RESUMO
BACKGROUND: Acute Respiratory Distress Syndrome (ARDS) due tocoronavirus disease (COVID-19) infection has a unique phenotype generating a growing need to determine the existing differences that can alter existing evidence-based management strategies for ARDS. RESEARCH QUESTION: What differences does the clinical profile of patients with ARDS due to COVID 19 and Non-COVID 19 have? STUDY DESIGN AND METHODS: We conducted a comparative, observational, retrospective study in the Intensive Care Unit (ICU)of a third-level hospital in Mexico City, from March 2020 through March 2022. Clinical, echocardiographic, and laboratory variables were compared between patients with ARDS due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and those due to other etiologies. RESULTS: We enrolled 140 patients with a diagnosis of ARDS. The study group of COVID-19 etiology were younger males, higher body mass index, progressed to organ dysfunction, required more frequently renal replacement therapy, and higher SOFA score. There was no difference in rates of right ventricular dysfunction. INTERPRETATION: COVID-19 ARDS exhibit much greater severity that led to higher admission and mortality rates, whilst being younger and less comorbid.
Assuntos
COVID-19 , Síndrome do Desconforto Respiratório , Humanos , Masculino , México , Síndrome do Desconforto Respiratório/terapia , Estudos Retrospectivos , SARS-CoV-2 , Atenção Terciária à Saúde , FemininoRESUMO
Continuous positive airway pressure is the gold standard treatment for obstructive sleep apnea. Different interfaces with distinct characteristics, advantages, and disadvantages are available, which may influence long-term adherence. Oronasal masks have been increasingly used. However, recent evidence suggest that nasal masks are more effective when continuous positive airway pressure is used to treat obstructive sleep apnea. The main objective of this review is to describe the basis for the selection of the interface for the treatment of obstructive sleep apnea with continuous positive airway pressure.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/terapia , Máscaras , Tomada de Decisão ClínicaRESUMO
The zero-temperature minimal energy structure of small free-standing Pd clusters (14≤N≤21, where N is the number of atoms in the cluster), their characteristics and their magnetic configurations are investigated. Results obtained using five different phenomenological many-body potentials (implemented in combination with a genetic algorithm search) are refined by means of various density functional theory (DFT) techniques. The agreement and differences between the results obtained with our procedure, using these five potentials, are displayed in detail. While phenomenological potentials yield values that approach the minimal energies of larger clusters, as compared with DFT results, they fail to predict the right symmetry group for some of the clusters with N>14. We find that the minimal energy configurations are not necessarily associated with high symmetry of the atomic arrangement. Actually, several cases of previously overlooked low symmetry structures turn out to have lower energies than more symmetric ones.