The value of serial serum lactate measurements in predicting the extent of ischemic bowel and outcome of patients suffering acute mesenteric ischemia

BACKGROUND Acute mesenteric ischemia (AMI) is an emergency with a mortality rate up to 50 %. Detecting AMI continues to be a major challenge. This study assed the correlation of repeated preoperative serum lactate with bowel necrosis and to identify risk factors for a lethal outcome in patients with AMI. METHODS A retrospective study of 91 patients with clinically and pathologically confirmed AMI from January 2006 to December 2012 was performed. RESULTS In-hospital mortality rate was 42.9 %. Two hundred nine preoperative lactate measurements were analyzed (2.3 ± 1.1 values per patient). Less than or equal to six hours prior to surgery, the mean serum lactate level was significantly higher (4.97 ± 4.21 vs. 3.24 ± 3.05 mmol/L, p = 0.006) and the mean pH significantly lower (7.28 ± 0.12 vs. 7.37 ± 0.08, p = 0.001) compared to >6 h before surgery. Thirty-four patients had at least two lactate measurements within 24 h prior to surgery. In this subgroup, 17 patients (50 %) exhibited an increase, 17 patients (50 %) a decrease in lactate levels. Forward logistic regression analysis showed that length of necrotic bowel and the highest lactate value 24 h prior to surgery were independent risk factors for mortality (r (2)  = 0.329). CONCLUSION The value of serial lactate and pH measurements to predict the length of necrotic bowel is very limited. Length of necrotic bowel and lactate values are independent risk factors for mortality.

Serial [18F]-fluoromisonidazole PET during radiochemotherapy for locally advanced head and neck cancer and its correlation with outcome.

PURPOSE The aim was to assess changes of tumour hypoxia during primary radiochemotherapy (RCT) for head and neck cancer (HNC) and to evaluate their relationship with treatment outcome. MATERIAL AND METHODS Hypoxia was assessed by FMISO-PET in weeks 0, 2 and 5 of RCT. The tumour volume (TV) was determined using FDG-PET/MRI/CT co-registered images. The level of hypoxia was quantified on FMISO-PET as TBRmax (SUVmaxTV/SUVmean background). The hypoxic subvolume (HSV) was defined as TV that showed FMISO uptake ⩾1.4 times blood pool activity. RESULTS Sixteen consecutive patients (T3-4, N+, M0) were included (mean follow-up 31, median 44months). Mean TBRmax decreased significantly (p<0.05) from 1.94 to 1.57 (week 2) and 1.27 (week 5). Mean HSV in week 2 and week 5 (HSV2=5.8ml, HSV3=0.3ml) were significantly (p<0.05) smaller than at baseline (HSV1=15.8ml). Kaplan-Meier plots of local recurrence free survival stratified at the median TBRmax showed superior local control for less hypoxic tumours, the difference being significant at baseline and after 2weeks (p=0.031, p=0.016). CONCLUSIONS FMISO-PET documented that in most HNC reoxygenation starts early during RCT and is correlated with better outcome.

Kundmachung: Vom 24. des laufenden Monates angefangen wird bei allen Linien die freie Passage von 5 Uhr Morgens bis 8 Uhr Abends ...

Welsch (Projektbearbeiter): Bekanntmachung über die Zulassung des freien Verkehrs aus und nach der Stadt Wien in der Zeit zwischen fünf Uhr morgens und acht Uhr abends (mit dem 24. November 1848)

Cold-Water Coral Distributions in the Drake Passage Area from Towed Camera Observations - Initial Interpretations

Seamounts are unique deep-sea features that create habitats thought to have high levels of endemic fauna, productive fisheries and benthic communities vulnerable to anthropogenic impacts. Many seamounts are isolated features, occurring in the high seas, where access is limited and thus biological data scarce. There are numerous seamounts within the Drake Passage (Southern Ocean), yet high winds, frequent storms and strong currents make seafloor sampling particularly difficult. As a result, few attempts to collect biological data have been made, leading to a paucity of information on benthic habitats or fauna in this area, particularly those on primarily hard-bottom seamounts and ridges. During a research cruise in 2008 six locations were examined (two on the Antarctic margin, one on the Shackleton Fracture Zone, and three on seamounts within the Drake Passage), using a towed camera with onboard instruments to measure conductivity, temperature, depth and turbidity. Dominant fauna and bottom type were categorized from 200 randomized photos from each location. Cold-water corals were present in high numbers in habitats both on the Antarctic margin and on the current swept seamounts of the Drake Passage, though the diversity of orders varied. Though the Scleractinia (hard corals) were abundant on the sedimented margin, they were poorly represented in the primarily hard-bottom areas of the central Drake Passage. The two seamount sites and the Shackleton Fracture Zone showed high numbers of stylasterid (lace) and alcyonacean (soft) corals, as well as large numbers of sponges. Though data are preliminary, the geological and environmental variability (particularly in temperature) between sample sites may be influencing cold-water coral biogeography in this region. Each area observed also showed little similarity in faunal diversity with other sites examined for this study within all phyla counted. This manuscript highlights how little is understood of these isolated features, particularly in Polar regions.

Transaction Costs, Production Costs, and the Passage of Time

No abstract available.

Passage [Illustration] : (Ölgemälde)

Grigory Glückmann

Epidemiologic and methodological issues in serial measurements of blood pressure: The blood pressure study in Mexican children

The Blood Pressure Study in Mexican Children (BPSMC) is a short term longitudinal study of serial blood pressure collected in three observation periods by standardized examinations of 233 female children, 10 to 12 years of age, enrolled in public and private primary schools in Tlalpan, Mexico. Study objectives were: (1) to describe from baseline information the distribution and relationship of blood pressure to age and selected anthropometric factors, as well as to compare the BPSMC results with other blood pressure studies, (2) to examine the sources and amount of variation present in serial blood pressure of 123 children, and (3) to evaluate observer performance by means of intra- and inter-observer variability.^ Stepwise regression results from baseline revealed that of all anthropometric factors and age, weight was the best predictor for blood pressure.^ The results of serial blood pressure measurements show that, besides the known sources of blood pressure variability (subject, day, reading), the physiologic event of menarche has an important bearing upon the variability and characterization of blood pressure in young girls. The assessment of the effects of blood pressure variability and reliability upon the design and analysis of epidemiologic studies, became apparent among post-menarcheal girls; where blood pressure measurements taken from them have low reliability. Research is needed to propose alternatives for assessing blood pressure during puberty.^ Finally, observer performance of blood pressure and anthropometry were evaluated. Anthropometric measurements had reliabilities in excess of R = 0.96. Acceptable reliabilities (R = 0.88 to 0.95) were obtained for systolic and diastolic (phase 4 and 5) blood pressures. The BPSMC showed a 50 percent decrease in measurement error from the first to the third observation periods. ^

Inorganic carbon and geochemistry measurements from landfast sea ice in Resolute Passage, Nunavut, Canada, as part of the Arctic-ICE project, May - June 2010

We conducted a six-week investigation of the sea ice inorganic carbon system during the winter-spring transition in the Canadian Arctic Archipelago. Samples for the determination of sea ice geochemistry were collected in conjunction with physical and biological parameters as part of the 2010 Arctic-ICE (Arctic - Ice-Covered Ecosystem in a Rapidly Changing Environment) program, a sea ice-based process study in Resolute Passage, Nunavut. The goal of Arctic-ICE was to determine the physical-biological processes controlling the timing of primary production in Arctic landfast sea ice and to better understand the influence of these processes on the drawdown and release of climatically active gases. The field study was conducted from 1 May to 21 June, 2010.

Coccolithophore size, abundance and calcification across Drake Passage (Southern Ocean), 2009

This data was collected during a cruise across Drake Passage in the Southern Ocean in February 2009. This data consists of coccolithophore abundance, calcification and primary production rates, carbonate chemistry parameters and ancillary data of macronutrients, chlorophyll-a, average mixed layer irradiance, daily irradiance above the sea surface, euphotic and mixed layer depth, temperature and salinity.

Algunas reflexiones acerca de la construcción del espacio en el cuento "A Drink in the Passage" de Alan Paton : Desafíos para la traducción

El presente trabajo constituye un primer acercamiento al estudio de los cuentos comprendidos en Tales of a Troubled Land del escritor sudafricano Alan Paton (1903-1988). A modo de introducción, haremos una breve reseña histórico-social de la Sudáfrica del apartheid (Cottrell, 2005; Gibson, 2009) que vincularemos con información biográfica del escritor (Paton, 1966; Lirola, 2008). Esta información resultará, a nuestro entender, relevante al momento de hacer una lectura profunda del cuento. Luego, estudiaremos cómo se conforman los espacios interno / externo (Foucault, 1986), especialmente aquellos que posibilitan el encuentro de blancos y negros (Barnard, 2007), con el fin de explorar cómo aparecen las barreras raciales en el texto. Por último, y a la luz de lo anterior, plantearemos algunas cuestiones centrales que se constituyen en desafíos al momento de abocarnos a la tarea de traducir este cuento, especialmente las relacionadas a la metáfora cristalizada en el 'passage' que, nombrado en el título, sirve de eje estructurador de la acción. Según nuestra hipótesis, la traducción de la construcción del espacio se vuelve un desafío ya que la distribución de los espacios y la circulación de la población en y entre ellos son inherentes al apartheid, no sólo en cuanto al sistema de segregación que el término designa, o al momento histórico en el que fue implementado, sino a la (im)posibilidad de que los individuos de las diferentes razas coexistan y se interrelacionen en una tierra que (no) les es común, en un espacio construido culturalmente desde la separación en lugar de desde la unidad

Algunas reflexiones acerca de la construcción del espacio en el cuento "A Drink in the Passage" de Alan Paton : Desafíos para la traducción

El presente trabajo constituye un primer acercamiento al estudio de los cuentos comprendidos en Tales of a Troubled Land del escritor sudafricano Alan Paton (1903-1988). A modo de introducción, haremos una breve reseña histórico-social de la Sudáfrica del apartheid (Cottrell, 2005; Gibson, 2009) que vincularemos con información biográfica del escritor (Paton, 1966; Lirola, 2008). Esta información resultará, a nuestro entender, relevante al momento de hacer una lectura profunda del cuento. Luego, estudiaremos cómo se conforman los espacios interno / externo (Foucault, 1986), especialmente aquellos que posibilitan el encuentro de blancos y negros (Barnard, 2007), con el fin de explorar cómo aparecen las barreras raciales en el texto. Por último, y a la luz de lo anterior, plantearemos algunas cuestiones centrales que se constituyen en desafíos al momento de abocarnos a la tarea de traducir este cuento, especialmente las relacionadas a la metáfora cristalizada en el 'passage' que, nombrado en el título, sirve de eje estructurador de la acción. Según nuestra hipótesis, la traducción de la construcción del espacio se vuelve un desafío ya que la distribución de los espacios y la circulación de la población en y entre ellos son inherentes al apartheid, no sólo en cuanto al sistema de segregación que el término designa, o al momento histórico en el que fue implementado, sino a la (im)posibilidad de que los individuos de las diferentes razas coexistan y se interrelacionen en una tierra que (no) les es común, en un espacio construido culturalmente desde la separación en lugar de desde la unidad