Vanessa Santos

Application of Fractional Controllers for Quad Rotor

This paper studies the application of fractional algorithms in the control of a quad-rotor rotorcraft. The development of a flight simulator provide the evaluation of the controller algorithm. Several basic maneuvers are investigated, namely the elevation and the position control.

Nontuberculous mycobacteria in respiratory specimens: clinical significance at a tertiary care hospital in the north of Portugal

1. Intern in the Department of Pulmonology, Sao Joao Hospital Center, EPE, Porto, Portugal. 2. Attending Physician. Department of Pulmonology, Sao Joao Hospital Center, EPE, Porto, Portugal. 3. Attending Physician. Department of Clinical Pathology, Sao Joao Hospital Center, EPE, Porto, Portugal. Nontuberculous mycobacteria (NTM) are ubiquitous in the human environment, and more than 150 NTM species have been described to date.(1) When inhaled by susceptible individuals, such as those with chronic lung disease, NTM can lead to chronic, progressive, and sometimes fatal respiratory symptoms. Over the last three decades, the incidence of NTM laboratory isolation and related lung disease has been increasing, surpassing that of tuberculosis in some areas.(1,2) However, the isolation of NTM from respiratory specimens might be due to contamination of specimens or colonization of patients that is transient, not necessarily indicating disease.(1) Here, we report the incidence of NTM isolation in the Pulmonology Department of the Sao Joao Hospital Center, a tertiary care university hospital located in Porto, the second most populous city in Portugal. It is the largest hospital in the northern region and one of the three largest in the country. We retrospectively analyzed patients who were seronegative for HIV and for whom NTM had been isolated in at least one respiratory specimen between January of 2008 and December of 2012. The samples were decontaminated with the N-acetyl-L-cysteine-sodium hydroxide method and inoculated into Middlebrook 7H9 broth medium (BBL Mycobacteria Growth Indicator Tube [MGIT]; Becton Dickinson, Franklin Lakes, NJ, USA), in accordance with the manufacturer instructions. Positive cultures, incubated and monitored in an automated culture system (BACTEC MGIT 960; Becton Dickinson), were examined by smear microscopy with Kinyoun staining for AFB. In the presence of AFB, we used a molecular assay for common mycobacteria and additional species (GenoType Mycobacterium CM/ AS; Hain Lifescience GmbH, Nehren, Germany), in accordance with the manufacturer instructions, to determine the species of the isolates. Demographic, clinical, radiological, and microbiological data were collected. The clinical relevance of the isolation in the respiratory sample was defined in accordance with the current American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) criteria.(3) Two hundred and two patients were included in this study. Of those, 118 (58%) were male. The mean age was 64 years (range, 23-89 years). The main risk factors identified were the underlying structural lung disease, such as COPD, in 73 patients (36%), bronchiectasis, in 62 (31%), and tuberculosis sequelae, in 40 (20%); and nonpulmonary conditions, such as diabetes mellitus, in 18 patients (9%), gastroesophageal reflux disease, in 16 (8%), and receiving immunosuppression therapy, in 12 (6%). Data on environmental exposure were not available. A total of 407 isolates were obtained, and the species were identified in 378 (93%). Of the 407 isolates, 237 (58%) were identified as being within the Mycobacterium avium complex (MAC) group and 141 (35%) were identified as belonging to one of 11 other Mycobacterium species, the remaining 29 (7%) being identified as mycobacteria but not down to the species level (Table 1). These isolates were obtained from sputum samples in 192 (95%) of the patients, bronchial lavage fluid samples in 13 (6%), BAL fluid samples in 7 (4%), a lung biopsy sample in 1 (0.5%), and a gastric aspirate sample in 1

Influence of critical hyperinflation in exercise capacity improvement after pulmonary rehabilitation in severely obstructed patients

Introduction: Hyperinflation is known to limit the increase in ventilation associated with exercise, and overinflated patients often have to adapt exercise training during pulmonary rehabilitation (PR). Objectives: To study the influence of critical hyperinflation (CH, defined as RV% ≥ 230% predicted value) in the improvement of exercise capacity in severely obstructed patients with chronic respiratory diseases after PR. Methods: Retrospective evaluation of records regarding demographic data, lung function tests as well as 6MWT results before and after PR. Results: 62 patients were included, mean age 61.6 yrs., 47 were male. 38 had COPD, 13 bronchiectasis, 4 asthma, 2 ACOS, 2 cystic fibrosis and3 other chronic lung diseases. PR mean duration was 11.8 wks., with upper and lower limbs strength and endurance training. At start, mean values for all patients were: 6MWD - 369.1m, FEV 1 % - 33.7%, RV% - 231.7%. 6MWD in patients with CH at the start was 361.8m and 376.0m in the others. At the end of PR, 6MWDs were respectively 376.7m and 391.9m, with no statistically significant difference between the groups ( p =0.963, independent-samples T test). Considering only COPD patients and those without exacerbation during PR, CH did not influence the results in exercise capacity after PR as well ( p values respectively 0.658 and 0.621), as did not the definition of lower cut offs of RV% for CH. Conclusion: In this group of severely obstructed patients with chronic lung diseases, the presence of critical hyperinflation did not influence exercise capacity change after PR.

Is exercise tolerance different in COPD and bronchiectasis patients who are severely obstructed

Introduction: COPD and bronchiectasis (BQ) are both characterized by airflow obstruction, but the physiopathology is different, so the systemic impact of the diseases, namely in exercise capacity, may be different. Aims: To compare exercise tolerance in severely obstructed patients with COPD and BQ. Methods: Patients with COPD and non-CF BQ with FEV1 Results: 71 patients were studied. The median age was 63 years, which 57 were male, 57 had smoking history, median BMI was 22.7 Kg/m2 and most (73.2%) had at least one comorbidity. Median FEV1%, FVC% and 6MWD were 33.5%, 69.0% and 375.0 m (IQR: 300-375m), respectively. Forty nine patients had COPD, with median age 64 years and median BMI 21.5 Kg/m2. The median values for FEV1%, CVF% and 6MWD were 32.8%, 71.9% and 370.0m, respectively. Twenty two patients had BQ, which median values were the following: age 55.5 years, BMI 26.0 Kg/m2, FEV1% 36.6%, FVC% 64.1% and 6MWD 425.0m. Statistically significant differences were found between groups regarding age ( p =0.007), BMI ( p =0.021), FEV1% ( p =0.013) and FVC% ( p =0.018). 6MWD difference did not achieve statistical significance ( p =0.059). Discussion: Despite all being severely obstructed, patients with COPD and BQ referred for PR still showed significant differences in age, nutrition status and lung function. Differences regarding exercise tolerance did not achieve statistical significance but may be clinically important and imply adaptations in PR program.