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Introduction. Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people. Objective. To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years. Materials and methods. We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults. Results. We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications’ mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%). Conclusions. About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.

Globally, thousands of metallurgical furnaces and process vessels are lined by several types of refractories. The harsh smelting conditions result in continuous refractory wear and deterioration which ultimately causes furnace to reline. For many vessels, the asset management workflow and refractory maintenance is predominantly proactive, and time based. Non-Destructive testing (NDT) methods can be utilized to change the traditional maintenance practices to a predictive and data-based decision-making function. In addition to reducing furnace refractory lining failures and molten metal leaks and run outs, this could potentially reduce the amount of highly toxically contaminated refractory waste disposal globally. In this paper, we review the NDT techniques that are utilized to determine refractory lining thicknesses and conditions in furnaces and process vessels.

Infrastructures which were constructed in the last century are approaching or have exceeded their design life. It is essential to maintain, repair and rehabilitate existing structures to ensure safety and develop a sensible rehabilitation plan. This paper suggests an inspection program for the condition evaluation of existing structures, particularly for structures that are approaching or exceeding their design/campaign lives. Cracking on concrete bridges is often induced by static and cyclic temperature loading. Throughout the service life of the structure, cracks will initiate, propagate, coalesce and form a greater damaged zone. Depending on the location and severity of the crack network; corrosion of reinforcement, debonding between concrete and reinforcement, and spalling of concrete may occur. The implementation of regular inspection or monitoring of structural condition is an essential component of asset management. Early detection of damaged zones can ease scheduling and reduce the cost of repair, which in turn also allows extension of structural lifespan without compromising safety. Similarly, for industrial properties, asset management and rehabilitation programs are paramount as they can significantly reduce capital expenditures in asset maintenance, if implemented prior to or at the early onset of structural degradation. This paper illustrates the use of NDT techniques for the condition assessment of a prestressed concrete bridge, as well as concrete storage silos. Both of which were either approaching or have exceeded their design campaign life and were needing a proper rehabilitation plan. The assessment included crack movement monitoring, crack depth determination, concrete strength estimation, and the detection of debonding between rebar and concrete.

Characterizing the urban form of cities from an aerodynamic point of view is essential to forecast pollutant dispersion, to implement and understand natural ventilation strategies or to enhance outdoor thermal comfort and pedestrian wind environment, to name a few. Nonetheless, accurate results make use, normally, of Computational Fluid Dynamic (CFD) simulations, wind tunnel experiments and/or field measurements. However, these methodologies are expensive, time consuming and sometimes impossible to carry out. Therefore, simplified ways of characterizing a city aerodynamically must be put forward to bridge this gap. Two of the most common aerodynamic parameters, namely z0 (roughness length) and zd (zero displacement length), can be related to the morphometry of the urban shape through simple morphometric indexes. This paper explores and analyses these indexes, and suggests an alternative and improved definition that might achieve more accurate results. Resumen Caracterizar la forma urbana de las ciudades desde un punto de vista aerodinámico es esencial para poder prever la dispersión de contaminantes, para implementar y comprender las estrategias de ventilación natural o para mejorar el control térmico en exteriores o el ambiente de viento peatonal, por citar sólo algunos casos. Para cualquiera de estos análisis, si se desea disponer de valores de cierta precisión es habitual emplear simulaciones mediante dinámica de fluidos computacional (CFD), experimentos en túnel de viento y/o tomas de datos de campo. Estos métodos, sin embargo, implican una inversión económica y temporal que en ocasiones no es posible realizar. El empleo de métodos simplificados para caracterizar la ciudad desde un punto de vista aerodinámico puede ayudar a hacer más sencillos estos procesos. Dos de los parámetros aerodinámicos más habituales, z0 (rugosidad superficial) y zd (longitud desplazamiento cero) pueden ponerse en relación con la morfometría de la forma urbana a través de índices morfométricos simples. Esta comunicación explora y analiza estos índices, y sugiere una definición alternativa y mejorada que puede posibilitar resultados más ajustados.

JUSTIFICATIVA E OBJETIVOS: O tubo laríngeo com sucção (LTS-II) é uma versão recente dos dispositivos supraglóticos reutilizáveis que permitem a drenagem gástrica. Neste estudo prospectivo e aleatório comparam-se inserção e ventilação de LTS-II descartável (LTS-D) com a reutilizável (LTS-II) para manuseio das vias aéreas em condições associadas com pressão abdominal elevada induzida por pneumoperitônio. MÉTODO: Sessenta pacientes, ASA I e II, submetidos à colecistectomia laparoscópica eletiva foram aleatoriamente separados para receber LTS-D (n = 30) ou LTS-II (n = 30) para manutenção das vias aéreas. Após a indução da anestesia geral, os dispositivos foram inseridos, seu correto posicionamento foi verificado e a pressão de vazamento de ar foi medida. Facilidade de inserção, qualidade do selo das vias aéreas, visualização fibrobroncoscópica, risco de insuflação gástrica, inserção do tubo nasogástrico e morbidade faríngea pós-operatória foram avaliados. RESULTADOS: Os índices de sucesso da primeira e segunda tentativas foram comparados nos dois grupos (86% versus 93% e 96% versus 96% nos grupos LTS-D e LTS-II, respectivamente). Um paciente de cada grupo não pode ser intubado após três tentativas Após a insuflação, a ventilação falhou em um paciente no grupo LTS-D e em dois pacientes no LTS-II e os pacientes precisaram ser intubados com cânula traqueal. O tempo até o primeiro volume corrente ser fornecido pelo LTS-D e LTS-II foi de 20,8 ± 11,6 e 18,2 ± 4,8 segundos, respectivamente (p = 0,27), e o tempo de fixação e manipulação foi de 73,3 ± 18,5 e 65,5 ± 16,2 segundos, respectivamente (p = 0,096). Sonda nasogástrica foi inserida em todos os pacientes. Não foram observadas diferenças significativas nas queixas pós-operatórias. CONCLUSÕES: Foi possível obter vias aéreas seguras com os dois dispositivos em condições de pressão intra-abdominal elevada.JUSTIFICATIVA Y OBJETIVOS: El tubo laríngeo con succión (LTSII) es una versión reciente de los dispositivos supraglóticos reutilizables que permiten el drenaje gástrico. En este estudio prospectivo y aleatorio, comparamos la inserción y la ventilación de LTS-II desechable (LTS-D) con la reutilizable (LTS-II) para la administración de las vías aéreas en condiciones asociadas con la presión abdominal elevada inducida por el neumoperitoneo. MÉTODO: Sesenta pacientes ASA I y II sometidos a la colecistectomía laparoscópica electiva fueron aleatoriamente divididos para recibir el LTS-D (n = 30) o LTS-II (n = 30) para la administración de las vías aéreas. Después de la inducción de la anestesia general, los dispositivos se insertaron, y se verificó su correcta posición junto con la presión de salida de aire que también se midió. La facilidad de inserción, la calidad del sellado de las vías aéreas, la visualización fibrobroncoscópica, el riesgo de insuflación gástrica, la inserción del tubo nasogástrico y la morbilidad faríngea postoperatoria fueron evaluadas. RESULTADOS: Los índices de éxito del primer y segundo intento se compararon en los de los grupos (86% vs. 93% y 96% vs. 96% en los grupos LTS-D y LTS-II, respectivamente); un paciente en cada grupo no pudo ser intubado después de haberlo intentado tres veces. Después de la insuflación, la ventilación de uno y de dos de los pacientes en los grupos LTS-D y LTS-II, respectivamente, falló y los pacientes necesitaron ser intubados con un tubo endotraqueal. El tiempo hasta que se suministró el primer volumen corriente a través del LTS-D y LTSII fue de 20,8 ± 11,6 y 18,2 ± 4,8 segundos, respectivamente (p = 0,27), el tiempo de fijación y manipulación fue de 73,3 ± 18,5 y 65,5 ± 16,2 segundos, respectivamente (p = 0,096). El tubo nasogástrico fue insertado en todos los pacientes. No se observaron diferencias significativas en los quejidos del postoperatorio. CONCLUSIONES: Se pudieron obtener vías aéreas seguras en condiciones con presión intraabdominal elevada con los dos dispositivos.BACKGROUND AND OBJECTIVE: The laryngeal tube suction II (LTS-II) is a recent version of reusable supraglottic airway devices allowing gastric drainage. In this prospective, randomized study we compared insertion and ventilation of disposable LTS-II (LTS-D) with reusable type (LTS-II) for airway management under conditions with elevated intra abdominal pressure induced by capnoperitoneum. METHODS: 60 ASA I and II patients undergoing elective laparoscopic cholecystectomy were randomized to receive either a LTS-D (n=30) or LTS-II (n=30) for airway management. After induction of general anaesthesia the devices were inserted, their correct placement was verified and airway leak pressure was measured. Ease of insertion, quality of airway seal, fiberoptic view, risk of gastric insufflation, insertion of nasogastric tube and postoperative pharyngeal morbidity were examined. RESULTS: First time and second time success rates were comparable for both groups (86% vs. 93% and 96% vs. 96% in LTS-D and LTS-II groups, respectively). One patient in each group could not be intubated after three attempts. After gas insufflation, ventilation of one patient in LTS-D and 2 patients in LTS-II groups was faulty and the patients were intubated with endotracheal tube. Time until delivery of first tidal volume for LTS-D and LTS-II was 20.8 ± 11.6 s, and 18.2 ± 4.8 seconds respectively (p = 0.27), fixation and manipulation time was 73.3 ± 18.5 and 65.5 ± 16.2 seconds, respectively (p = 0.096). Nasogastric tube insertion was successful in all patients. There were no significant differences in postoperative complaints. CONCLUSIONS: Both devices provide a secure airway under conditions of elevated intra abdominal pressure.

Introduction: Medications are a fundamental part of the treatment of multiple pathologies. However, despite their benefits, some are considered potentially inappropriate medications for older people given their safety profile. Epidemiological data differences related to potentially inappropriate medications make it difficult to determine their effects on elderly people., Objective: To estimate the prevalence and types of potentially inappropriate medications using the 2019 Beers Criteria® in a cohort of adults older than 65 years., Materials and Methods: We performed an observational, multicenter, retrospective, longitudinal study of a four-year follow-up of potentially inappropriate medications in community-dwelling older adults., Results: We followed 820 participants from five cities for four years (2012-2016) and evaluated them in three different moments (m1 = 2012, m2 = 2014, and m3 = 2016). The average age was 69.07 years, and 50.9% were women. The potentially inappropriate medication prevalence in the participants was 40.24%. The potentially inappropriate medications' mean among the studied subjects in the first moment was 1.65 (SD = 0.963), in the second was 1.73 (SD = 1.032), and in the third was 1.62 (SD = 0.915). There were no statistical differences between measurements (Friedman test, value = 0.204). The most frequent potentially inappropriate medications categories were gastrointestinal (39.4%), analgesics (18.8%), delirium-related drugs (15.4%), benzodiazepines (15.2%), and cardiovascular (14.2%)., Conclusions: About half of the population of the community-dwelling older adults had prescriptions of potentially inappropriate medications in a sustained manner and without significant variability over time. Mainly potentially inappropriate medications were gastrointestinal and cardiovascular drugs, analgesics, delirium-related drugs, and benzodiazepines.