Effect of haematocrit on pump and kidney dysfunction after myocardial revascularization

Objective - Kidney dysfunction is a common complication after cardiac surgery. It occurs in 7 to 31% of the patients. The lowest haematocrit after cardiopulmonary bypass surgery (LHCT) has been identified as a risk factor for kidney dysfunction after cardiac surgery. The aim of this study is to determine whether different levels of haematocrit during cardiopulmonary bypass surgery are related to kidney dysfunction.Methods and results-A prospective study was conducted on consecutive adult patients undergoing myocardial revascularization. Preoperative renal function was assessed by baseline serum creatinine level (CrPre). Peak postoperative creatinine (CrPost) was defined as the highest daily in-hospital postoperative value. Peak fractional change in creatinine (% Delta Cr) was defined as the difference between the CrPre and CrePost represented as a percentage of the preoperative value. The LHTC was defined as the lowest recorded haematocrit prior to weaning from the initial pump run. A category variable was created for haematocrit based on the distribution of values. The category variable had the following cut-off points: less than 23%, 23.1 to 28% and greater than 28.1 %. Lowest haematocrit (26.62 +/- 4.15%), CPB (74.71 +/- 24.90 min), CrPre (1.23 +/- 0.37 mg/dl) and highest CrPost (1.52 +/- 0.47 mg/dl) data varied in near-normal fashion. Statistical significance has been observed in the < 23% lowest haematocrit group (CrIPOD and Cr5POD; P = 0.006) and the 23.1 28% lowest haematocrit level group (CrPre and Cr2POD; P = 0.047). CrPre and Cr5POD did not differ between groups (P > 0.05). The multiple linear regression model confirmed that the determinants for higher %Delta Cr were age, body surface area and preoperative serum creatinine level.Conclusion - The LHTC was not identified as a risk factor for kidney dysfunction after myocardial revascularization.

Pump excited state absorption in holmium-doped fluoride glass

The primary excited state absorption processes relating to the (5)I(6) -> (5)I(7) 3 mu m laser transition in singly Ho(3+)-doped fluoride glass have been investigated in detail using time-resolved fluorescence spectroscopy. Selective laser excitation of the (5)I(6) and (5)I(7) energy levels established the occurrence of two excited state absorption transitions from these energy levels that compete with previously described energy transfer upconversion processes. The (5)I(7) -> (5)I(4) excited state absorption transition has peak cross sections at 1216 nm (sigma(esa)=2.8x10(-21) cm(2)), 1174 nm (sigma(esa)=1x10(-21) cm(2)), and 1134 nm (sigma(esa)=7.4x10(-22) cm(2)) which have a strong overlap with the (5)I(8) -> (5)I(6) ground state absorption. on the other hand, it was established that the excited state absorption transition (5)I(6) -> (5)S(2) had a weak overlap with ground state absorption. Using numerical solution of the rate equations, we show that Ho(3+)-doped fluoride fiber lasers employing pumping at 1100 nm rely on excited state absorption from the lowest excited state of Ho(3+) to maintain a population inversion and that energy transfer upconversion processes compete detrimentally with the excited state absorption processes in concentrated Ho(3+)-doped fluoride glass. (c) 2008 American Institute of Physics.

Drying kinetics of tomato by using electric resistance and heat pump dryers

Drying kinetics of tomato was studied by using heat pump dryer (HPD) and electric resistance dryers with parallel and crossed airflow. The performance of both systems was evaluated and compared and the influence of temperature, air velocity, and tomato type on the drying kinetics was analyzed. The use of HPD showed to be adequate in the drying process of tomatoes, mainly in relation to the conversion rate of electric energy into thermal energy. The heat pump effective coefficient of performance (COPHT,EF) was between 2.56 and 2.68, with an energy economy of about 40% when compared to the drying system with electric resistance. The Page model could be used to predict drying time of tomato and statistical analysis showed that the model parameters were mainly affected by drying temperature.

Use of gastric balloon manometry for estimation of intra-abdominal pressure in horses

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The balloon flights in the tropics of the hibiscus project

HIBISCUS is a project for studying the dynamics, microphysics and chemistry of the Tropical Tropopause Layer based on balloon measurements. Thirteen heavy sondes and 18 short duration balloons of different types have been used for local process studies. Eight superpressure (BP) and 3 Infra Red Montgolfier (MIR) long duration balloons have been flown for extending the investigations at global scale around the world. Overall the campaign has been very successful operationally as well as scientifically. The paper provides a description of the balloons, the instruments and the strategy used for meeting at best the goals of the project.

Installation of a getter vacuum pump in cathode-anode region of a high-power klystron amplifier - Propose and feasible

The possibility to install a getter vacuum pump and its feasible in the anode of a high-power klystron amplifier is investigated in order to decrease of the pressure in the gun and consequently increasing its lifetime. The study is conducted using a 1.3 GHz, 100 A and 240 kV high-power klystron with five reentrant coaxial cavities, assembled in a cylindrical drift tube 1.2 m long. This work takes into account the specific conductance of components of gun and all important gas sources, like the degassing of the drift tube, the cavity walls, the cathode, the anode, and the collector, as well the position and pumping speed of the getter vacuum pump in anode region. © 2006 IEEE.

Extração de contornos de telhados usando princípios de Snake Balloon

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Analysis of renal function after on and off pump coronary artery bypass grafting

Cardiopulmonary bypass (CPB) is often associated with renal dysfunction, as measured by plasma creatinine levels and hemodialysis rates. Aim. To compare creatinine clearance (CrCl), estimated with the Cockroft and Gault formula, between patients undergoing off-pump coronary artery bypass grafting (OPCAB) versus on-pump CABG (on-CAB). Material and methods. Between April 2008 and April 2009, 119 patients underwent coronary bypass graft surgery. Fifty-eight (58) of these patients underwent OPCAB while 61 had on-CAB. Creatinine clearance, plasma creatinine levels, and clinical outcome were compared between the groups. A creatinine clearance value of 50 mL/minute was accepted as the lowest limit of normal renal function. Results. There were two hospital deaths caused by sepses after pulmonary infection. Creatinine clearance (Preoperative OPCAB 73,64±33,72 x on-CAB 75,70±34,30mL/min; discharge OPCAB 75,73±35,07 x on-CAB 79,07±34,71 mL/ min; p=0,609), and creatinine levels (Preoperative OPCAB 1,04±0,38 x on-CAB 1,13±0,53 mg/dL; discharge OPCAB 1,12±0,79 x on-CAB 1,04±0,29mg/dL; p=0,407) did not show statistically inter-group differences. Conclusion. Deterioration in renal function is associated with higher rates of postoperative complications. No significant difference in CrCl could be demonstrated between the groups.

Computed tomographic dacryocystography in children undergoing balloon dacryoplasty

PURPOSE To ascertain whether the volume and circumference of the lacrimal sac and nasolacrimal duct as measured by contrast-enhanced computed tomographic dacryocystography (CT-DCG) before and after balloon dacryoplasty could be used to predict clinical success in children with congenital nasolacrimal obstruction. METHODS Nasolacrimal ducts of children aged 2 to 6 years with clinical signs of congenital nasolacrimal duct obstruction undergoing balloon dilation were imaged with contrast-enhanced CT-DCG before and 5 minutes after the procedure. The circumference of the most dilated portion of the lacrimal sac was measured on the axial plane. The volume of contrast within the nasolacrimal duct and sac was also measured before and after the procedure. Clinical success was defined as the disappearance of signs of epiphora. RESULTS A total of 18 nasolacrimal ducts of 13 children were included. The average circumference of the most dilated portion of the lacrimal sac was 1.30 +/- 0.45 cm (range, 0.64-2.50 cm) before the procedure. The average contrast volume was 0.12 +/- 0.08 cm(3) (range, 0.01-0.38 cm(3)) before and 0.07 +/- 0.06 cm(3) (range, 0.01-0.20 cm(3)) after (P = 0.01). Data were analyzed using multivariate logistic regression with a backward variable input model; a decrease in contrast volume before and after dilation (P = 0.04) was associated with clinical success, whereas the larger size of the most dilated portion of the lacrimal sac (P = 0.01) was associated with clinical failure. CONCLUSIONS Contrast-enhanced CT-DCG provides useful information about nasolacrimal anatomy in children with congenital nasolacrimal duct obstruction. The decrease in contrast volume before and after balloon dilation was predictive of success; A larger size of the most dilated portion of the lacrimal sac was associated with clinical failure. (J AAPOS 2012;16:464-467)

Computational and experimental characterization of a low-cost piezoelectric valveless diaphragm pump

Flow pumps act as important devices in areas such as Bioengineering, Medicine, and Pharmacy, among other areas of Engineering, mainly for delivering liquids or gases at small-scale and precision flow rate quantities. Principles for pumping fluids based on piezoelectric actuators have been widely studied, since they allow the construction of pump systems for displacement of small fluid volumes with low power consumption. This work studies valveless piezoelectric diaphragm pumps for flow generation, which uses a piezoelectric ceramic (PZT) as actuator to move a membrane (diaphragm) up and down as a piston. The direction of the flow is guaranteed by valveless configuration based on a nozzle-diffuser system that privileges the flow in just one pumping direction. Most research efforts on development of valveless flow pump deal either with computational simulations based on simplified models or with simplified physical approaches based on analytical models. The main objective of this work is the study of a methodology to develop a low-cost valveless piezoelectric diaphragm flow pump using computational simulations, parametric study, prototype manufacturing, and experimental characterization. The parametric study has shown that the eccentricity of PZT layer and metal layer plays a key role in the performance of the pump.

Association of Proton Pump Inhibitor Use on Cardiovascular Outcomes With Clopidogrel and Ticagrelor Insights From the Platelet Inhibition and Patient Outcomes Trial

Background-The clinical significance of the interaction between clopidogrel and proton pump inhibitors (PPIs) remains unclear. Methods and Results-We examined the relationship between PPI use and 1-year cardiovascular events (cardiovascular death, myocardial infarction, or stroke) in patients with acute coronary syndrome randomized to clopidogrel or ticagrelor in a prespecified, nonrandomized subgroup analysis of the Platelet Inhibition and Patient Outcomes (PLATO) trial. The primary end point rates were higher for individuals on a PPI (n = 6539) compared with those not on a PPI (n = 12 060) at randomization in both the clopidogrel (13.0% versus 10.9%; adjusted hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.04 -1.38) and ticagrelor (11.0% versus 9.2%; HR, 1.24; 95% CI, 1.07-1.45) groups. Patients on non-PPI gastrointestinal drugs had similar primary end point rates compared with those on a PPI (PPI versus non-PPI gastrointestinal treatment: clopidogrel, HR, 0.98; 95% CI, 0.79-1.23; ticagrelor, HR, 0.89; 95% CI, 0.73-1.10). In contrast, patients on no gastric therapy had a significantly lower primary end point rate (PPI versus no gastrointestinal treatment: clopidogrel, HR, 1.29; 95% CI, 1.12-1.49; ticagrelor, HR, 1.30; 95% CI, 1.14-1.49). Conclusions-The use of a PPI was independently associated with a higher rate of cardiovascular events in patients with acute coronary syndrome receiving clopidogrel. However, a similar association was observed between cardiovascular events and PPI use during ticagrelor treatment and with other non-PPI gastrointestinal treatment. Therefore, in the PLATO trial, the association between PPI use and adverse events may be due to confounding, with PPI use more of a marker for, than a cause of, higher rates of cardiovascular events.

Low levels of adherence with proton pump inhibitor therapy contribute to therapeutic failure in gastroesophageal reflux disease

To assess adherence to proton pump inhibitor (PPI) treatment and associated variables in patients with gastroesophageal reflux disease (GERD). Cross-sectional and prospective comprising 240 consecutive adult patients, diagnosed with GERD for whom continuous use of standard or double dose of omeprazole had been prescribed. Patients were ranked as ne-GERD (162: 67.5%) or e-GERD classified according to the Los Angeles classification as A (48:20.0%), B (21:8.6%), C (1:0.5%), D (1:0.5%), and Barrett's esophagus (7:2.9%). The Morisky questionnaire was applied to assess adherence to therapy and a GERD questionnaire to assess symptoms and their impact. Adherence was correlated with demographics, cotherapies, comorbidities, treatment duration, symptoms scores, endoscopic findings, and patient awareness of their disease. 126 patients (52.5%) exhibited high level of adherence and 114 (47.5%) low level. Youngers (P= 0.002) or married (O.R. 2.41, P= 0.03 vs. widowers) patients had lower levels of adherence; symptomatic patients exhibited lower adherence (P= 0.02). All other variables studied had no influence on adherence. Patients with GERD attending a tertiary referral hospital in Sao Paulo exhibited a high rate of low adherence to the prescribed PPI therapy that may play a role in the therapy failure. Age <60 years, marital status and being symptomatic were risk factors for low adherence.

Zooplankton, micronekton and biological pump: Beyond the mesopelagic zone

[EN] Migrant biota transports carbon to the mesopelagic zone due to their feeding at the shallower layers and their defecation, respiration, excretion and mortality at depth. The so-called active flux has been considered a small number compared to gravitational sinking. Recent assessments in subtropical waters show an important effect due to predation by interzonal diel vertical migrants (DVMs). The consumption and subsequent transport of epipelagic zooplankton by DVMs (mainly micronekton) to the mesopelagic zone seemed similar to the mean gravitational export. However, the consequences of this active transport to the bathypelagic zone are almost unknown. Here, we show the effect of the Atlantic and Pacific equatorial upwelling systems on the vertical distribution of acoustic backscatter from the surface to bathypelagic depths. The enhancement of the acoustic signal below the upwelling zone was observed to reach 4000 m depth, coinciding with high abundances and activity of bacteria at those depths. The results suggest an active carbon transport from the epipelagic driven by zooplankton and micronekton, enhancing the efficiency of the biological pump and giving an insight about the fate of an increased productivity at the shallower layers of the ocean