Anemia and brain oxygen after severe traumatic brain injury.

PURPOSE: To investigate the relationship between hemoglobin (Hgb) and brain tissue oxygen tension (PbtO(2)) after severe traumatic brain injury (TBI) and to examine its impact on outcome. METHODS: This was a retrospective analysis of a prospective cohort of severe TBI patients whose PbtO(2) was monitored. The relationship between Hgb-categorized into four quartiles (≤9; 9-10; 10.1-11; >11 g/dl)-and PbtO(2) was analyzed using mixed-effects models. Anemia with compromised PbtO(2) was defined as episodes of Hgb ≤ 9 g/dl with simultaneous PbtO(2) < 20 mmHg. Outcome was assessed at 30 days using the Glasgow outcome score (GOS), dichotomized as favorable (GOS 4-5) vs. unfavorable (GOS 1-3). RESULTS: We analyzed 474 simultaneous Hgb and PbtO(2) samples from 80 patients (mean age 44 ± 20 years, median GCS 4 (3-7)). Using Hgb > 11 g/dl as the reference level, and controlling for important physiologic covariates (CPP, PaO(2), PaCO(2)), Hgb ≤ 9 g/dl was the only Hgb level that was associated with lower PbtO(2) (coefficient -6.53 (95 % CI -9.13; -3.94), p < 0.001). Anemia with simultaneous PbtO(2) < 20 mmHg, but not anemia alone, increased the risk of unfavorable outcome (odds ratio 6.24 (95 % CI 1.61; 24.22), p = 0.008), controlling for age, GCS, Marshall CT grade, and APACHE II score. CONCLUSIONS: In this cohort of severe TBI patients whose PbtO(2) was monitored, a Hgb level no greater than 9 g/dl was associated with compromised PbtO(2). Anemia with simultaneous compromised PbtO(2), but not anemia alone, was a risk factor for unfavorable outcome, irrespective of injury severity.

Flank stability and processes off the western Canary Islands: a review from El Hierro and La Palma

The morphological characterisation of the western submarine island flanks of El Hierro and La Palma differentiates four type-zones that may give new insights into the evolution of oceanic island slopes. The different type-zones result from the interplay between constructive volcanic processes, hemipelagic settling and volcano collapses. The latter results in massive debris avalanche deposits, which form large volcaniclastic aprons. In most cases, the headwall scarps are clearly exposed on the emerged part of the islands. The events that occurred in the youngest and westernmost islands of El Hierro and La Palma have vertical runouts exceeding 6,000 m and volumes that can reach several hundred km3. The landslide frequency for the entire Canaries is one major event per 90 ka. Triggering mechanisms are closely related to magmatic processes. The increase in the shear stress is directly linked with the forceful intrusion of magma along ridge-rift systems, while in the western Canary Islands it seems that the main process reducing shear resistance may be related to the rise in pore pressure due to hydrothermal circulation.

[Hematological malignancy: management of anemia and leukopenia by primary care physicians]

In hematological malignancies, the occurrence of anemia is very common and can have significant consequences on daily life. Treatment includes essentially red blood cell transfusions. The prescription of erythropoietic agents and/or iron is exceptionnal and often not registered in Switzerland. The onset of neutropenia is also frequently encountered and in some situations may require the prescription of myeloid growth factors. The purpose of this article is to focus on the current recommendations of these two issues for practitioners.

Carence en fer sans anémie: où en est-on en 2012 [Iron deficiency without anemia: where are we in 2012?].

Should we treat iron deficiency without anemia? The simple fact that the question can be formulated already leads to controversies. During the past years, the development of a new formulation of intravenous iron has helped fuel the controversy. What is the situation in 2012? This article gives a practical point of view on the actual situation and provides indications on the use of new intravenous medications.

Quesada Sanz, Fernando y Zamora Merchán, Mar (eds.), El caballo en la antigua Iberia (estudios sobre los équidos en la Edad del Hierro), Bibliotheca Archaeologica Hispana, 19, Madrid, 2003, 253 pp.

La colaboración editorial entre la Real Academia de la Historia y la Universidad Autónoma de Madrid ha hecho posible el libro que nos ocupa, inscrito en la espléndida serie de temas peninsulares BAH. colección que alcanza ya los 19 títulos en sus primeros cuatro años de existencia. El caballo en la antigua Iberia aborda un tema necesitado de una revisión en nuestro actual panorama historiográfico; tal objetivo se cumple mediante una serie de capítulos independientes, fruto del trabajo de diversos estudiosos y especialistas que, desde metodologías y ciencias muy diferentes entre sí, tienen en común un mismo objeto de estudio.

El armamento de hierro de Capsech (Olot, Gerona)

En el Museo Municipal de O1ot se hallan agrupadas en una misma vitrina armas de hierro de diversas épocas y procedencias.! El lote principal lo forman los materiales de la necrópolis de incineración de Capsech, situada en el Pla de Gibrella, Vall de Vianya, a unos 24 Km. al norte de la ciudad de Olot. Este yacimiento fue hallado en la segunda mitad del siglo XIX y no se han realizado, desde entonces, excavaciones en este lugar.

Cerámicas de época celtibérica en la Edad del Hierro asturiana

Este artículo pretende simplemente reinterpretar ciertas cerámicas procedentes de yacimientos asturianos, las cuales han sido publicadas previamente y cuya orientación cronológica o cultural, según los casos, permite ofrecer en el momento actual nuevas precisiones o interpretaciones.

"El Barranc de Gàfols" (Ginestar, Tarragona) y "Aldovesta" (Benifallet, Tarragona): estudio arqueozoológico como base de teorización sobre la dieta humana a principios de la Edad del Hierro y la complejidad económica en el curso bajo del Ebro.

En relación a trabajos recientes sobre los patrones de poblamiento protohistórico en el curso bajo del Ebro y la causalidad económica (Asensio el alii, 1996/ Mascort el alii, 1991), decidimos plantear un estudio que nutriera dichas hipótesis mediante el análisis arqueozoológico de dos yacimientos culturalmente contemporáneos y de cronologías sucesivas, ubicados a orillas de este río.

The role of the Fanconi anemia network in the response to DNA replication stress.

Fanconi anemia is a genetically heterogeneous disorder associated with chromosome instability and a highly elevated risk for developing cancer. The mutated genes encode proteins involved in the cellular response to DNA replication stress. Fanconi anemia proteins are extensively connected with DNA caretaker proteins, and appear to function as a hub for the coordination of DNA repair with DNA replication and cell cycle progression. At a molecular level, however, the raison d'être of Fanconi anemia proteins still remains largely elusive. The thirteen Fanconi anemia proteins identified to date have not been embraced into a single and defined biological process. To help put the Fanconi anemia puzzle into perspective, we begin this review with a summary of the strategies employed by prokaryotes and eukaryotes to tolerate obstacles to the progression of replication forks. We then summarize what we know about Fanconi anemia with an emphasis on biochemical aspects, and discuss how the Fanconi anemia network, a late acquisition in evolution, may function to permit the faithful and complete duplication of our very large vertebrate chromosomes.

Acute reversible Charles Bonnet syndrome precipitated by sudden severe anemia.

PURPOSE: To report the sudden onset of reversible Charles Bonnet syndrome precipitated byacute severe anemia. METHODS: The charts of three patients (Usher syndrome, bilateral macular degeneration, and bilateral retinal vein occlusion) with acute Charles Bonnet syndrome in the setting of severe anemia were reviewed. RESULTS: Anemia resulted from bladder surgery, recto-colitis, and severe urinary tract infection. Hemoglobin ranged from 78 to 86 g/L. Decreased visual acuity and formed visual hallucinations (giants, flowers, animals) were present in all three patients. Rapid reversal of Charles Bonnet syndrome and visual acuity improvement followed blood transfusion. CONCLUSIONS: Acute severe anemia can precipitate Charles Bonnet syndrome, which may be reversible by blood transfusion.

Portulaca granulato-stellulata new for El Hierro Islands( Canary Islands).

Portulaca granulato-stellulata (Poellnitz) C. Ricceri & P. V. Arrigoni is a subcosmopolitan plant of uncertain origin (DANIN et al., 1978; DANIN, 2000). It has been recently reported from Tenerife Island (DANIN & REYES-BETANCORT, 2006), the first reference for the Canary Islands, since prior to this, the taxon had not been detected from any of the Macaronesian islands. Its presence was undetected due to its inclusion within the complex Portulaca oleracea sensu lato (HANSEN & SUNDING, 1993: 170; STIERSTORFER & GAISBERG, 2006).