Osmotic diuresis due to urea as the cause of hypernatraemia in critically ill patients

Hypernatraemia is common in critically ill patients and has been shown to be an independent predictor of mortality. Osmotic urea diuresis can cause hypernatraemia due to significant water losses but is often not diagnosed. Free water clearance (FWC) and electrolyte free water clearance (EFWC) were proposed to quantify renal water handling. We aimed to (i) identify patients with hypernatraemia due to osmotic urea diuresis and (ii) investigate whether FWC and EFWC are helpful in identifying renal loss of free water.

Pain and swelling after periapical surgery related to oral hygiene and smoking

OBJECTIVES: To evaluate pain and swelling during the first week after periapical surgery and its relation to patient age, gender, oral hygiene, and smoking. STUDY DESIGN: One hundred two patients (31 men and 71 women) with a mean age of 40.2 years underwent periapical surgery. Age, gender, and oral hygiene and cigarette smoking before and during the postoperative course were noted. Pain and swelling scores were recorded on a descriptive 4-point scale at 2, 6, and 12 hours after surgery, and each day thereafter for 1 week. The data were statistically evaluated for significant differences. RESULTS: The highest intensity of pain occurred during the first 48 hours, and swelling peaked on the second postoperative day. Patient age and gender had no significant effect on postoperative symptoms (P > .05). Patients with poor oral hygiene before surgery presented greater pain and swelling during the first postsurgical hours, and smokers before surgery also suffered more pain. The number of cigarettes smoked in the postoperative period and oral hygiene after surgery had no effect on pain or inflammation (P > .05). CONCLUSIONS: Periapical surgery caused little pain and moderate swelling during the first 2 days after the intervention; these findings were more distinct in patients with poor oral hygiene before surgery and in smokers.

High incidence of optic disc swelling at very high altitudes

OBJECTIVES: To determine the incidence of optic disc swelling as a possible indicator of cerebral edema in a large group of healthy mountaineers exposed to very high altitudes and to correlate these findings with various clinical and environmental factors and occurrence of acute mountain sickness and high-altitude cerebral edema. METHODS: This multidisciplinary, prospective, observational cohort study was performed in 2005 within the scope of a medical research expedition to Muztagh Ata (7546 m [24,751 ft]) in Western Xinjiang Province, China. Twenty-seven healthy mountaineers aged 26 to 62 years participated. Medical examinations were performed in Switzerland 1 month before and 4 1/2 months after the expedition. Ophthalmologic examinations were performed at 4 high camps (maximum elevation, 6865 m [22,517 ft]). Optic disc status was documented using digital photography. Further assessments included arterial oxygen saturation and cerebral acute mountain sickness scores. RESULTS: Sixteen of 27 study subjects (59%) exhibited optic disc swelling during their stay at high altitudes, with complete regression on return to lowlands. Significant correlation was noted between optic disc swelling and lower arterial oxygen saturation (odds ratio, 0.86 per percentage of arterial oxygen saturation; 95% confidence interval, 0.81-0.92; P < .001), younger age (odds ratio, 0.95 per year; 95% confidence interval, 0.90-0.99; P = .03), and higher cerebral acute mountain sickness scores (odds ratio, 2.32 per 0.1 point; 95% confidence interval, 1.48-3.63; P < .001). CONCLUSION: Optic disc swelling occurs frequently in high-altitude climbers and is correlated with peripheral oxygen saturation and symptoms of acute mountain sickness. It is most likely the result of hypoxia-induced brain volume increase.

Decompressive hemicraniectomy in subarachnoid haemorrhage: the influence of infarction, haemorrhage and brain swelling

OBJECTIVE: To analyse decompressive hemicraniectomy (DHC) in patients with aneurysmal subarachnoid haemorrhage (SAH) with regard to infarction, haemorrhage or brain swelling. METHODS: DHC was performed in 43 of 787 patients with SAH. Patients were stratified according to (1) primary brain swelling without and (2) with additional intracerebral haematoma, (3) secondary brain swelling without rebleeding or infarcts and (4) with infarcts or (5) with rebleeding. Outcome was assessed according to the modified Rankin scale at 6 months RESULTS: Overall, 36 of 43 patients (83.7%) with DHC and 241 of 744 patients (32.4%) without DHC have been of a poor grade on admission (World Federation of Neurological Societies grading 4-5; p<0.0001). Favourable outcome was achieved in 11 of 43 (25.6%) patients with DHC. There was no difference in favourable outcome after primary (25%) versus secondary (26.1%) DHC (p = 1.0). Subgroup analysis (brain swelling vs bleeding vs infarcts) revealed no difference in the rate of favourable outcome. In a multivariate analysis, acute hydrocephalus (p = 0.02) and clinical herniation (p = 0.03) were significantly associated with unfavourable outcome. CONCLUSIONS: We conclude that primary and secondary hemicraniectomy may be warranted, irrespective of the underlying aetiology-infarction, haemorrhage or brain swelling. The time from onset of intractable ICP to DHC seems to be crucial, rather than the time from SAH to DHC.

Measuring the mechanical properties of plant cells by combining micro-indentation with osmotic treatments

Growth in plants results from the interaction between genetic and signalling networks and the mechanical properties of cells and tissues. There has been a recent resurgence in research directed at understanding the mechanical aspects of growth, and their feedback on genetic regulation. This has been driven in part by the development of new micro-indentation techniques to measure the mechanical properties of plant cells in vivo. However, the interpretation of indentation experiments remains a challenge, since the force measures results from a combination of turgor pressure, cell wall stiffness, and cell and indenter geometry. In order to interpret the measurements, an accurate mechanical model of the experiment is required. Here, we used a plant cell system with a simple geometry, Nicotiana tabacum Bright Yellow-2 (BY-2) cells, to examine the sensitivity of micro-indentation to a variety of mechanical and experimental parameters. Using a finite-element mechanical model, we found that, for indentations of a few microns on turgid cells, the measurements were mostly sensitive to turgor pressure and the radius of the cell, and not to the exact indenter shape or elastic properties of the cell wall. By complementing indentation experiments with osmotic experiments to measure the elastic strain in turgid cells, we could fit the model to both turgor pressure and cell wall elasticity. This allowed us to interpret apparent stiffness values in terms of meaningful physical parameters that are relevant for morphogenesis.

Concrete Swelling in Two Spanish Dams

Several chemical reactions are able to produce swelling of concrete for decades after its initial curing, a problem that affects a considerable number of concrete dams around the world. Principia has had several contracts to study this problem in recent years, which have required reviewing the state-ofthe-art, adopting appropriate mathematical descriptions, programming them into user routines in Abaqus, determining model parameters on the basis of some parts of the dams’ monitored histories, ensuring reliability using some other parts, and finally predicting the future evolution of the dams and their safety margins. The paper describes some of the above experience, including the programming of sophisticated nonisotropic swelling models, that must be compatible with cracking and other nonlinearities involved in concrete behaviour. The applications concentrate on two specific cases, an arch-gravity dam and a double-curvature arch dam, both with a long history of concrete swelling and which, interestingly, entailed different degrees of success in the modelling efforts

Contribution to Theme A of the Benchmark Workshop: Effect of Concrete Swelling on the Equilibrium and Displacements of an Arch Dam

The Kariba dam is undergoing concrete expansion as a result of an alkali-aggregate reaction. The model adopted to simulate the process is explained in the paper; it is based on the model first proposed by Ulm et al, as later modified by Saouma and Perotti. It has been implemented in the commercial finite element code Abaqus and applied to solve the benchmark problem. The parameters of the model were calibrated using the data recorded up to 1995. The calibrated model was then used for predicting the evolution of the dam up to the present date. Apart from this prediction the paper offers a number of conclusions, such as the fact that the stress level appears to have a major influence on the expansion process; and it presents some suggestions to improve the formulation of the benchmark, such as providing temperature data and widening the locations and conditions of the data employed in the calibration

Concrete Swelling in Existing Dams

Several chemical reactions are able to produce swelling of concrete for decades after its initial curing, a problem that affects a considerable number of concrete dams around the world. Principia has had several contracts to study this problem in recent years, which have required reviewing the state-of-the-art, adopting appropriate mathematical descriptions, programming them into user routines in Abaqus, determining model parameters on the basis of some parts of the dams’ monitored histories, ensuring reliability using some other parts, and finally predicting the future evolution of the dams and their safety margins. The paper describes some of the above experience, including the programming of sophisticated non-isotropic swelling models, that must be compatible with cracking and other nonlinearities involved in concrete behaviour. The applications concentrate on two specific cases, an archgravity dam and a double-curvature arch dam, both with a long history of concrete swelling and which, interestingly, entailed different degrees of success in the modelling efforts

Concrete Swelling in Two Spanish Dams

Several chemical reactions are able to produce swelling of concrete for decades after its initial curing, a problem that affects a considerable number of concrete dams around the world. Principia has had several contracts to study this problem in recent years, which have required reviewing the state-ofthe-art, adopting appropriate mathematical descriptions, programming them into user routines in Abaqus, determining model parameters on the basis of some parts of the dams’ monitored histories, ensuring reliability using some other parts, and finally predicting the future evolution of the dams and their safety margins. The paper describes some of the above experience, including the programming of sophisticated nonisotropic swelling models, that must be compatible with cracking and other nonlinearities involved in concrete behaviour. The applications concentrate on two specific cases, an arch-gravity dam and a double-curvature arch dam, both with a long history of concrete swelling and which, interestingly, entailed different degrees of success in the modelling efforts.

Effect of Concrete Swelling on the Equilibrium and Displacements of an Arch Dam

The Kariba dam is undergoing concrete expansion as a result of an alkali-aggregate reaction. The model adopted to simulate the process is explained in the paper; it is based on the model first proposed by Ulm et al, as later modified by Saouma and Perotti. It has been implemented in the commercial finite element code Abaqus and applied to solve the benchmark problem. The parameters of the model were calibrated using the data recorded up to 1995. The calibrated model was then used for predicting the evolution of the dam up to the present date. Apart from this prediction the paper offers a number of conclusions, such as the fact that the stress level appears to have a major influence on the expansion process; and it presents some suggestions to improve the formulation of the benchmark, such as providing temperature data and widening the locations and conditions of the data employed in the calibration

Growth of Fusarium species as affected by temperature and osmotic potential (NaCl and KCl) interactions.

Myceliar growth of 90 Fusarium strains os F. acuminatum, F. chlamydosporum, F. culmorum, F. equiseti, F.verticillioides, F. oxysporum, F. proliferatum, F. solani an F. sambucinum isolated from fluvial channels and sea beds of the south-eastern coast of Spain was tested on potato-dextrose-agar adjusted to different matric potentials with either KCl or NaCl (from - 1.50 to - 144.54 bars).

The interactive effects of temperature and osmotic potential on the growth of marines isolates of Fusarium solani

The mycelial growth of 18 Fusarium solani strains isolated from sea beds of the south-eastern coast of Spain was tested on potato-dextrose agar adjusted to different osmotic potentials with either KCl or NACl (-1.50 to -144.54 bars) in 10ºC intervals ranging from 15 to 35ºC. Fungal growth was determined by measuring colony diameter after 4 days incubation. Mycelial growth was maximal at 25ºC. The quantity and frequency pattern of mycelial growth of F. solani differ significantly at 15 and 25ºC, with maximal occurring at the highest water potential tested (-1.50 bars); and at 35ºC, with a maximal mycelial growth at -13.79 bars. The effect of water potential was independent of salt composition. The general growth pattern of F. solani showed declining growth at potentials below -41.79 bars. Fungal growth at 35ºC was always higher than that growth at 15ºC, of all the water potentials tested. Significant differences observed in the response of mycelia to water potential and temperature as main and interactive effects. The viability of cultures was increasingly inhibited as the water potential dropped, but some growth was still observed at -99.56 bars. These findings could indicate that marine strains of F. solani have a physiological mechanism that permits survival in environments with low water potential. The observed differences in viability and the magnitude growth could indicate that the biological factors governing potential and actual growth are affected by osmotic potential in different ways.

The Interactive Effects of Temperature and Osmotic Potential on the Growth of Aquatic Isolates of Fusarium culmorum.

The mycelial growth of 10 Fusarium culmorum strains isolated from water of the Andarax riverbed in the provinces of Granada and Almeria in southeastern Spain was tested on potato-dextroseagar adjusted to different osmotic potentials with either KCl or NaCl (−1.50 to−144.54 bars) at 10◦C intervals ranging from15◦ to 35◦C. Fungal growth was determined by measuring colony diameter after 4 d of incubation. Mycelial growth was maximal at 25◦C. The quantity and capacity of mycelial growth of F. culmorum were similar at 15 and 25◦C, with maximal growth occurring at −13.79 bars water potential and a lack of growth at 35◦C. The effect of water potential was independent of salt composition. The general growth pattern of Fusarium culmorum growth declined at potentials below −13.79 bars. Fungal growth at 25◦C was always greater than growth at 15◦C, at all of the water potentials tested. Significant differences were observed in the response ofmycelia to water potential and temperature as main and interactive effects. The number of isolates that showed growth was increasingly inhibited as the water potential dropped, but some growth was still observable at −99.56 bars. These findings could indicate that F. culmorum strains isolated from water have a physiological mechanism that permits survival in environments with low water potential. Propagules of Fusarium culmorum are transported long distances by river water, which could explain the severity of diseases caused by F.culmorum on cereal plants irrigated with river water and its interaction under hydric stress ormoderate soil salinity. The observed differences in growth magnitude and capacity could indicate that the biological factors governing potential and actual growth are affected by osmotic potential in different ways.