Pulmonary infections can be life threatening for children with neuromuscular diseases who have impaired ability to clear secretions. Intrapulmonary percussive ventilation (IPV) is a pneumatic device that delivers air ...Pulmonary infections can be life threatening for children with neuromuscular diseases who have impaired ability to clear secretions. Intrapulmonary percussive ventilation (IPV) is a pneumatic device that delivers air and aerosol to the lungs at frequencies of 200 to 300 cycles per minute at peak pressures from 20 to 40 cm H2O. Anecdotal reports and pilot studies show its safety and effectiveness in mobilizing secretions in patients with cystic fibrosis. Objective: To test the hypothesis that IPV used in a pulmonary program for adolescents with neuromuscular disease would reduce the number of days of antibiotic use for pulmonary infection. Methods: A randomized, controlled study was conducted to compare efficacy of IPV with incentive spirometry (IS) in reducing number of days of antibiotic use in adolescents with neuromuscular disease. The secondary endpoints were the number of respiratory infections, hospitalizations, and school days missed. Results: A total of 18 patients were enrolled (9 IPV, 9 IS). Antibiotic use was significantly higher with IS (24/1000 patient-days) compared with IPV(0/1000 patient-days), (incidence rate ratio, 43; 95% confidence interval, 6- 333). The IS group spent more days hospitalized (4.4/1000 patient-days vs 0/1000 patient- days) than the IPV group (incidence rate ratio, 8.5; 95% confidence interval, 1.1- 67). The IPV group had 0 episodes of pneumonia or bacterial bronchitis compared with 3 events in the IS group, although this did not meet statistical significance. Conclusion: Intrapulmonary percussive ventilation as part of a preventive pulmonary regimen reduced days of antibiotic use and hospitalization for respiratory illness in adolescents with neuromuscular disease.展开更多
目的探讨多元药物过敏急性胰腺炎患者行药物激发试验药学监护的策略,为多元药物过敏患者药学监护提供参考。方法临床药师参与1例多元药物过敏的急性胰腺炎患者的会诊,对患者的既往过敏病史(对左氧氟沙星、哌拉西林他唑巴坦、丙基硫氧嘧...目的探讨多元药物过敏急性胰腺炎患者行药物激发试验药学监护的策略,为多元药物过敏患者药学监护提供参考。方法临床药师参与1例多元药物过敏的急性胰腺炎患者的会诊,对患者的既往过敏病史(对左氧氟沙星、哌拉西林他唑巴坦、丙基硫氧嘧啶过敏,先锋霉素V皮肤过敏试验阳性)进行评估分析,建议行药物激发试验明确药物过敏诊断,并根据患者病情及药物激发试验结果提出用药建议。结果患者急性胰腺炎合并感染,进行β-内酰胺类抗生素规范化皮试及头孢哌酮舒巴坦的药物激发试验,结果为阴性,遂选用头孢哌酮舒巴坦(3 g q8h)进行抗感染治疗,期间无过敏反应发生。治疗期间临床药师对患者进行全程药学监护。结论药品过敏史评估与药物激发试验对于多元药物过敏患者抗菌药物选择策略十分重要,临床药师应结合临床实际与患者情况,协助医生制定治疗方案,对患者进行全程药学监护,保证其用药的安全性与有效性。展开更多
为研究不同岩性对爆破地震波能量分布特征影响,通过数值模拟,研究了岩石、微风化岩石、砂岩、塌积物等四种岩石介质以及改变岩石的密度、弹性模量、抗压强度等物理力学参数对爆破地震波能量分布特征影响,同时,与实验室模拟测试实验和现...为研究不同岩性对爆破地震波能量分布特征影响,通过数值模拟,研究了岩石、微风化岩石、砂岩、塌积物等四种岩石介质以及改变岩石的密度、弹性模量、抗压强度等物理力学参数对爆破地震波能量分布特征影响,同时,与实验室模拟测试实验和现场爆破测试实验进行了对比分析。研究表明:在炸药震源近区,地震波信号的频率高达几千到几万Hz,且岩石越坚硬,越致密,地震波的频率越高,能量越强;在炸药震源远区,地震波信号的频率仅为几十到几百Hz,且岩石越松软,密度越小,地震波能量越强。In order to study different lithologies’ effects on the energy distribution characteristics of blasting seismic waves, four rock media such as rock, slightly weathered rock, sandstone and colluvium are studied through numerical simulation, and the influence of changing rock density, elastic modulus, compressive strength and other physical and mechanical parameters on the energy distribution characteristics of blasting seismic waves is studied. At the same time, the findings were compared with laboratory simulation tests and field blasting experiments. The results show that in the near area of the explosive source, the frequency of seismic wave signals can reach several thousand to tens of thousands of Hz, and the harder and denser the rock, the higher the frequency and the stronger the energy of the seismic waves;On the far area, the frequency of seismic wave signals is only tens to hundreds of Hz, the softer and less dense the rock, the stronger the energy of the seismic waves.展开更多
文摘Pulmonary infections can be life threatening for children with neuromuscular diseases who have impaired ability to clear secretions. Intrapulmonary percussive ventilation (IPV) is a pneumatic device that delivers air and aerosol to the lungs at frequencies of 200 to 300 cycles per minute at peak pressures from 20 to 40 cm H2O. Anecdotal reports and pilot studies show its safety and effectiveness in mobilizing secretions in patients with cystic fibrosis. Objective: To test the hypothesis that IPV used in a pulmonary program for adolescents with neuromuscular disease would reduce the number of days of antibiotic use for pulmonary infection. Methods: A randomized, controlled study was conducted to compare efficacy of IPV with incentive spirometry (IS) in reducing number of days of antibiotic use in adolescents with neuromuscular disease. The secondary endpoints were the number of respiratory infections, hospitalizations, and school days missed. Results: A total of 18 patients were enrolled (9 IPV, 9 IS). Antibiotic use was significantly higher with IS (24/1000 patient-days) compared with IPV(0/1000 patient-days), (incidence rate ratio, 43; 95% confidence interval, 6- 333). The IS group spent more days hospitalized (4.4/1000 patient-days vs 0/1000 patient- days) than the IPV group (incidence rate ratio, 8.5; 95% confidence interval, 1.1- 67). The IPV group had 0 episodes of pneumonia or bacterial bronchitis compared with 3 events in the IS group, although this did not meet statistical significance. Conclusion: Intrapulmonary percussive ventilation as part of a preventive pulmonary regimen reduced days of antibiotic use and hospitalization for respiratory illness in adolescents with neuromuscular disease.
文摘目的探讨多元药物过敏急性胰腺炎患者行药物激发试验药学监护的策略,为多元药物过敏患者药学监护提供参考。方法临床药师参与1例多元药物过敏的急性胰腺炎患者的会诊,对患者的既往过敏病史(对左氧氟沙星、哌拉西林他唑巴坦、丙基硫氧嘧啶过敏,先锋霉素V皮肤过敏试验阳性)进行评估分析,建议行药物激发试验明确药物过敏诊断,并根据患者病情及药物激发试验结果提出用药建议。结果患者急性胰腺炎合并感染,进行β-内酰胺类抗生素规范化皮试及头孢哌酮舒巴坦的药物激发试验,结果为阴性,遂选用头孢哌酮舒巴坦(3 g q8h)进行抗感染治疗,期间无过敏反应发生。治疗期间临床药师对患者进行全程药学监护。结论药品过敏史评估与药物激发试验对于多元药物过敏患者抗菌药物选择策略十分重要,临床药师应结合临床实际与患者情况,协助医生制定治疗方案,对患者进行全程药学监护,保证其用药的安全性与有效性。
文摘为研究不同岩性对爆破地震波能量分布特征影响,通过数值模拟,研究了岩石、微风化岩石、砂岩、塌积物等四种岩石介质以及改变岩石的密度、弹性模量、抗压强度等物理力学参数对爆破地震波能量分布特征影响,同时,与实验室模拟测试实验和现场爆破测试实验进行了对比分析。研究表明:在炸药震源近区,地震波信号的频率高达几千到几万Hz,且岩石越坚硬,越致密,地震波的频率越高,能量越强;在炸药震源远区,地震波信号的频率仅为几十到几百Hz,且岩石越松软,密度越小,地震波能量越强。In order to study different lithologies’ effects on the energy distribution characteristics of blasting seismic waves, four rock media such as rock, slightly weathered rock, sandstone and colluvium are studied through numerical simulation, and the influence of changing rock density, elastic modulus, compressive strength and other physical and mechanical parameters on the energy distribution characteristics of blasting seismic waves is studied. At the same time, the findings were compared with laboratory simulation tests and field blasting experiments. The results show that in the near area of the explosive source, the frequency of seismic wave signals can reach several thousand to tens of thousands of Hz, and the harder and denser the rock, the higher the frequency and the stronger the energy of the seismic waves;On the far area, the frequency of seismic wave signals is only tens to hundreds of Hz, the softer and less dense the rock, the stronger the energy of the seismic waves.
