Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review

Abstract OBJECTIVE Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults. METHOD The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12). Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22;p=0.82); Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03); in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82;p=0.90) and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19) also showed no difference. CONCLUSION Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.

Nitrate and ammonium in soil solution in tobacco management systems

Tobacco farmers of southern Brazil use high levels of fertilizers, without considering soil and environmental attributes, posing great risk to water resources degradation. The objective of this study was to monitor nitrate and ammonium concentrations in the soil solution of an Entisol in and below the root zone of tobacco under conventional tillage (CT), minimum tillage (MT) and no-tillage (NT). The study was conducted in the small-watershed Arroio Lino, in Agudo, State of Rio Grande do Sul, Brazil. A base fertilization of 850 kg ha-1 of 10-18-24 and topdressing of 400 kg ha-1 of 14-0-14 NPK fertilizer were applied. The soil solution was sampled during the crop cycle with a tension lysimeter equipped with a porous ceramic cup. Ammonium and nitrate concentrations were analyzed by the distillation and titration method. Nitrate concentrations, ranging from 8 to 226 mg L-1, were highest after initial fertilization and decreased during the crop cycle. The average nitrate (N-NO3-) concentration in the root zone was 75 in NT, 95 in MT, and 49 mg L-1 in CT. Below the root zone, the average nitrate concentration was 58 under NT, 108 under MT and 36 mg L-1 under CT. The nitrate and ammonium concentrations did not differ significantly in the management systems. However, the nitrate concentrations measured represent a contamination risk to groundwater of the watershed. The ammonium concentration (N-NH4+) decreased over time in all management systems, possibly as a result of the nitrification process and root uptake of part of the ammonium by the growing plants.

A Rotating black ring solution in five dimensions

The vacuum Einstein equations in five dimensions are shown to admit a solution describing a stationary asymptotically flat spacetime regular on and outside an event horizon of topology S1S2. It describes a rotating black ring. This is the first example of a stationary asymptotically flat vacuum solution with an event horizon of nonspherical topology. The existence of this solution implies that the uniqueness theorems valid in four dimensions do not have simple five-dimensional generalizations. It is suggested that increasing the spin of a spherical black hole beyond a critical value results in a transition to a black ring, which can have an arbitrarily large angular momentum for a given mass.

Towards and ab initio description of magnetism in ionic solids

The physical contributions to the KNiF3 magnetic exchange coupling integral have been obtained from specially designed ab initio cluster model calculations. Three important mechanisms have been identified. These are the delocalization of the magnetic orbitals into the anion p band, the variational contribution of the second-order interactions, and the many-body terms hidden in the two-body operator and the Heisenberg Hamiltonian.

Velocity cross-correlations and atomic momentum transfer in simple liquids with different potential cores

Time correlation functions between the velocity of a tagged particle and velocities of particles within specified ranges of initial separations have been obtained by molecular dynamics simulation. These correlation functions have allowed us to analyze the momentum transfer between particles in different coordination shells. Two simple liquids at very different densities and two purely repulsive potentials with very different softnesses have been considered. The longitudinal correlations, which are the velocity cross-correlations along the initial direction defined by the centers of two given particles, have been calculated separately. It has been proven that these correlations should be attributed to particles both in front of and behind the central one. As with propagating longitudinal modes, they are strongly dependent on the softness of the potential core. Some characteristic features of the velocity correlation functions after the initial rise should be related to nonlongitudinal correlations. It has been shown that velocity cross-correlations between distinct particles cannot only be attributed to the direct interactions among particles, but also to the motions induced by the movement of a tagged particle on their neighbors.

Towards and ab initio description of magnetism in ionic solids

The physical contributions to the KNiF3 magnetic exchange coupling integral have been obtained from specially designed ab initio cluster model calculations. Three important mechanisms have been identified. These are the delocalization of the magnetic orbitals into the anion p band, the variational contribution of the second-order interactions, and the many-body terms hidden in the two-body operator and the Heisenberg Hamiltonian.

Local character of magnetic coupling in ionic solids

Magnetic interactions in ionic solids are studied using parameter-free methods designed to provide accurate energy differences associated with quantum states defining the Heisenberg constant J. For a series of ionic solids including KNiF3, K2NiF4, KCuF3, K2CuF4, and high- Tc parent compound La2CuO4, the J experimental value is quantitatively reproduced. This result has fundamental implications because J values have been calculated from a finite cluster model whereas experiments refer to infinite solids. The present study permits us to firmly establish that in these wide-gap insulators, J is determined from strongly local electronic interactions involving two magnetic centers only thus providing an ab initio support to commonly used model Hamiltonians.

Neutral atoms in ionic lattices: Excited states of KCl:Ag(0)

The optical-absorption spectrum of a cationic Ag0 atom in a KCl crystal has been studied theoretically by means of a series of cluster models of increasing size. Excitation energies have been determined by means of a multiconfigurational self-consistent field procedure followed by a second-order perturbation correlation treatment. Moreover results obtained within the density-functional framework are also reported. The calculations confirm the assignment of bands I and IV to transitions of the Ag-5s electron into delocalized states with mainly K-4s,4p character. Bands II and III have been assigned to internal transitions on the Ag atom, which correspond to the atomic Ag-4d to Ag-5s transition. We also determine the lowest charge transfer (CT) excitation energy and confirm the assignment of band VI to such a transition. The study of the variation of the CT excitation energy with the Ag-Cl distance R gives additional support to a large displacement of the Cl ions due to the presence of the Ag0 impurity. Moreover, from the present results, it is predicted that on passing to NaCl:Ag0 the CT onset would be out of the optical range while the 5s-5p transition would undergo a redshift of 0.3 eV. These conclusions, which underline the different character of involved orbitals, are consistent with experimental findings. The existence of a CT transition in the optical range for an atom inside an ionic host is explained by a simple model, which also accounts for the differences with the more common 3d systems. The present study sheds also some light on the R dependence of the s2-sp transitions due to s2 ions like Tl+.

Rigorous characterization of oxygen vacancies in ionic oxides

Charged and neutral oxygen vacancies in the bulk and on perfect and defective surfaces of MgO are characterized as quantum-mechanical subsystems chemically bonded to the host lattice and containing most of the charge left by the removed oxygens. Attractors of the electron density appear inside the vacancy, a necessary condition for the existence of a subsystem according to the atoms in molecules theory. The analysis of the electron localization function also shows attractors at the vacancy sites, which are associated to a localization basin shared with the valence domain of the nearest oxygens. This polyatomic superanion exhibits chemical trends guided by the formal charge and the coordination of the vacancy. The topological approach is shown to be essential to understand and predict the nature and chemical reactivity of these objects. There is not a vacancy but a coreless pseudoanion that behaves as an activated host oxygen.

Monitoring the clinical introduction of a glutamine and antioxidant solution in critically ill trauma and burn patients

OBJECTIVE: Enteral glutamine supplementation and antioxidants have been shown to be beneficial in some categories of critically ill patients. This study investigated the impact on organ function and clinical outcome of an enteral solution enriched with glutamine and antioxidant micronutrients in patients with trauma and with burns. METHODS: This was a prospective study of a historical control group including critically ill, burned and major trauma patients (n = 86, 40 patients with burns and 46 with trauma, 43 in each group) on admission to an intensive care unit in a university hospital (matching for severity, age, and sex). The intervention aimed to deliver a 500-mL enteral solution containing 30 g of glutamine per day, selenium, zinc, and vitamin E (Gln-AOX) for a maximum of 10 d, in addition to control treatment consisting of enteral nutrition in all patients and intravenous trace elements in all burn patients. RESULTS: Patients were comparable at baseline, except for more inhalation injuries in the burn-Gln-AOX group (P = 0.10) and greater neurologic impairment in the trauma-Gln-AOX group (P = 0.022). Intestinal tolerance was good. The full 500-mL dose was rarely delivered, resulting in a low mean glutamine daily dose (22 g for burn patients and 16 g for trauma patients). In burn patients intravenous trace element delivery was superior to the enteral dose. The evolution of the Sequential Organ Failure Assessment score and other outcome variables did not differ significantly between groups. C-reactive protein decreased faster in the Gln-AOX group. CONCLUSION: The Gln-AOX supplement was well tolerated in critically ill, injured patients, but did not improve outcome significantly. The delivery of glutamine below the 0.5-g/kg recommended dose in association with high intravenous trace element substitution doses in burn patients are likely to have blunted the impact by not reaching an efficient treatment dose. Further trials testing higher doses of Gln are required.

Towards optimal fractionation of lignocellulosic biomass using switchable ionic liquids

En ny familj av reversibla (switchable) joniska vätskor (SIL) innehållande 1,8-diazobicyklo-[5.4.0]-undek-7-en (DBU), en molekyl innehållande en eller flera hydroxyl- grupper (t.ex. glycerol) och en sur gas (CO2, SO2) syntetiserades via en enkel procedur samt karakteriserades. [DBU][karbonat] eller [sulfonat] bildades ur en respektive icke-jonisk blandning av en molekylär, organisk polyol (eller ennan molekyl innehållande en OH-grupp) och en amidinbas under bubblandet av en sur gas. Därtill kunde den joniska vätskan omvandlas tillbaka till sina beståndsdelar med hjälp av att upphetta och/eller bubbla en inert gas såsom kväve genom vätskan. SIL- strukturerna kartlades med bl.a. NMR- och FTIR- spektroskopi. Omvandlingen från lågpolära (molekylära) vätskor till högpolära joniska vätskor (SIL) bekräftades även genom att observera förändringar i deras fysikaliska egenskaper, såsom viskositet och färg. Nedbrytningstemperaturerna hos SILs bestämdes med hjälp av termogravimetrisk analys (TGA) som antydde att nedbrytningstemperaturen hos de syntetiserade föreningarna log mellan 50 och 200oC. De nya joniska vätskorna uppvisade högre nedbrytningstemperaturer jämfört med i litteraturen tidigare förekommande exempel och kunde därför tillämpas på flera ändamål. Därtill, reversibla (switchable) joniska vätskor uppbyggda av bl.a. alkoholer, antingen hexanol eller butanol, och CO2 samt en amidin (DBU) användes vid upplösning och fraktionering av ved. Joniska vätskor syntetiserade ur glycerol och sura gaser tillsammans med amidiner användes även för fraktionering av andra lignocellulosor såsom färsk björk (Betula pendula). Björkflis utsattes för behandling, för en period på en till fem dagar vid 100oC och under atmosfäriskt tryck. Alla syntetiserade joniska vätskor visade sig vara relativt neutrala i avseende på upplösning och avlägsnandet av lignin. Slutligen, optimala fraktioneringprocessbetingelser för ved med reversibla joniska vätskor kartlades. Fraktionering av vedbiomassa med dessa joniska vätskor uppvisade sig att vara en selektiv och effektiv metod för extraktion av olika komponenter från lignocellulosa. Den olösta fraktionen hos en vedflis, närmast cellulosa, fibrillerades. -------------------------------------------------------------------------------------------------------------------- Tässä työssä kehitettiin perhe uuden tyyppisiä, reversiibeleitä (switchable) ioninesteitä ( SIL ) joka koostuvat orgaanisesta super-emäksestä kuten 1,8- diatsabisyklo [ 5.4.0] undek- 7-eeni (DBU ) ja yhden tai useampia hydroksyyliryhmiä sisältältävästä molekyylistä (esim. glyseroli) ja happamasta kaasusta (CO2 , SO2) yksinkertaisen menetelmän avulla. [DBU] [ karbonaatti] tai [sulfonaatti] syntetisoitiin kunkin lähtöaineen seoksista kuplittamalla seosta happamalla kaasulla jolloin eksoterminen reaktio tapahtui ja ioninen neste syntyi. Ioniset nesteet voitiin palauttaa takaisin lähtöaineseokseksi kuumentamalla ja/tai kuplittamalla neutraalia kaasua (esim. typpi) seoksen läpi. SIL rakenteet määritettiin ja niiden ominaisuudet kartoitettiin eri menetelmillä, mukaan lukien NMR- ja FTIR -spektroskopia. Ionisen, korkeapoläärisen nesteen syntyminen todennettiin myös viskositeettimittauksilla ja värinmuutoksilla käyttäen hyväksi polariteetti-indikaattoria (Nile red). Myös hajoamislämpötilat määritettiin termogravimetrisellä analyysillä (TGA) ja todettiin että syntetisoitujen yhdisteiden hajoamislämpötila oli välillä 50 ja 200oC . Näiden uusien reversiibeleiden ioninesteiden hajoamisämpötilat olivat korkeammat verrattuna kirjallisuudessa aikaisemmin mainittuihin esimerkkeihin joten niitä voidaan soveltaa useisiin tarkoituksiin. Myös ioninesteitä jotka sisälsivät primäärejä alkoholeja rakennusaineina syntetisoitiin ja hyödynnettiin puun fraktioinnissa. Männyn ja kuusen lisäksi tuoreita koivulastuja onnistuttiin fraktioimaan miedoissa olosuhteissa. Kaikkien syntetisoitujen ioninesteiden todettiin olevan suhteellisen neutraaleja ligniinin liuotuksen suhteen. Vielä, optimaaliset fraktiointiolosuhteet määritettiin ryhmälle reversiibeleitä ioninesteitä ja näiden uudenlaisten ioninesteiden todettiin olevan tehokkaita puun ja muiden lignoselluloosien eri fraktioiden liuotuksessa. Liukenematon osa puulastua joka oli lähinnä selluloosaa fibrilloitui.

Sels d’imidazolium avec des anions catalytiques : vers le développement de nouveaux catalyseurs bio-hybrides actifs en milieu liquide ionique

Les liquides ioniques connaissent depuis quelques décennies un essor particulier en raison de leurs nombreuses propriétés physico-chimiques intéressantes, telles qu’une faible pression de vapeur saturante, une viscosité limitée, une faible miscibilité avec la plupart des solvants communs, ou encore des propriétés d’agencement supramoléculaire, qui en font des outils puissants dans de nombreux domaines de la chimie. Les sels d’imidazolium représentent la plus grande famille de liquides ioniques à ce jour. Leur modulabilité leur permet d’être dérivés pour de nombreuses applications spécifiques, notamment en synthèse organique, où ils sont utilisés majoritairement comme solvants, et plus récemment comme catalyseurs. Les travaux présentés dans cette thèse se concentrent sur leur utilisation en synthèse organique, à la fois comme solvants et principalement comme catalyseurs chiraux, catalyseurs pour lesquels l’anion du sel est l’espèce catalytique, permettant d’ajouter de la flexibilité et de la mobilité au système. En tirant parti de la tolérance des liquides ioniques envers la majorité des macromolécules naturelles, l’objectif principal des travaux présentés dans cette thèse est le développement d’un nouveau type de catalyseur bio-hybride reposant sur l’encapsulation d’un sel d’imidazolium dans une protéine. Par le biais de la technologie biotine-avidine, l’inclusion supramoléculaire de sels d’imidazolium biotinylés portant des contre-anions catalytiques dans l’avidine a été réalisée et exploitée en catalyse. Dans un premier temps, le développement et l’étude de deux sels de 1-butyl-3-méthylimidazolium possédant des anions chiraux dérivés de la trans-4-hydroxy-L-proline sont rapportés, ainsi que leur comportement dans des réactions énantiosélectives d’aldol et d’addition de Michael. Ces types de composés se sont révélés actifs et performants en milieu liquide ionique. Dans un second temps, la préparation de sels d’imidazolium dont le cation est biotinylé et portant un contre-anion achiral, a été réalisée. Le comportement de l’avidine en milieu liquide ionique et son apport en termes de chiralité sur le système bio-hybride ont été étudiés. Les résultats montrent le rôle crucial des liquides ioniques sur la conformation de la protéine et l’efficacité du catalyseur pour des réactions d’aldol. Dans un dernier temps, l’influence de la structure du cation et de l’anion sur le système a été étudiée. Différents espaceurs ont été introduits successivement dans les squelettes cationiques et anioniques des sels d’imidazolium biotinylés. Dans le cas du cation, les résultats ne révèlent aucune influence majeure sur l’efficacité du catalyseur. La structure de l’anion se montre cependant beaucoup plus importante : la préparation de différents catalyseurs bio-hybrides possédant des anions aux propriétés physico-chimiques différentes a permis d’obtenir de plus amples informations sur le mode de fonctionnement du système bio-hybride et de la coopérativité entre l’avidine et l’anion du sel d’imidazolium.La nature ionique de la liaison cation-anion offrant une liberté de mouvement accrue à l’anion dans la protéine, la tolérance à différents substrats a également été abordée après optimisation du système.