer in accordance with section 110(c) of the NHPA. The senior official shall ensure that the public benefit from, and access to, Federally owned historic properties. (c) The Council is directed to
Publications - GMC 9 | Alaska Division of Geological & Geophysical Surveys
; Texaco West Kavik #1; Canning River B-1; ARCO Kavik #1; Forest Kemik #1; BP Kemik #2; Canning River A-1 ; Toolik Federal #1 Authors: Curiale, J.A. Publication Date: 1982 Publisher: Alaska Division of Geological eight North Slope wells: Mobil West Staines #2; Texaco West Kavik #1; Canning River B-1; ARCO Kavik #1
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Energy-Water Nexus and Energy Systems Integration | Energy Systems
on a new area of research geared at finding ways to balance our water use for power systems. Photo of a body of water NREL's research explores the relationship between how much water is evaporated to spectrum. Learn more about NREL's energy-water nexus research. Team with us on water-energy nexus research
NREL to Lead Novel Field Demonstration of Wind Turbine Control at the Wind
Power Plant Level | News | NREL to Lead Novel Field Demonstration of Wind Turbine Control at the Wind Power Plant Level NREL to Lead Novel Field Demonstration of Wind Turbine Control at the Wind to test wind turbine technology controls at the overall wind power plant level. This is a significant
Alternative Fuels Data Center: Maps and Data
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Concentrating Solar Power Projects - Morón | Concentrating Solar Power |
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From Nigel Lockyer: Five things you should know | News
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MicroBooNE project team recognized by Department of Energy | News
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Power Association (SEPA), produced a webinar Utility Participation in the Roof Top Solar PV Market with ). These leaders are pioneering utility-owned rooftop solar programs to broaden the reach of solar PV utility hired solar PV developers who, representing CPS Energy, will install, own, and maintain solar
Solar Plus: A Holistic Approach to Distributed Solar PV | Solar Research |
NREL Plus: A Holistic Approach to Distributed Solar PV Solar Plus: A Holistic Approach to Distributed Solar PV A new NREL report analyzes "solar plus," an emerging approach to distributed solar photovoltaic (PV) deployment that uses energy storage and controllable devices to optimize
2015 PV Solar Resource Workshop | Photovoltaic Research | NREL
PV Solar Resource Workshop 2015 PV Solar Resource Workshop Friday, February 27, 2015 Chairs understand the solar resource available to PV plants and opportunities for the community to improve over the as Adobe Acrobat PDFs. Solar Resource Needs for Prediction and Monitoring of PV Performance
The New Jersey Water Resources Research Institute at Rutgers NJAES
Rutgers New Jersey Agricultural Experiment Station [The New Jersey Water Resources Research wetland Program Areas The New Jersey Water Resources Research Institute (NJWRRI) is a federally-funded water in the state. Its mission is to: sponsor research on all aspects of water quality, water quantity
Energy Systems Integration Facility Insight Center | Energy Systems
simulation data. Photo of researchers studying data on a 3-D power system profile depicting the interaction of renewable energy resources on the grid. Capabilities The Insight Center offers the following Integration Facility Insight Center Located adjacent to the Energy System Integration Facility's High
NREL Leads Wind Farm Modeling Research - Continuum Magazine | NREL
ten 2-MW Bonus wind turbines. Photo provided by HC Sorensen, Middelgrunden Wind Turbine Cooperative ) has created complex computer modeling tools to improve wind turbine design and overall wind farm activity surrounding a multi-megawatt wind turbine. In addition to its work with Doppler LIDAR, the
@NWTC Newsletter: Summer 2014 | Wind | NREL
, Developmental Role in Major Wind Journal Boosting Wind Plant Power Output by 4%-5% through Coordinated Turbine . Part 2: Wind Farm Wake Models New Framework Transforms FAST Wind Turbine Modeling Tool (Fact Sheet ) Sensitivity Analysis of Wind Plant Performance to Key Turbine Design Parameters: A Systems Engineering
Geothermal Energy Basics | NREL
Geothermal Energy Basics Geothermal Energy Basics Many technologies have been developed to take advantage of geothermal energy-the heat from the earth. This heat can be drawn from several sources: hot hot spring. The Earth's heat-called geothermal energy-escapes as steam at a hot springs in Nevada
Nuclear and Particle Physics, Astrophysics and Cosmology : T-2 : LANL
linked in Search T-2, Nuclear and Particle Physics, Astrophysics and Cosmology T-2 Home T Division Focus Areas Nuclear Information Service Nuclear Physics Particle Physics Astrophysics Cosmology CONTACTS Group energy security, heavy ion physics, nuclear astrophysics, physics beyond the standard model, neutrino
-redshifted), Observed Flux, Statistical Error (Based on the optimal extraction algorithm of the IRAF packages were acquired using different instrumental settings for the blue and red parts of the spectrum to avoid extracted for systematics checks of the wavelength calibration. Wavelength and flux calibration were applied
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. Education Ph.D., Computer Science, Colorado School of Mines M.S., Computer Science, University of Queensland B.S., Computer Science, Colorado School of Mines Brunhart-Lupo Nicholas Brunhart-Lupo Computational Science Nicholas.Brunhart-Lupo@nrel.gov
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| NREL Bobi A. Garrett - Deputy Laboratory Director and Chief Operating Officer Bobi A. Garrett - Deputy Laboratory Director and Chief Operating Officer A photo of Bobi A. Garrett, Deputy Laboratory Director and Chief Operating Officer In her role as deputy laboratory director/chief operating officer (COO
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§ 800.10(c) provides further direction for the ACHP to consider requesting the preparation of a Reports Background. Section 213 of the National Historic Preservation Act (NHPA) [16 U.S.C. § 470u ] directs the Secretary of the Interior (Secretary), if requested by the Chairman of the Advisory Council on
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Exploring Renewable Energy Integration in California - Text Version |
look at different penetrations of solar and understand how the duck chart shape change and how much analyses and different scenario analyses to understand the key drivers behind these challenges. Today, we each of our different scenarios. We have three different renewable portfolios that we looked at. On the
Presentations - Herriott, T.M. and others, 2015 | Alaska Division of
Details Title: Sequence stratigraphic framework of the Upper Jurassic Naknek Formation, Cook Inlet forearc Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of ., Wartes, M.A., and Decker, P.L., 2015, Sequence stratigraphic framework of the Upper Jurassic Naknek
Defenselink Special: Remembering September 11, 2001 - Six Years Later ...
Sept. 11 Memorial observance, honoring the 184 people who perished when American Airline 77 crashed observance today honoring the 184 people who perished when American Airlines Flight 77 crashed into the , Irwin gets emotional quickly when talking about the day that 184 people died here. One-hundred twenty
Wind Data | Geospatial Data Science | NREL
Class 3 or greater are suitable for most utility-scale wind turbine applications, whereas class 2 areas ) with adequate wind resource for wind turbine applications may exist in some Class 1 areas. The degree Wind Data Wind Data These datasets detail the wind resource available in the United States. 50-m
-specific analysis can be used to assess the risk induced by loss of a wind turbine blade. The study used for different wind turbine configurations. The authors used assumptions specific to the National Wind ., failure rate for wind turbine rotors) are based on a 13-year-old report on wind turbines installed in
NREL: Renewable Resource Data Center - Wind Resource Information
and Actual Wind Turbine Sites (September 1982) and a Wind Energy Resource Atlas of the United States Wind Resource Information Photo of five wind turbines at the Nine Canyon Wind Project. The Nine Canyon Wind Project in Benton County, Washington, includes 37 wind turbines and 48 MW of capacity
NREL Research Determines Integration of Plug-in Electric Vehicles Should
transportation and energy systems engineer at NREL and author of the new Nature Energy paper, "Impact of Muratori, author of the new Nature Energy paper "Impact of Uncoordinated Plug-in Electric Vehicle Integration of Plug-in Electric Vehicles Should Play a Big Role in Future Electric System Planning News
Publications - SR 65 | Alaska Division of Geological & Geophysical Surveys
; Geophysical Surveys Comments: Your help is crucial in the compilation of future Alaska Minerals Reports. The quality and completeness of the information in these annual reports is dependent on input from all members of the mineral industry. Please take time to fill out the current mining and mineral activity
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; Geophysical Surveys Comments: Your help is crucial in the compilation of future Alaska Minerals Reports. The quality and completeness of the information in these annual reports is dependent on input from all members of the mineral industry. Please take time to fill out the current mining and mineral activity
radiation and therefore it cannot be seen, which has earned it the title Dark Matter. Dark matter rest (approximately three quarters) of all the matter and energy in the universe is referred to as dark energy. Dark matter is most commonly hypothesized to be made up of exotic particles such as WIMPS (Weakly
: Attend a Dark Matter Day event October 23, 2017 The world will soon be celebrating the hunt for the universe's most elusive matter in a series of Dark Matter Day events planned in over a dozen countries reveals most accurate measurement of dark matter structure in the universe August 3, 2017 Dark Energy
, technology, engineering and math fields. New world-leading limit on dark matter search from PICO experiment February 27, 2017 The PICO-60 dark matter bubble chamber experiment has produced a new dark matter limit . Construction of world's most sensitive dark matter detector moves forward September 26, 2016 LUX-ZEPLIN (LZ), a
New Jersey | Midmarket Solar Policies in the United States | Solar Research
| NRELA> Jersey New Jersey An arrow graphic shows that New Jersey's renewable portfolio standard property by a renewable system is exempt from property tax. Utility Incentive Programs The Board of Public incentive programs. Renewable Portfolio Standard New Jersey Board of Public Utilities: RPS Background New
Joint Center for Energy Storage Research
singly charged lithium ions in the lithium-ion battery by new doubly or triple charged ions. Learn More Cells that Run on Air Scientists at UIC and Argonne Produce New Design of a True Lithium-air Battery phones from cumbersome bricks to sleek, powerful devices was possible because of the lithium-ion
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Richard T. (Rick) Elander | NREL
T. (Rick) Elander Photo of Rick Elander Richard Elander Researcher VI-Chemical Engineering Chemicals and AIChE Annual Meeting, multiple years Education M.S., Chemical Engineering (Biochemical Engineering), Colorado State University B.S., Chemical Engineering, University of Pennsylvania Professional
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PV & Solar Resource Testing Accelerated Testing & Analysis Systems Engineering Project Sandia National Laboratories' PV Performance Modeling Collaborative website. Jinko Solar. PV systems mounted on the ground. Jinko Solar PV Lifetime installation at NREL. need-alt Light-induced degradation
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For more information about solar photovoltaic energy, visit the following resources: Solar PV Photovoltaic Technology Basics Solar Photovoltaic Technology Basics Solar cells, also called photovoltaic (PV) cells by scientists, convert sunlight directly into electricity. PV gets its name from the
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Publications Publications NREL publishes a variety of publications related to geothermal energy geothermal energy research. Featured Publications Mexico's Geothermal Market Assessment Report NREL Technical investment in the country's geothermal energy sector. Since 2013, Mexico has enacted comprehensive reforms to
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. 2015. Methods for Analyzing the Economic Value of Concentrating Solar Power with Thermal Energy in the United States, Potential Lessons for ChinaPDF. Golden, CO: National Renewable Energy . Renewable Electricity: Insights for the Coming DecadePDF. Golden, CO: National Renewable Energy Laboratory
Ramin Faramarzi Photo of Ramin Faramarzi Ramin Faramarzi Researcher V-Mechanical Engineering Engineering, California State University B.S. Mechanical Engineering, North Carolina State University articles and is a registered mechanical engineer in the state of California. Education M.S. Mechanical
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Golden Rays - July 2017 | Solar Research | Solar Research | NREL
Operator, First Solar, and NREL tested a 300-MW PV plant to demonstrate that, with proper controls, PV can technique to measure charge-carrier transport in PV materials. Solar Plus: A Holistic Approach to Distribution Solar PV By optimizing how PV interacts with other electricity loads at the household- and grid
THE QPF DIFFERENT BETWEEN THE 12-KM NAM PARENT DOMAIN AND THE 4-KM NAM CONUS NEST? (04 Nov 2011) WHAT 28 MAR 2000? Eta Post Processor WHY IS THE SLP DIFFERENT BETWEEN AWIPS AND AFOS? (updated 6 Nov 98 IN THE BUFR OUTPUT DIFFERENT FROM WHAT IS OBSERVED? Eta Data Assimilation System (EDAS) COMMENTS ON
Western Wind Data Set | Grid Modernization | NREL
replicates the stochastic nature of wind power plant output. NREL modeled hysteresis around wind turbine cut where wind speeds are often near wind turbine cut-out (~25 m/s), SCORE output does not replicate the Vestas V90). The hysteresis-corrected SCORE is an attempt to put the wind turbine hysteresis at cut-out
Wind Energy | Climate Neutral Research Campuses | NREL
turbine or wind farm is one of the few technologies that supplies renewable energy at the scale required . Before determining whether a site is suitable for a wind turbine, read the Wind Energy Siting Handbook Community College has installed a wind turbine on site and now offers an Associate Degree in wind energy and
Glossary | Efficient Windows Collaborative
double-hung windows as a means of counterbalancing the weight of the sash during opening and closing. Bay a fixed sash or a double-hung window. Also referred to as bead stop. Blackbody. The ideal, perfect member of the lower sash which meet at the middle of a double-hung window. Clerestory. A window in the
Publications - PDF 97-29I | Alaska Division of Geological & Geophysical
igneous rocks of the Tanana B-1 Quadrangle and vicinity Authors: Newberry, R.J., and Haug, S.A , and Sr isotopic data for igneous rocks of the Tanana B-1 Quadrangle and vicinity: Alaska Division of ; Isotopes; Plutonic; STATEMAP Project; Trace Elements; Volcanic Top of Page Department of Natural Resources
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hour fcst Visibility [m] 014 planetary boundary layer WDIR 15 hour fcst Wind Direction (from which blowing) [degtrue] 015 planetary boundary layer WIND 15 hour fcst Wind Speed [m/s] 016 planetary boundary layer RH 15 hour fcst Relative Humidity [%] 017 planetary boundary layer DIST 15 hour fcst Geometric
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layer WDIR analysis Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND analysis Wind Speed [m/s] 017 planetary boundary layer RH analysis Relative Humidity [%] 018 planetary boundary layer DIST analysis Geometric Height [m] 019 surface 4LFTX analysis Best (4 layer) Lifted Index [K
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layer WDIR analysis Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND analysis Wind Speed [m/s] 017 planetary boundary layer RH analysis Relative Humidity [%] 018 planetary boundary layer DIST analysis Geometric Height [m] 019 surface 4LFTX analysis Best (4 layer) Lifted Index [K
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Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical DGGS AR 2010 Publication Details Title: Alaska Division of Geological & Geophysical Surveys Annual Report Authors: DGGS Staff Publication Date: Jan 2011 Publisher: Alaska Division of Geological &
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* Methane Clouds Observed Near Titan's Equator May Explain Presence of Riverbeds on the Surface * 'Dark Center for Adaptive Optics A University of California Science and Technology Center home AO of Cosmic Time * Celebration of Science and Technology Centers Class of 2000 AO Headlines 2009
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NREL: Renewable Resource Data Center - Geothermal Resource Related Links
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Energy Analysis Research | Energy Analysis | NREL
innovation through integration. Illustration of NREL energy analysis research, including impact systems analysis integrates all aspects of our capability set to develop future energy system scenarios evaluate and understand the impact of markets, policies, and financing on technology uptake and the impact
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Smithsonian Marine Station at Fort Pierce Website Search Box Search Field: SMS Website Search Search Submit: Submit Advanced Search IRLSI Home Search the Inventory The IRL Stewardship IRL Photo Gallery Links and Events About Us SMS Home Roseate Spoonbill Search by Word or Phrase Go to Species
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boundary layer WDIR 24 hour fcst Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND 24 hour fcst Wind Speed [m/s] 017 planetary boundary layer RH 24 hour fcst Relative Humidity [%] 018 planetary boundary layer DIST 24 hour fcst Geometric Height [m] 019 surface 4LFTX 24 hour fcst
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Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical 2002 Publisher: Alaska Division of Geological & Geophysical Surveys Ordering Info: Download below Reference DGGS Staff, and Werdon, M.B., 2002, Alaska GeoSurvey News - Geologic Investigations in the Salcha
2017 Cybersecurity Workshop: Readouts from Working Groups - Video Text
applicability of artificial intelligence to search for cybersecurity gaps in our existing SKATA networks. Second primarily renewable that all back each other up; that are all highly intelligent, artificial intelligence we have in cyber security, digital technologies, artificial intelligence. We think that that would
Preservation50 - Making Archaeology Public
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analysis to expand the midscale solar market. The midscale market for solar photovoltaics (PV), loosely than other PV market segments in recent years. Featured Analysis Midmarket Solar Policies in the United Midscale Commercial Solar Market Midscale Commercial Solar Market NREL experts are providing
authorized by section 3709.05 of the Revised Code. (C) "Circulation system" means an arrangement of transferred and does not mean the person who formerly operated or maintained the public swimming pool. (J ://catalog.asme.org/. ASME documents are also generally available at the state library of Ohio. (c) American national
. Northern Command: For Students The 1700s "To provide for calling forth the militia to execute the laws of the union, suppress insurrections, and repel invasions." - Article 1, Section 8, Clause 15 , Constitution of the United States Because the common defense of the New World was so crucial, our forefathers
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Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska Section; Resource Assessment; Tyonek Formation; Type Section Top of Page Department of Natural Resources State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical Surveys Home
Presentations - Twelker, Evan and others, 2014 | Alaska Division of
Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Details Title: Preliminary results from 2014 geologic mapping in the Talkeetna Mountains, Alaska Lande, Lauren, 2014, Preliminary results from 2014 geologic mapping in the Talkeetna Mountains, Alaska
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evaluation, and improve wind turbine and wind power plant performance. A photo of a snowy road leading to a single wind turbine surrounded by snow-covered pine trees against blue sky. Capabilities NREL's power plant and small wind turbine development. Algorithms and programs exist for simulating, designing
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resources, bioenergy and bio-based products, zero energy buildings, wind energy, geothermal energy, solar Energy Systems Enhance National Security Washington D.C., March 14, 2002 Experts from the U.S . Department of Energy's National Renewable Energy Laboratory (NREL) have identified key renewable energy
and x-ray spectroscopy pioneer, Farrel W. Lytle, and include precious metals such as gold, silver structure of matter called x-ray absorption spectroscopy. The foils were donated by entrepreneur, scientist activities on x-ray fluorescence imaging in ancient materials like fossils and the Archimedes Palimpsest
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Finding New Ways to Foster Clean Energy Partnerships - Continuum Magazine
market impact of the research conducted at DOE's national laboratories by doubling the intensity of . Many of these achievements stem from internal process improvements that have enhanced NREL's ability to " that factors in elements of each innovation's patentability, commercial impact, and licensing
Renewable Energy Technical Potential | Geospatial Data Science | NREL
Technical Potential Renewable Energy Technical Potential The renewable energy technical potential level from Resource to Technical to Economic to Market. The benefit of assessing technical potential is potential-resource, technical, economic, and market-as shown in the graphic with key assumptions. Technical
Thermochemical Process Integration, Scale-Up, and Piloting | Bioenergy |
; represented by spheres of hydrogen and carbon monoxide, then to "Gas Cleanup, Solids Removal, Reforming ; represented by a gasoline dispenser nozzle. A green arrow of "Fast Pyrolysis" and blue arrows for Distillation," and finally to "Fuels," represented by a gasoline dispenser nozzle Variety of
UFR Process was established on July 29, 2014, by the execution of the Memorandum of Understanding Process is being led by a Steering Group consisting of the Council on Environmental Quality, the Review was established on July 29, 2014, through an interagency Memorandum of Understanding by eleven
Publications - GMC 410 | Alaska Division of Geological & Geophysical
) Keywords Geochemistry; Rare Earth Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical
Publications - GMC 409 | Alaska Division of Geological & Geophysical
) Keywords Geochemistry; Rare Earth Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical
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hierarchical control architecture that enables a hybrid control approach, where centralized control systems will be complemented by distributed control algorithms for solar inverters and autonomous control of ), involves developing a novel control scheme that provides system-wide monitoring and control using a small
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to achieve the Replacement Fuel Goal. For more information on the Private and Local Government Fleet Private and Local Government Fleets Under the Energy Policy Act (EPAct) of 1992, the U.S . Department of Energy (DOE) was directed to determine whether private and local government fleets should be
Software Tools for Battery Design | Transportation Research | NREL
battery designers, developers, and manufacturers create affordable, high-performance lithium-ion (Li-ion Software Tools for Battery Design Software Tools for Battery Design Under the Computer-Aided ) batteries for next-generation electric-drive vehicles (EDVs). An image of a simulation of a battery pack
Ahmad Pesaran Honored with DOE Assistant Secretary's 2017 EERE Outstanding
lithium-ion battery performance for electric vehicles. No stranger to inspiring colleagues, providing Michelbacher (INL, VTO Battery and Electrification), Steven Boyd (DOE, VTO Battery and Electrification), Brian Cunningham (DOE, VTO Battery and Electrification), Samuel Gillard (DOE, VTO Battery and Electrification
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commercially available, large-format isothermal battery calorimeter for lithium-ion battery safety testing to test the performance and safety of large-format lithium-ion batteries used extensively in electric develop NREL intellectual property representing an isothermal battery calorimeter. The technical
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Employee Spotlight: Clarence Chang | Argonne National Laboratory
batteries --Electricity transmission --Smart Grid Environment -Biology --Computational biology --Environmental biology ---Metagenomics ---Terrestrial ecology --Molecular biology ---Clinical proteomics and biomarker discovery ---Interventional biology ---Proteomics --Structural biology -Environmental science &
Summer teachers' teaching tool
and nervous system of the frog. Skeleton System Organs Digestive System Nervous System Berkeley Lab students study anatomy of a frog in Biology class room. The pictures showed the skeleton, organs, digestive
Solar Access: Issues and Policy Options | State, Local, and Tribal
: approximately 2,580 megawatts (MW) of new residential solar photovoltaic (PV) capacity was brought online in home with rooftop solar Figure 1. Example of a residential solar PV system. NREL 00565 The existing Governments | NREL Solar Access: Issues and Policy Options Solar Access: Issues and Policy
Smoot Astrophysics Research Program
the same basic force and have frozen out to different forces in the cooler present Universe. We see Implications of the COBE DMR Map of the Early Universe What COBE DMR saw: The COBE DMR (Cosmic Background Explorer Differential Microwave Radiometer) mapped the microwave (wavelengths of 9, 5,6, and 3.3
electron neutrino, muon neutrino, or tau neutrino. The three different neutrinos are complemented by anti of the neutrinos we detect will look different (have a different flavor) compared to the time they Big World of Small Neutrinos Neutrinos will find you! Fig 1: Hubble image of the deep field
Introductory Talk: Whole Frog Project
geometric primitives (points, lines, polygons, etc.) that accurately represent the shape of the surface constant value (color). This operation effectively defines the boundary between areas of different color about 10 seconds on a 56K baud modem. The controls can be set to send compressed images of 3 different
1 At speeds above mid-range, both the engine and electric motor are used to propel the vehicle. The gasoline engine provides power to the drive-train directly and to the electric motor via the generator. Go , generator, power split device, and electric motor visible. The car is moving. There are blue arrows flowing
Solution for Data Security Challenges Faced by Smart Grid Evolution - Video
the same utility - different business units that are dealing with generation, transmission, and smart grid, the consumers now also have access to information about zero utilization and the different alive to sense what's going on. And then there's certainly variety with the various different elements
all the same. It appears that tornadoes arise in many different ways, and perhaps different process can be associated with the tornado at different times in its life cycle. Moreover, not all tornadoes , mesocyclone) be? Where do you propose to put the dividing lines between tornado-tornado cyclone-mesocyclone? c
The GFS Atmospheric Model description
model has only one type of cloud cover represented by C. In the tropics the cloudiness is primarily due mainly through grid-scale condensation. The fractional cloud cover C is available at all model levels , 1996: Parameterizations for the absorption of solar radiation by water vapor and ozone. J. Atmos. Sci
Teachers Participate in Scientific Work to Prepare for School Year
improve the quality of science, mathematics and technology education in Colorado schools, the U.S critical agents of change in working to improve science, mathematics and technology education in our Science and Technology Education Irene Hays. "This is NREL's way of helping the quality of teaching
Publications - PIR 2008-1C | Alaska Division of Geological & Geophysical
investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Division of Geological & Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2008-1C Publication Details Title: Evaluation of stratigraphic continuity between the
Publications - PIR 2003-1 | Alaska Division of Geological & Geophysical
, Alluvial facies and paleosols in the Cretaceous Nanushuk formation, Kanayut River, North Slope, Alaska Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2003-1 Publication Details Title: Alluvial facies and paleosols in the Cretaceous
Publications - RI 2015-7 | Alaska Division of Geological & Geophysical
Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS RI 2015-7 Publication Details Title: Surficial geology of the Tyonek area, south-central of the Tyonek area, south-central Tyonek Quadrangle, Alaska: Alaska Division of Geological &
Publications - PIR 2015-5-5 | Alaska Division of Geological & Geophysical
., 2015, Stratigraphic reconnaissance of the Middle Jurassic Red Glacier Formation, Tuxedni Group, at Red Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2015-5-5 Publication Details Title: Stratigraphic reconnaissance of the Middle Jurassic
Publications - PIR 2008-1A | Alaska Division of Geological & Geophysical
of recent geologic field investigations in the Brooks Range Foothills and North Slope, Alaska: Alaska Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska ; Tectonics; Thermal History; Thrust; Toolik River; Torok Formation; Turbidites; Turonian; Valanginian Top of
Electric and Plug-In Hybrid Electric Fleet Vehicle Testing | Transportation
Research | NREL Electric and Plug-In Hybrid Electric Fleet Vehicle Evaluations Electric and Plug-In Hybrid Electric Fleet Vehicle Evaluations How Electric and Plug-In Hybrid Electric Vehicles Work EVs use batteries to store the electric energy that powers the motor. EV batteries are charged by
Eastern Wind Data Set | Grid Modernization | NREL
cell was computed by combining these data sets with a composite turbine power curve. Wind power plants wind speed at the site. Adjustments were made for model biases, wake losses, wind gusts, turbine and conversion was also updated to better reflect future wind turbine technology. The 12-hour discontinuity was
Systems Engineering Models and Tools | Wind | NREL
(tm)) that provides wind turbine and plant engineering and cost models for holistic system analysis turbine/component models and wind plant analysis models that the systems engineering team produces. If you integrated modeling of wind turbines and plants. It provides guidance for overall wind turbine and plant
NREL Taps Young to Oversee Geothermal Energy Program | News | NREL
Taps Young to Oversee Geothermal Energy Program News Release: NREL Taps Young to Oversee Geothermal (NREL) promoted Katherine Young to laboratory program manager for geothermal energy. Young has been with NREL since 2008, working as a senior geothermal analyst and engineer in the Strategic Energy Analysis
, graphs, or information about datasets). A RESTful web service (external link) - a URL that computer to get the same information in a more computer-program-friendly format like JSON (external link .jsonlKVP, where column names are on every row): Each column has a column name and one type of information
NREL and Hawaiian Electric Navigate Uncharted Waters of Energy
potential grid impact of adding customer-side storage to rooftop solar systems-a scenario that could soon Systems Integration Facility's (ESIF's) power hardware-in-the-loop capability. NREL's ESIF was one of the justify activation of a specific grid support function called "volt-var control" for all new
DRIVE: Drive-Cycle Rapid Investigation, Visualization, and Evaluation
specialized statistical clustering methods. The duration of these representative drive cycles, which aim to , DRIVE can benefit a variety of users. For example: Fleet managers can use the tool to make educated investment decisions by determining, in advance, the payback period for a given technology. Vehicle
Publications - PDF 98-36A | Alaska Division of Geological & Geophysical
Oxides; Rocks; STATEMAP Project; Trace Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical
Publications - GMC 370 | Alaska Division of Geological & Geophysical
(249.0 K) Keywords Rare Earth Elements Top of Page Department of Natural Resources, Division of Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska Visiting Alaska State Employees DGGS State of Alaska search Alaska Division of Geological & Geophysical
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Search! Enter a search term and hit the search button to quickly find an image Go The above "Quick Search" box will find ANY words you type in. Use "*" to truncate a word (dog* will get more precise search, try the "Advanced Search" option below. More search options, including
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Air Force Special Operations Command Air Force Special Operations Command Join the Air Force Home Sheets AFSOC Senior Leaders AFSOC Heritage Units 1st Special Operations Wing 24th Special Operations Wing 27th Special Operations Wing 352nd Special Operations Wing 353rd Special Operations Group 492nd Special
Publications - GMC 350 | Alaska Division of Geological & Geophysical
in the NPRA, Alaska as follows: Ikpikpuk #1 core, cuttings, and sidewall core; South Meade #1 cuttings; Brontosaurus #1 cuttings and core; Walakpa #1 core; and Walakpa #2 cuttings and core Authors follows: Ikpikpuk #1 core, cuttings, and sidewall core; South Meade #1 cuttings; Brontosaurus #1 cuttings
; International Journal of Energy Research 32 (5), 379-407. Ahn, K.S., Shet, S., Deutsch, T., Jiang, C.S., Yan, Y and Sustainable Energy, an AIP journal. Research Interests Dr. Turner has been recognized as a methods, definitions, and reporting protocols." Journal of Materials Research 25 (01), 3-16. Yin, W.J
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Integration Image | Loop View | Daily View | Point Guidance | | Experimental Air Quality Guidance | Product Map To View Additional Guidance Graphic of Air Quality Forecast Guidance for the CONUS Mouse over or Image Alaska 1-Hr Average Ozone Concentration Image Hawaii 1-Hr Average Ozone Concentration Image 8-Hr
Climate Prediction Center - Outreach: 41st Annual Climate Diagnostics &
the University of Maine Climate Change Institute and School of Earth and Climate Sciences and is co (drought, heat waves, severe weather, tropical cyclones) in the framework of climate variability and change and including the use of paleoclimate data. Arctic climate variability and change, and linkages to
Engineering Institute Information Science & Technology Institute Center for Space and Earth Science Management System Environmental Outreach Feature Stories Individual Permit for Storm Water Public Reading Management (First-line and Mid-level) (Engineering Management, Research Management, Technical Management
manufacturing, buildings efficiency, concentrating solar power, geothermal energy, transportation, water power Integration Facility Geothermal Energy Grid Modernization Hydrogen & Fuel Cells Integrated Energy Research Research Researching energy systems and technologies-and the science behind them-for a
Homepage P. Fischer, LBNL, Berkeley CA | UC Santa Cruz CA
mesoscale magnetic x-ray microscopy and spectroscopy (ultra-)fast spin dynamics soft x-ray tomography of condensed matter x-ray optics publications presentations invited talks conference contributions curriculum
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and Tools Energy Analysis Data and Tools NREL develops energy analysis data and tools to assess collections. Data Products Technology and Performance Analysis Tools Energy Systems Analysis Tools Economic and Financial Analysis Tools
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Consumidor Laboratórios Legislação Comunicação Social Programa de Monitoramento BPL Produtos analisados de selos Indique! Sugestão para o Programa de Análise de Produtos Licitações Material de Portal do Governo Brasileiro mdic Carta de Serviços Inmetro nos Estados Acre Alagoas AmapÃ
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) soilm1 0-10cm soil moisture soilm2 10-40cm soil moisture soilm3 40-100cm soil moisture soilm4 100-200cm soil moisture soilt1 0-10cm soil temperature soilt2 10-40cm soil temperature soilt3 40-100cm soil temperature soilt4 100-200cm soil temperature thick700.ptype 850-700mb thickness precipitation type thick850
design TEA LCA Biochemical conversion process pathways Algal biomass production and conversion pathways Production," Green Chemistry (2015) Process Design and Economics for the Conversion of Lignocellulosic Production," Applied Energy (2011) Process Design and Economics for Biochemical Conversion of
Home Unclaimed Property Investments Cash Management Debt Management Admin Sign-In State of Alaska > provides cash management, investment and portfolio management, debt management and accounting services for investments, establishes and implements policies, and provides administrative and information technology
Conservation Education Timber Management Wildland Fire & Aviation Burn Permits Firewise Alaska Brochure (PDF) Fire Management Plans Fire Assignments Annual Fire Statistics Fire Terms Glossary Incident Business Management Grants Become an Alaska Firewise Community Community Wildland Fire Protection Plans
Conservation Education Timber Management Wildland Fire & Aviation Burn Permits Firewise Alaska Brochure (PDF) Fire Management Plans Fire Assignments Annual Fire Statistics Fire Terms Glossary Incident Business Management Grants Become an Alaska Firewise Community Community Wildland Fire Protection Plans
Ag Data Commons Monthly Metrics | National Agricultural Library
and Nutrition Service(84)","value":"Food and Nutrition Service(84)"," and Nutrition Service(84)","value":"Food and Nutrition Service(84)"," and Nutrition Service(84)","value":"Food and Nutrition Service(84)","
postdoctoral fellow. He developed his expertise in electrochemistry and lithium-ion batteries (failure for lithium-ion batteries. His current research focuses on developing: 1) a fundamental understanding electrochemical performance of lithium-ion batteries. Research Interests Fundamental understanding of
MATLAB Software Versions and Licenses for the Peregrine System |
: Feature usage info: Users of MATLAB: (Total of 6 licenses issued; Total of ... licenses in use) Users of Compiler: (Total of 1 license issued; Total of ... licenses in use) Users of Distrib_Computing_Toolbox : (Total of 4 licenses issued; Total of ... licenses in use) Users of MATLAB_Distrib_Comp_Engine: (Total of
2014 NREL Photovoltaic Reliability Workshops | Photovoltaic Research | NREL
Curves and Visual Inspection of PV Modules Deployed at TEP Solar Test Yard-Peter McNutt, NREL Data Determining PV System's Degradation Rate and the Impact of Data Filters-Wilson Zexu Zhang, REC Solar Pte. Ltd " Test in Qualifying Solar PV Inverters-Dutch Uselton, Lennox IND System Reliability for Utility PV
Energy Systems Integration Newsletter - January 2017 | Energy Systems
) project with PV manufacturer First Solar and NREL, First Solar designed an advanced plant-level controller relatively long history of interconnecting solar photovoltaic (PV) systems to its electric grid, with state Photo of a solar array. Tests Show Large Solar Plants Can Balance a Low-Carbon Grid In recent years
Top Five Large-Scale Solar Myths | State, Local, and Tribal Governments |
of large-scale photovoltaic (PV) facilities or solar farms tend to include a myriad of misperceptions technologies do use mirrors which can cause glare, most solar farms use PV modules to generate electricity. PV panels in order to convert solar energy into electricity. PV modules are generally less reflective than
NOVA - Official Website | Invisible Universe Revealed
): They look like artworks in the heavens. Each one of them is different, like snowflakes. And these are coming to a focus at different points. And that is the classic problem called "spherical aberration chips of paint. They had thrown off the laser-guided measuring tool used to shape the mirror. JIM
Virtual Frog Dissection: Interactive 3D Graphics Via the Web
Kit''. A student using this kit has the ability to view various parts of a frog from many different angles, and with the different anatomical structures visible or invisible. For example, the student can up to 60 kilobytes for high quality. Clicking on the image yields different results depending on how
ACHP | Section 106 Disaster Response Planning FAQ
§ 800.1(c)). What happens once the "emergency" response phase to the disaster is over? The ACHP be shared and in what format. 36 CFR § 800.11(c) provides further information on how the Secretary Introduction In response to recent catastrophic events across the country, such as flooding, snow, ice
Module 4: Text Versions | State, Local, and Tribal Governments | NREL
own or finance a system. We'll help you understand the different financing types available to local often specific to a particular segment of the market with different amounts of incentives, different system size caps, and different total funds or aggregate capacity. The customer can identify if solar PV
Publications - PIR 2008-1B | Alaska Division of Geological & Geophysical
., Preliminary results of recent geologic field investigations in the Brooks Range Foothills and North Slope Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2008-1B Publication Details Title: Measured section and facies analysis of the Lower
Publications - PIR 2008-1G | Alaska Division of Geological & Geophysical
Wartes, M.A., and Decker, P.L., eds., Preliminary results of recent geologic field investigations in the Surveys Skip to content State of Alaska myAlaska My Government Resident Business in Alaska content DGGS PIR 2008-1G Publication Details Title: Turonian-Campanian strata east of the Trans-Alaska
ACHP | Working Together to Build a More Inclusive Preservation Program
Street is all about creating lasting memories. When people visit the Georgetown Square, whether it be a ," but that's when historic preservation gets truly tested. When you have to remind people that even helps raise awareness and gives more validity to what we are doing locally. I think when people hear
Wind Power Innovation Enables Shift to Utility-Scale - Continuum Magazine
the 1930s, a farmer in South Dakota built a small wind turbine on his farm, generating enough enough electricity to power thousands of homes. Aerial photo of large wind turbine with mountains in the background. Aerial view of the Siemens utility-scale wind turbine at the National Wind Technology Center
Publications - GMC 86 | Alaska Division of Geological & Geophysical Surveys
DGGS GMC 86 Publication Details Title: Compressibility test data for the following seven NPRA wells : Inigok Test Well #1; Ikpikpuk Test Well #1; South Barrow Test Well #1; South Barrow Test Well #2; South Barrow #3; Peard Test Well #1; Point Barrow Core Test #1 Authors: Unknown Publication Date: 1988
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Features What Time is it? USNO Master Clock Cesium Fountain Linear Ion Trap GPS Satellite Time Transfer Network Time Service Telephone Time US Time Zones Systems of Time Leap Seconds Highlights Daily Home ntp.org Contact the USNO The Sky This Week Sun Rise/Set Tour Info Travel Directions Department of
Phase III of Early Restoration | NOAA Gulf Spill Restoration
information about this phase of Early Restoration, including fact sheets on each project. The final Phase III 44 projects are documented in a final Record of Decision. Information about Phase III of Early Archive Home Phase III of Early Restoration Phase III of Early Restoration Beach habitat would be restored
Golden Rays - June 2017 | Solar Research | NREL
information on NREL's research and development of solar technologies. To receive new issues by email panels. A Pathway to 10 Terawatts of PV A global PV capacity of 5-10 terawatts could be installed by 2030 % renewable power by 2025. Currently, 38% of the continent's electricity comes from renewable resources. The
Publications - Search Help | Alaska Division of Geological & Geophysical
main content Publications Search Help General Hints The search engine will retrieve those publications publication's title is known, enter those words in the title input box. The search engine will look for all of .). Publication Year The search engine will retrieve all publication years by default. Select one publication year
Fermilab | Science | Questions for the Universe | The Birth of the Universe
Fermilab and the LHC Dark matter and dark energy ADMX Muons More fundamental particles and forces Theory , that could explain ultra-high-energy cosmic rays, dark matter and perhaps even dark energy. Experiments Accelerators for science and society Particle Physics 101 Science of matter, energy, space and time How
Engineers (IEEE), a member of the IEEE Standards Board, and a member of the Board of Governors. He is a | 303-275-4333 Richard (Dick) DeBlasio is a Research Fellow Emeritus in the Energy Systems Integration Renewable Energy Laboratory (NREL), and a member of the NREL Research Fellows Council that reports to the
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Saikrishna Mukkamala Saikrishna Mukkamala Researcher IV-Chemical Engineering Saikrishna.Mukkamala thermochemical, biochemical pathways Bio product and fuel characterization Education M.S. Chemical Engineering , University of Maine B.S. Chemical Engineering, JNTU-India Featured Publications S. Mukkamala, M.C. Wheeler
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Alaska Community Forest Council
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Firewood on Alaska State Lands
Conservation Education Timber Management Wildland Fire & Aviation Burn Permits Firewise Alaska Brochure (PDF) Fire Management Plans Fire Assignments Annual Fire Statistics Fire Terms Glossary Incident Business Management Grants Become an Alaska Firewise Community Community Wildland Fire Protection Plans
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University-International Center for Automotive Research (CU-ICAR) (2009-2012) Intern/Reliability Engineer selection for body-in-white." International Journal of Sustainable Manufacturing 2, no. 4 (August 2012 Structure Case Study." Accepted for publication in International Journal of Sustainable Engineering
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Hailey Boyer Photo of Hailey Boyer Hailey Boyer Undergraduate IV-Chemical Engineering Hailey.Boyer studying chemical engineering at the University of South Carolina. She was hired through as an intern at via the Hybrid-Sulfur process Electrochemical modeling Education B.S. Chemical Engineering, University
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the System Advisor Model (SAM) PV engineering PV performance reliability and safety Solar resource Research Photo of a city landscape with a sun in the background. Solar energy research at NREL includes photovoltaics, concentrating solar power, solar grid and systems integration, and market research
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. Impact Analysis Conducting analyses to determine the viability of geothermal energy production and Hybrid Systems Exploring the potential benefits of combining geothermal with other renewable energy Designing new models and studying new techniques to increase the production of geothermal energy.
Sertac Akar Photo of Sertac Akar Sertac Akar Energy Analyst - Geothermal Sertac.Akar@nrel.gov | 303 systems (GIS) and remote sensing (RS) Research Interests Techno-economic analysis of geothermal energy resource assessment (exploration & production) Desalination of brackish water using geothermal energy
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Operations Inc. Tunalik Test Well #1; Walakpa Test Well #1 and #2; Inigok Test Well #1 Authors: O'Sullivan Operations Inc. Tunalik Test Well #1; Walakpa Test Well #1 and #2; Inigok Test Well #1: Alaska Division of
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Search Go search Uranium Leasing Program Programmatic Environmental Impact Statement Information Center Environmental Impact Statement (PEIS) for the Uranium Leasing Program. The United States Department of Energy (DOE) Office of Legacy Management (LM) has prepared a Programmatic Environmental Impact Statement (PEIS
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Discovery of the fourth quark in the Standard Model
, using the MARK I detector, (above left) and on the East Coast, at DOEÂs Brookhaven Laboratory Burton Richter at DOEÂs SLAC Sam Ting and team at DOE's Brookhaven 1974 The discovery of charm , the fourth quark in the Standard Model, occurred simultaneously on the West Coast, at DOEÂs SLAC
NREL Adds Solar Array Field to Help Inform Consumers | NREL
PV modules at NREL's new solar array field. Workers install PV modules just north of the NREL parking be Added Each Year Once completed, the new solar array field will house four rows of PV modules. The the lifetime of a PV system, and that increases the per-kilowatt-hour cost of generating solar
Geometric Analysis, Visualization, and Conceptualization of 3D Image Data
collection of geometric primitives (points, lines, polygons, etc.) that accurately represent the shape of the different color. The masks mentioned above are human supplied hints as to where to draw these contour lines ) Acquire information about the inside of an object, and generate a 3D image data set (2) Define the regions
American Association of Physics Teachers - AAPT.org
Memorial Lecture, and the 2018 J. D. Jackson Award Nov 01 2017 Barbara L. Whitten will be the recipient of ) announced today that the 2017 Paul Zitzewitz Excellence in K-12 Physics Teaching Award winner is J. Mark State University - Marion in honoring the life of professor, Dr. Gordon J. Aubrecht, II. Read more Â
The William Perry Center for Hemispheric Defense Studies (The Perry Center)
de usuario multilingüe para sus visitantes, y consolidará el contenido que solÃa extenderse a sites. * * * 21 septiembre, 2017 El Centro William J. Perry se complace en anunciar su nuevo hogar virtual. La nueva página, ubicada en [http://williamjperrycenter.org], ofrece una verdadera experiencia
Defense.gov Special Report: Gates Bids Farewell to Troops
service members and their families for their service. Gates will retire as secretary of defense on June 30 - Defense Secretary Robert M. Gates has served for four-and-a-half years -- longer than all but four of his of the Defense Department. He was focused almost exclusively on the war in Iraq. Story Gates' Bio
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Toggle navigation Home Statistics Providers FAQs Information Contact Don't Be a Shot Dodger! Meet , the flu knocks everyone off their game. Don't be a Shot Dodger! Contact your health care provider or Clinicians (PDF, 31KB) - UPDATED 09/27/17 Novel Influenza Information N.C. Memo to Clinicians on Influenza A
It! What is Soil? Chip Off the Old Block Soil Forming Factors Matters of Life and Death Underneath It All Wise Choices A World of Soils << 1 Soil Forming Factors 2 A Top to Bottom Guide 3 Making a Soil Monolith 4 Soil Orders 5 State Soil Monoliths 6 Where in the Soil World Are You? >> A Top to
Archiving IPY 2007-8 May 21, 2012 IPY IPY Report: May 2010 May 21, 2012 IPY IPY Report: April 2010 May 21 , 2012 IPY IPY Report: March 2010 May 21, 2012 IPY IPY Report: February 2010 May 21, 2012 IPY IPY Report : January 2010 May 21, 2012 IPY IPY Report: December 2009 May 21, 2012 IPY IPY Report: November 2009 May 21
Muon Accelerator Program (MAP) | Muon Collider | Research Goals
mysterious something else: dark matter and dark energy. We have learned that in fact we do not know what most what dark matter and dark energy are--and creating a revolution in our understanding of particle ? What are matter, energy, space and time? How did we get here and where are we going? Physicists have
Fermilab | Science | Questions for the Universe | The Particle World | What
is dark matter? How can we make it in the laboratory? Fermilab Search Toggle Fermilab Navbar Fermilab and the LHC Dark matter and dark energy ADMX Muons More fundamental particles and forces Theory there so many kinds of particles? What is dark matter? How can we make it in the laboratory? What are
Heterogeneous Catalysis for Thermochemical Conversion Publications |
pentagons is an upside-down Y shape and H2 +with a sideways Y shape with two lines at the base. A gold arrow a photo of woody biomass. In the center is a diamond shape composed of four outer triangle sections blue spheres. In the upper left is a large molecule shape made up of a hexagon of black spheres
Publications - PDF 95-33B | Alaska Division of Geological & Geophysical
D-1, C-1, and part of the B-1 quadrangles, east-central Alaska Authors: Clough, J.G., Mull, C.G , Interpretive bedrock geologic map of the Charley River D-1, C-1, and part of the B-1 quadrangles, east-central 1:63,360. http://doi.org/10.14509/1713 Publication Products Maps & Other Oversized Sheets Maps
Visiting Astronomer's Guide | SOAR
Water Drinking water is safe at all the AURA-O facilities (La Serena, Tololo and Pachón). Elsewhere in VPN in order to access the Night Reports. Transportation from La Serena to Pachón and back SOAR trip from the La Serena offices to Cerro Pachón is about 1h45m. Please note that the carryall passes
Publications - PDF 98-37A v. 1.1 | Alaska Division of Geological &
main content DGGS PDF 98-37A v. 1.1 Publication Details Title: Geologic map of the Tanana A-1 and A-2 ., 1998, Geologic map of the Tanana A-1 and A-2 quadrangles, central Alaska: Alaska Division of Geological & Other Oversized Sheets Maps & Other Oversized Sheets Sheet 1 Preliminary geologic map of the
Scanning Tunneling Microscopy | Materials Science | NREL
of Scanning Tunneling Microscopy Capabilities Two-dimensional STM image 2D STM image of Si(111) 7Ã7 clusters along a fault boundary Occupied-state STM image taken on a Si(111)7Ã7 surface, showing two 7Ã7 tip at each point, an image of the sample surface is generated (topographic image). For very flat
The RAPID Toolkit: Facilitating Utility-Scale Renewable Energy Development
energy and bulk transmission projects. The RAPID Toolkit, developed by the National Renewable Energy Renewable Energy Development The RAPID Toolkit: Facilitating Utility-Scale Renewable Energy Development information about federal, state, and local permitting and regulations for utility-scale renewable energy and
), 26th Marine Expeditionary Unit (MEU), practice non-lethal control techniques during a non-lethal Skip to main content (Press Enter). Toggle navigation Non-Lethal Weapons Program Search Search JNLWP: Search Search JNLWP: Search Non-Lethal Weapons Program U.S. Department of Defense Non-Lethal
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Organic Framework," J. Phys. Chem. Lett. 7, 3660 (2016). Arias, D.; Ryerson, J.; Cook, J.; Damrauer , N.; Johnson, J., "Polymorphism Influences Singlet Fission Rates in Tetracene Thin Films," ; Chem. Sci. 7, 1185 (2016). Schrauben, J.N.; Zhao Y.; Mercado, C.; Ryerson, J.; Dron, P.; Michl, J.; Zhu
DGIC Interconnection Insights | Distributed Generation Interconnection
appointed by the "Government/Customer" stakeholder group (one member) or the "DG Industry group. That is, the value of such a group (and the willpower to establish one) may be much less evident Distributed Resources Collaborative, California Smart Inverter Working Group, and Massachusetts Technical
status of ENSO go to the ENSO Advisory (issued when appropriate) or the latest monthly Climate Diagnostics Bulletin. More technical information on the global patterns of abnormal precipitation and , J. Climate, 5, 577-593). A general description of a warm (ENSO) episode and its composite evolution
Water Rights Information Enter Account Number (File Type and File Number). File Type: File Number: See mining claims bills! To make a payment by credit card or from your bank account, click here. Case, Land , and Water Information Search Records Display Case File Information Display Land Information Display
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Renewable Energy Economic Potential | Geospatial Data Science | NREL
Economic Potential Renewable Energy Economic Potential Economic potential, one measure of renewable electricity is less than the revenue available. Illustration that shows economic potential grow smaller at each level from Resource to Technical to Economic to Market. Estimating Renewable Energy Economic