Perioperative fluid therapy: a statement from the international fluid optimization group

Perioperative fluid therapy remains a highly debated topic. Its purpose is to maintain or restore effective circulating blood volume during the immediate perioperative period. Maintaining effective circulating blood volume and pressure are key components of assuring adequate organ perfusion while avoiding the risks associated with either organ hypo- or hyperperfusion. Relative to perioperative fluid therapy, three inescapable conclusions exist: overhydration is bad, underhydration is bad, and what we assume about the fluid status of our patients may be incorrect. There is wide variability of practice, both between individuals and institutions. The aims of this paper are to clearly define the risks and benefits of fluid choices within the perioperative space, to describe current evidence-based methodologies for their administration, and ultimately to reduce the variability with which perioperative fluids are administered. Based on the abovementioned acknowledgements, a group of 72 researchers, well known within the field of fluid resuscitation, were invited, via email, to attend a meeting that was held in Chicago in 2011 to discuss perioperative fluid therapy. From the 72 invitees, 14 researchers representing 7 countries attended, and thus, the international Fluid Optimization Group (FOG) came into existence. These researches, working collaboratively, have reviewed the data from 162 different fluid resuscitation papers including both operative and intensive care unit populations. This manuscript is the result of 3 years of evidence-based, discussions, analysis, and synthesis of the currently known risks and benefits of individual fluids and the best methods for administering them. The results of this review paper provide an overview of the components of an effective perioperative fluid administration plan and address both the physiologic principles and outcomes of fluid administration. We recommend that both perioperative fluid choice and therapy be individualized. Patients should receive fluid therapy guided by predefined physiologic targets. Specifically, fluids should be administered when patients require augmentation of their perfusion and are also volume responsive. This paper provides a general approach to fluid therapy and practical recommendations.

Dysglycemias in pregnancy: from diagnosis to treatment. Brazilian consensus statement

There is an urgent need to find consensus on screening, diagnosing and treating all degrees of DYSGLYCEMIA that may occur during pregnancies in Brazil, considering that many cases of DYSGLYCEMIA in pregnant women are currently not diagnosed, leading to maternal and fetal complications. For this reason the Brazilian Diabetes Society (SBD) and the Brazilian Federation of Gynecology and Obstetrics Societies (FEBRASGO), got together to introduce this proposal. We present here a joint consensus regarding the standardization of clinical management for pregnant women with any degree of Dysglycemia, on the basis of current information, to improve medical assistance and to avoid related complications of Dysglycemia in pregnancy to the mother and the fetus. This consensus aims to standardize the diagnosis among general practitioners, endocrinologists and obstetricians allowing the dissemination of information in basic health units, public and private services, that are responsible for screening, diagnosing and treating disglycemic pregnant patients.

Cytotoxicity of denture base and hard chairside reline materials: a systematic review

Statement of problem. Adverse reactions to the materials used for the fabrication and reline of removable denture bases have been observed.Purpose. The purpose of this study was to systematically review the published literature on the cytotoxicity of denture base and hard reline materials.Material and methods. MEDLINE via PubMed, Google Scholar, and Scopus databases for the period January 1979 to December 2009 were searched with the following key words: (biocompatibility OR cytotoxic* OR allergy OR burning mouth OR cell culture techniques) and (acrylic resins OR denture OR monomer OR relin* OR denture liners). The inclusion criteria included in vitro studies using either animal or human cells, in which the cytotoxicity of the denture base and hard chairside reline resins was tested. Studies of resilient lining materials and those that evaluated other parameters such as genotoxicity and mutagenicity were excluded. Articles published in the English language and in peer-reviewed journals focusing on the cytotoxicity of these materials were reviewed.Results. A total of 1443 articles were identified through the search. From these, 20 studies were judged to meet the selection criteria and were included in the review. In the majority of the studies, continuous cell lines were exposed to eluates of specimens made from the materials, and mitochondrial activity was used to estimate cell viability. The tested acrylic resins were grouped according to 5 major categories: (1) heat-polymerized; (2) microwave-polymerized; (3) autopolymerizing; (4) light-polymerized; and (5) hard chairside reliners.Conclusions. This review provided some evidence that the heat-polymerized resins showed lower cytotoxic effects than autopolymerizing denture base acrylic resins and light or dual polymerized reline resins. However, because of the large number of variables in the reviewed literature, a definitive conclusion could not be drawn. (J Prosthet Dent 2012;107:114-127)

The equivalence principle revisited

A precise fomulation of the strong Equivalence Principle is essential to the understanding of the relationship between gravitation and quantum mechanics. The relevant aspects are reviewed in a context including General Relativity but allowing for the presence of torsion. For the sake of brevity, a concise statement is proposed for the Principle: An ideal observer immersed in a gravitational field can choose a reference frame in which gravitation goes unnoticed. This statement is given a clear mathematical meaning through an accurate discussion of its terms. It holds for ideal observers (time-like smooth non-intersecting curves), but not for real, spatially extended observers. Analogous results hold for gauge fields. The difference between gravitation and the other fundamental interactions comes from their distinct roles in the equation of force.

Recommended Guidelines for the Conduct and Evaluation of Prognostic Studies in Veterinary Oncology

There is an increasing need for more accurate prognostic and predictive markers in veterinary oncology because of an increasing number of treatment options, the increased financial costs associated with treatment, and the emotional stress experienced by owners in association with the disease and its treatment. Numerous studies have evaluated potential prognostic and predictive markers for veterinary neoplastic diseases, but there are no established guidelines or standards for the conduct and reporting of prognostic studies in veterinary medicine. This lack of standardization has made the evaluation and comparison of studies difficult. Most important, translating these results to clinical applications is problematic. To address this issue, the American College of Veterinary Pathologists' Oncology Committee organized an initiative to establish guidelines for the conduct and reporting of prognostic studies in veterinary oncology. The goal of this initiative is to increase the quality and standardization of veterinary prognostic studies to facilitate independent evaluation, validation, comparison, and implementation of study results. This article represents a consensus statement on the conduct and reporting of prognostic studies in veterinary oncology from veterinary pathologists and oncologists from around the world. These guidelines should be considered a recommendation based on the current state of knowledge in the field, and they will need to be continually reevaluated and revised as the field of veterinary oncology continues to progress. As mentioned, these guidelines were developed through an initiative of the American College of Veterinary Pathologists' Oncology Committee, and they have been reviewed and endorsed by the World Small Animal Veterinary Association.

An interplanetary mission to Neptune system: Gravitational capture and maneuvers around triton

The gravitational capture was initially used to understand the capture of planetary satellites. However, in the 90's decade, this phenomenon was applied in spacecraft trajectories. Belbruno and Miller studied missions in the Earth-Moon system that uses this technique to save fuel during the insertion of the spacecraft in its final orbit around the Moon. Using a parameter defined as twice the two-body energy of the planet-particle system, Yamakawa also studied the gravitational capture in the Earth-Moon system. In the present paper, this technique is used to study a mission that goes to the Neptune system and perform a gravitational capture in the satellite Triton. The results show direct and retrograde trajectories, for different values of the initial conditions.

ASTER: A Brazilian mission to an asteroid

The first Brazilian mission to an asteroid is being planned. The target is the asteroid 2001 SN263, which has a NEA orbit of class AMOR. Spectral analysis indicated that this is a C-type asteroid. This type of asteroids are dark and difficult to be studied from Earth. They hold clues of the initial stages of planetary formation and also the origin of water and life on Earth. In fact, radar data showed that 2001 SN263 is composed of three bodies with diameters of about 2.8 km, 1.1 km and 0.4 km. Therefore, the spacecraft will have the opportunity to explore three bodies on the same trip. The mission is scheduled to be launched in 2015, reaching the asteroid in 2018. It will be used a small spacecraft (150 kg) with 30 kg for the payload. The set of scientific instruments being considered to explore the target of this mission include an Imaging Camera, a Laser Rangefinder, an Infrared Spectrometer, a Synthetic Aperture Radar and a Mass Spectrometer. The main measurements to be made include the bulk properties (size, shape, mass, density, dynamics, spin state), the internal properties (structure, gravity field) and surface properties (mineralogy, morphology, elemental composition). The mission also opens an opportunity for some relevant experiments, not directly related to the target. Two such experiments will take benefit from being on board of the spacecraft along the journey to the asteroid system, which will take about three years. The first is an astrobiology experiment. The main goal of this experiment is to determine the viability of the microorganisms survival in extraterrestrial environments simulated in laboratory (chemical atmosphere, temperature, desiccation, vacuum, microgravity and radiation). The second experiment is a plasma package. The main objectives of this experiment are to study the structure and electrodynamics of plasma along the trajectory, the plasma instability processes and the density and temperature of plasma of solar wind origin along the trajectory and near the asteroids. This mission represents a great challenge for the Brazilian space program. It is being structured to allow the full engagement of the Brazilian universities and technological companies in all the necessary developments to be carried out. In this paper, we present some aspects of this mission and details of the payload that will be used and the scientific expectations. Copyright ©2010 by the International Astronautical Federation. All rights reserved.

The aster mission: Exploring for the first time a triple system asteroid

2001 SN263 is a triple system asteroid. Although it was discovery in 2001, in 2008 astronomical observation carried out by Arecibo observatory revealed that it is actually a system with three bodies orbiting each other. The main central body is an irregular object with a diameter about 2.8 km, while the other two are small objects with less than 1 km across. This system presents an orbital eccentricity of 0.47, with perihelion of 1.04 and aphelion of 1.99, which means that it can be considered as a Near Earth Object. This interesting system was chosen as the target for the Aster mission - first Brazilian space exploration undertaking. A small spacecraft with 150 kg of total mass, 30 kg of payload with 110 W available for the instruments, is scheduled to be launched in 2015, and in 2018 it will approach and will be put in orbit of the triple system. This spacecraft will use electric propulsion and in its payload it will carry image camera, laser rangefinder, infrared spectrometer, mass spectrometer, and experiments to be performed in its way to the asteroid. This mission represents a great challenge for the Brazilian space program. It is being structured to allow the full engagement of the Brazilian universities and technological companies in all the necessary developments to be carried out. In this paper, we present some aspects of this mission, including the transfer trajectories to be used, and details of buss and payload subsystems that are being developed and will be used. Copyright ©2010 by the International Astronautical Federation. All rights reserved.

Influenza among the elderly in the Americas: A consensus statement

Influenza exacts a heavy burden on the elderly, a segment of the population that is estimated to experience rapid growth in the near future. In the past decade most developed and several developing countries have recommended influenza vaccination for those > 65 years of age. The World Health Organization (WHO) set a goal of 75% influenza vaccination coverage among the elderly by 2010, but it was not achieved. In 2011, the Technical Advisory Group at the Pan American Health Organization, Regional Office of WHO for the Americas, reiterated the influenza vaccine recommendation for older adults. Relatively little information has been compiled on the immunological aspect of aging or on reducing its impact, information particularly relevant for clinicians and gerontologist with firsthand experience confronting its effects. To fill this data gap, in 2012 the Americas Health Foundation (Washington, D.C., United States) and the nonprofit, Fighting Infectious Diseases in Emerging Countries (Miami, Florida, United States), convened a panel of Latin American clinicians and gerontologists with expertise in influenza to discuss key issues and develop a consensus statement. The major recommendations were to improve influenza surveillance throughout Latin America so that its impact can be quantified; and to conduct laboratory confirmation of influenza for all patients who have flu-like symptoms and are frail, immunosuppressed, have comorbidities, are respiratory compromised, or have been admitted to a hospital. The panel also noted that: since evidence for antivirals in the elderly is unclear, their use should be handled on a case-by-case basis; despite decreased immunological response, influenza vaccination in older adults is still crucial; indirect immunization strategies should be encouraged; and traditional infection control measures are essential in long-term care facilities.

Evaluation of the Tropical Rainfall Measuring Mission 3B43 product over an inland area in Brazil and the effects of satellite boost on rainfall estimates

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The triple near-Earth asteroid (153591) 2001 SN263: an ultra-blue, primitive target for the Aster space mission

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

The effect of offset implant configuration on bone stress distribution: a systematic review

Purpose: The aim of this systematic review was to compare straight-line and offset implant configurations for three-element implant-retained prostheses. Materials and Methods: Two independent reviewers conducted a review on PubMed/Medline, EMBASE, and Cochrane Library for studies published in English, from January 1, 1995 to January 17, 2014. A systematic review was conducted following the PRISMA statement. All relevant titles were selected according to inclusion/exclusion criteria. From this pool of titles, abstracts and full texts were reviewed. Results: A total of 6080 titles were identified with the initial search. Twenty-one were selected based on title and abstract. Of these, after discussion and complete reading, 12 studies were selected according to the inclusion and exclusion criteria, all of which were in vitro studies. Conclusions: A systematic review of the current literature showed only in vitro evidence that there is no consensus on the advantage of using an offset configuration implant compared to those in straight-line configuration, even though some studies present a slight improvement of bone stress distribution when an offset implant is under oblique loading (PICO).