Los abonos verdes en la agricultura

Presenta la práctica del abonamiento en verde que consiste en establecer cultivos de rápido y abundante desarrollo vegetativo para ser enterrados en la época más adecuada. Selecciona el tipo de planta que tiene la susceptibilidad a descomponerse y este la tierra lista para cultivar.

Early multimodal outcome prediction after cardiac arrest in patients treated with hypothermia.

OBJECTIVES: Therapeutic hypothermia and pharmacological sedation may influence outcome prediction after cardiac arrest. The use of a multimodal approach, including clinical examination, electroencephalography, somatosensory-evoked potentials, and serum neuron-specific enolase, is recommended; however, no study examined the comparative performance of these predictors or addressed their optimal combination. DESIGN: Prospective cohort study. SETTING: Adult ICU of an academic hospital. PATIENTS: One hundred thirty-four consecutive adults treated with therapeutic hypothermia after cardiac arrest. MEASUREMENTS AND MAIN RESULTS: Variables related to the cardiac arrest (cardiac rhythm, time to return of spontaneous circulation), clinical examination (brainstem reflexes and myoclonus), electroencephalography reactivity during therapeutic hypothermia, somatosensory-evoked potentials, and serum neuron-specific enolase. Models to predict clinical outcome at 3 months (assessed using the Cerebral Performance Categories: 5 = death; 3-5 = poor recovery) were evaluated using ordinal logistic regressions and receiving operator characteristic curves. Seventy-two patients (54%) had a poor outcome (of whom, 62 died), and 62 had a good outcome. Multivariable ordinal logistic regression identified absence of electroencephalography reactivity (p < 0.001), incomplete recovery of brainstem reflexes in normothermia (p = 0.013), and neuron-specific enolase higher than 33 μg/L (p = 0.029), but not somatosensory-evoked potentials, as independent predictors of poor outcome. The combination of clinical examination, electroencephalography reactivity, and neuron-specific enolase yielded the best predictive performance (receiving operator characteristic areas: 0.89 for mortality and 0.88 for poor outcome), with 100% positive predictive value. Addition of somatosensory-evoked potentials to this model did not improve prognostic accuracy. CONCLUSIONS: Combination of clinical examination, electroencephalography reactivity, and serum neuron-specific enolase offers the best outcome predictive performance for prognostication of early postanoxic coma, whereas somatosensory-evoked potentials do not add any complementary information. Although prognostication of poor outcome seems excellent, future studies are needed to further improve prediction of good prognosis, which still remains inaccurate.

Crescimento e nodulação de Acacia mangium, Enterolobium contortisiliquum e Sesbania virgata em solo contaminado com metais pesados

Um dos desafios atuais da pesquisa é encontrar plantas e microssimbiontes tolerantes e que possibilitem a revegetação de áreas degradadas por excesso de metais pesados. Este experimento foi realizado no período de agosto a dezembro de 1998, em casa de vegetação do Departamento de Ciência do Solo da UFLA, Lavras (MG), com o objetivo de avaliar a tolerância a metais pesados e a capacidade de estabelecimento de simbiose de rizóbio de diferentes origens com Enterolobium contortisiliquum (tamboril), Acacia mangium (acácia) e Sesbania virgata (sesbânia), em misturas de solos, que continham proporções de solo contaminado (PSC): (0, 15, 30, 45 e 60% v/v) com Zn, Cd, Pb e Cu (18.600, 135, 600 e 596 mg dm-3, extraídos por aqua regia, respectivamente), diluído em Latossolo Vermelho distrófico. Estirpes recomendadas (E) e isolados de solo contaminado (ISC) e de solo não contaminado (ISNC), cuja tolerância a Cu, Cd e Zn foi determinada previamente "in vitro", foram inoculados. O aumento da PSC nas misturas inibiu o crescimento vegetativo, a produção de matéria seca e a nodulação das três espécies. A simbiose tamboril-BR4406 foi a mais tolerante e acácia-BR3617 a mais sensível à contaminação do solo. Os ISC que foram mais tolerantes "in vitro" formaram nódulos eficientes em solo sem contaminação, mas foram ineficientes em solos contaminados. Na PSC 15% (Zn = 750; Cd = 22,1; Pb = 65,1 e Cu = 111 mg dm-3 extraídos por DTPA) a atividade específica da nitrogenase aumentou 5 e 10 vezes em relação ao solo sem contaminação para as simbioses sesbânia-BR5401 e tamboril-BR4406, respectivamente. A tolerância de rizóbio a metais "in vitro" não correspondeu à tolerância da simbiose em solo contaminado.

Efeito de três manejos do lençol freático na adaptação fisiomorfológica do feijoeiro (Phaseolus vulgaris, L.) ao encharcamento

Estudou-se o efeito de três manejos do lençol freático na indução de adaptações fisiomorfológicas do cultivar Bat 477 de feijão (Phaseolus vulgaris, L.) à hipoxia, com vistas em caracterizar a influência relativa dos principais fatores físicos, químicos e biológicos interferentes. O experimento foi realizado em campo, na ESALQ/USP, Piracicaba (SP), de março a junho de 1999, utilizando-se caixas de cimento amianto de 1.000 L como unidade experimental no delineamento de parcelas inteiramente ao acaso, com quatro tratamentos e cinco repetições. As caixas receberam estrutura própria de manejo e controle do lençol freático. Simulou-se ao máximo um meio físico/condição natural de uma várzea. Após a indução no período vegetativo, a eficiência dos manejos foi testada pela inundação temporária do solo no fim do florescimento/formação de vagens. Houve um efetivo processo de nodulação das raízes, a despeito da condição de alta saturação do solo. As características biométricas de crescimento, embora acusando prejuízo da hipoxia, evidenciaram a utilização pela planta de mecanismos adaptativos morfológicos (raízes adventícias e lenticelas), biológicos (fixação de N) e fisiomorfológicos (resistividade estomática e transpiração). Já as características biométricas de colheita evidenciaram que tanto o manejo do lençol mantido a 15 cm como o de elevação gradativa, embora com rendimento de grãos sem vantagem estatística sobre o manejo não-indutivo, foram efetivos, permitindo a planta completar seu ciclo, além de menor comprometimento na qualidade de grãos. A alternância de vantagens relativas biométricas entre os dois manejos não acarretou diferença estatística no rendimento de grãos, levando-se a inferir ser vantajoso o uso de cultivares de ciclo mais longo nesse tipo de condição.

Dinâmica do afilhamento afetada pela disponibilidade de nitrogênio e sua influência na produção de espigas e grãos em trigo

O aumento do número e da sobrevivência de afilhos e a produção de espigas e grãos em trigo foram avaliados em relação à disponibilidade de N, em três experimentos realizados na Estação Experimental Agronômica da UFRGS (Eldorado do Sul, RS), em 1995, 1997 e 1998. Foi utilizado o cv. Embrapa16, semeado no final de junho na densidade de 300sementes aptas m-2. Os tratamentos, em 1995, consistiram da aplicação de 40kgha-1 de N em diferentes estádios de desenvolvimento da planta (da emergência à emissão da 5ªfolha do colmo principal), seguidos ou não da aplicação de 40kgha-1 de N na emissão da 7ªfolha. Em 1997 e 1998, diferentes doses de N foram aplicadas na emergência das plantas, seguidas ou não da aplicação de N no momento de emissão da 7ªfolha. O N aplicado no início do período vegetativo estimulou maior emissão de afilhos, enquanto o N aplicado na emissão da 7ª folha reduziu sua mortalidade e manteve a sincronia de desenvolvimento entre colmo principal e afilhos. Em decorrência, aumentou o número de espigas por área, refletindo no aumento do rendimento de grãos.

Efeitos do aumento do teor de fósforo na semente, obtido via adubação foliar, no crescimento e na nodulação do feijoeiro

Sementes de feijoeiro (Phaseolus vulgaris L.) com alto teor de P, obtidas de plantas que receberam adubação foliar, foram utilizadas em um experimento em casa de vegetação para avaliar os efeitos do teor de P na semente, no crescimento e na nodulação do feijoeiro no estádio vegetativo. O experimento tinha arranjo fatorial 2x2x3x3 em blocos ao acaso com quatro repetições: dois cultivares (Carioca e Rio Tibagi), dois teores de P na semente (baixo e alto, correspondentes a 4,3 e 5,6mgg-1, em Carioca, e 4,8 e 6,3mgg-1, em Rio Tibagi), três doses de P aplicado ao solo (0, 30 e 60mgkg-1, respectivamente, P0, P30 e P60) e três épocas de coleta (20, 30 e 40dias após emergência - DAE). O alto teor de P na semente aumentou a matéria seca das plantas de feijoeiro em P0 nas três coletas, e em P30, aos 40DAE. Plantas originadas de sementes com alto teor de P mostraram menor dependência do suprimento de P no solo, quanto à produção de matéria seca, do que aquelas oriundas de sementes com baixo P. O alto teor de P na semente aumentou o número de nódulos em Carioca em P0, aos 20 e 30DAE, e aumentou a massa de nódulos em P30, aos 20DAE nos dois cultivares e, aos 40DAE, em P30 em Carioca e em P60 em Rio Tibagi. A acumulação de N na parte aérea aos 20DAE foi superior nas plantas originadas de sementes com alto teor de P. Segundo os resultados, sementes com alto teor de P obtido via adubação foliar podem aumentar o crescimento, a nodulação e a acumulação de N do feijoeiro em estádios iniciais de crescimento, particularmente sob baixas doses de P aplicado ao solo.

Treatment strategies in primary vitreoretinal lymphoma: a 17-center European collaborative study.

IMPORTANCE: The best treatment option for primary vitreoretinal lymphoma (PVRL) without signs of central nervous system lymphoma (CNSL) involvement determined on magnetic resonance imaging or in cerebrospinal fluid is unknown. OBJECTIVE: To evaluate the outcomes of treatment regimens used for PVRL in the prevention of subsequent CNSL. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study was conducted at 17 referral ophthalmologic centers in Europe. We reviewed clinical, laboratory, and imaging data on 78 patients with PVRL who did not have CNSL on presentation between January 1, 1991, and December 31, 2012, with a focus on the incidence of CNS manifestations during the follow-up period. INTERVENTIONS: The term extensive treatment was used for various combinations of systemic and intrathecal chemotherapy, whole-brain radiotherapy, and peripheral blood stem cell transplantation. Therapy to prevent CNSL included ocular radiotherapy and/or ocular chemotherapy (group A, 31 patients), extensive systemic treatment (group B, 21 patients), and a combination of ocular and extensive treatment (group C, 23 patients); 3 patients did not receive treatment. A total of 40 patients received systemic chemotherapy. MAIN OUTCOMES AND MEASURES: Development of CNSL following the diagnosis of PVRL relative to the use or nonuse of systemic chemotherapy and other treatment regimens. RESULTS: Overall, CNSL developed in 28 of 78 patients (36%) at a median follow-up of 49 months. Specifically, CNSL developed in 10 of 31 (32%) in group A, 9 of 21 (43%) in group B, and 9 of 23 (39%) in group C. The 5-year cumulative survival rate was lower in patients with CNSL (35% [95% CI, 50% to 86%]) than in patients without CNSL (68% [95% CI, 19% to 51%]; P = .003) and was similar among all treatment groups (P = .10). Adverse systemic effects occurred in 9 of 40 (23%) patients receiving systemic chemotherapy; the most common of these effects was acute renal failure. CONCLUSIONS AND RELEVANCE: In the present series of patients with isolated PVRL, the use of systemic chemotherapy was not proven to prevent CNSL and was associated with more severe adverse effects compared with local treatment.

Fertilizantes fosfatados e produção da soja em solos com diferentes capacidades tampão de fosfato

Objetivou-se avaliar a eficiência de fertilizantes fosfatados na nutrição e na produção da soja em três solos distintos quanto à capacidade-tampão de fosfato: Neossolo Quartzarênico, Latossolo Vermelho-Amarelo distrófico textura média e Latossolo Vermelho-Amarelo distrófico textura argilosa. Experimentos foram realizados em casa de vegetação em esquema fatorial (2 x 4) + 8, comparando duas fontes-teste de P (FT1 e FT2) em quatro doses, além de oito tratamentos adicionais: fonte teste 3 (FT3); superfosfato triplo (ST) + calcário calcítico; ST + calcário dolomítico; mistura ST + FT1; ST + FT2; termofosfato magnesiano; fosfato de Araxá e testemunha (sem P). As doses de P foram definidas com base na análise do P remanescente, sendo diferentes para cada solo. O fornecimento de fósforo pela aplicação da FT1 e FT2 provocou aumento na produção de matéria seca e de grãos de soja. O uso das FT's, isoladamente ou em mistura com o ST, proporcionou crescimento vegetativo e produção equiparáveis aos dos tratamentos com ST e termofosfato. O aumento no fator capacidade de P do solo restringiu a absorção e contribuiu para maior eficiência de utilização do nutriente pela soja, nivelando os efeitos dos tratamentos.

Notfälle in der Pädiatrie [Pediatric emergencies]

We describe the most frequent emergencies in pediatrics and discuss their differential diagnosis and therapy. Dyspnea, shock, coma, convulsions, infectious CNS affections, head injury and burns are reported in detail. The importance of correct diagnosis and correct clinical assessment is emphasized, as they influence therapy and further management of the patients.

Pre-hospital risk factors for inpatient death from severe febrile illness in malian children.

BACKGROUND: Inpatient case fatality from severe malaria remains high in much of sub-Saharan Africa. The majority of these deaths occur within 24 hours of admission, suggesting that pre-hospital management may have an impact on the risk of case fatality. METHODS: Prospective cohort study, including questionnaire about pre-hospital treatment, of all 437 patients admitted with severe febrile illness (presumed to be severe malaria) to the paediatric ward in Sikasso Regional Hospital, Mali, in a two-month period. FINDINGS: The case fatality rate was 17.4%. Coma, hypoglycaemia and respiratory distress at admission were associated with significantly higher mortality. In multiple logistic regression models and in a survival analysis to examine pre-admission risk factors for case fatality, the only consistent and significant risk factor was sex. Girls were twice as likely to die as boys (AOR 2.00, 95% CI 1.08-3.70). There was a wide variety of pre-hospital treatments used, both modern and traditional. None had a consistent impact on the risk of death across different analyses. Reported use of traditional treatments was not associated with post-admission outcome. INTERPRETATION: Aside from well-recognised markers of severity, the main risk factor for death in this study was female sex, but this study cannot determine the reason why. Differences in pre-hospital treatments were not associated with case fatality.

Brain Tissue Hypoxia is a Strong Predictor of Outcome after Severe Traumatic Brain Injury Independent from Elevated Intracranial Pressure

Introduction: Low brain tissue oxygen pressure (PbtO2) is associated with worse outcome in patients with severe traumatic brain injury (TBI). However, it is unclear whether brain tissue hypoxia is merely a marker of injury severity or a predictor of prognosis, independent from intracranial pressure (ICP) and injury severity. Hypothesis: We hypothesized that brain tissue hypoxia was an independent predictor of outcome in patients wih severe TBI, irrespective of elevated ICP and of the severity of cerebral and systemic injury. Methods: This observational study was conducted at the Neurological ICU, Hospital of the University of Pennsylvania, an academic level I trauma center. Patients admitted with severe TBI who had PbtO2 and ICP monitoring were included in the study. PbtO2, ICP, mean arterial pressure (MAP) and cerebral perfusion pressure (CPP = MAP-ICP) were monitored continuously and recorded prospectively every 30 min. Using linear interpolation, duration and cumulative dose (area under the curve, AUC) of brain tissue hypoxia (PbtO2 < 15 mm Hg), elevated ICP >20 mm Hg and low CPP <60 mm Hg were calculated, and the association with outcome at hospital discharge, dichotomized as good (Glasgow Outcome Score [GOS] 4-5) vs. poor (GOS 1-3), was analyzed. Results: A total of 103 consecutive patients, monitored for an average of 5 days, was studied. Brain tissue hypoxia was observed in 66 (64%) patients despite ICP was < 20 mm Hg and CPP > 60 mm Hg (72 +/- 39% and 49 +/- 41% of brain hypoxic time, respectively). Compared with patients with good outcome, those with poor outcome had a longer duration of brain hypoxia (1.7 +/- 3.7 vs. 8.3 +/- 15.9 hrs, P<0.01), as well as a longer duration (11.5 +/- 16.5 vs. 21.6 +/- 29.6 hrs, P=0.03) and a greater cumulative dose (56 +/- 93 vs. 143 +/- 218 mm Hg*hrs, P<0.01) of elevated ICP. By multivariable logistic regression, admission Glasgow Coma Scale (OR, 0.83, 95% CI: 0.70-0.99, P=0.04), Marshall CT score (OR 2.42, 95% CI: 1.42-4.11, P<0.01), APACHE II (OR 1.20, 95% CI: 1.03-1.43, P=0.03), and the duration of brain tissue hypoxia (OR 1.13; 95% CI: 1.01-1.27; P=0.04) were all significantly associated with poor outcome. No independent association was found between the AUC for elevated ICP and outcome (OR 1.01, 95% CI 0.97-1.02, P=0.11) in our prospective cohort. Conclusions: In patients with severe TBI, brain tissue hypoxia is frequent, despite normal ICP and CPP, and is associated with poor outcome, independent of intracranial hypertension and the severity of cerebral and systemic injury. Our findings indicate that PbtO2 is a strong physiologic prognostic marker after TBI. Further study is warranted to examine whether PbtO2-directed therapy improves outcome in severely head-injured patients .

Barbiturate infusion for intractable intracranial hypertension and its effect on brain oxygenation.

OBJECTIVE: Barbiturate-induced coma can be used in patients to treat intractable intracranial hypertension when other therapies, such as osmotic therapy and sedation, have failed. Despite control of intracranial pressure, cerebral infarction may still occur in some patients, and the effect of barbiturates on outcome remains uncertain. In this study, we examined the relationship between barbiturate infusion and brain tissue oxygen (PbtO2). METHODS: Ten volume-resuscitated brain-injured patients who were treated with pentobarbital infusion for intracranial hypertension and underwent PbtO2 monitoring were studied in a neurosurgical intensive care unit at a university-based Level I trauma center. PbtO2, intracranial pressure (ICP), mean arterial pressure, cerebral perfusion pressure (CPP), and brain temperature were continuously monitored and compared in settings in which barbiturates were or were not administered. RESULTS: Data were available from 1595 hours of PbtO2 monitoring. When pentobarbital administration began, the mean ICP, CPP, and PbtO2 were 18 +/- 10, 72 +/- 18, and 28 +/- 12 mm Hg, respectively. During the 3 hours before barbiturate infusion, the maximum ICP was 24 +/- 13 mm Hg and the minimum CPP was 65 +/- 20 mm Hg. In the majority of patients (70%), we observed an increase in PbtO2 associated with pentobarbital infusion. Within this group, logistic regression analysis demonstrated that a higher likelihood of compromised brain oxygen (PbtO2 < 20 mm Hg) was associated with a decrease in pentobarbital dose after controlling for ICP and other physiological parameters (P < 0.001). In the remaining 3 patients, pentobarbital was associated with lower PbtO2 levels. These patients had higher ICP, lower CPP, and later initiation of barbiturates compared with patients whose PbtO2 increased. CONCLUSION: Our preliminary findings suggest that pentobarbital administered for intractable intracranial hypertension is associated with a significant and independent increase in PbtO2 in the majority of patients. However, in some patients with more compromised brain physiology, pentobarbital may have a negative effect on PbtO2, particularly if administered late. Larger studies are needed to examine the relationship between barbiturates and cerebral oxygenation in brain-injured patients with refractory intracranial hypertension and to determine whether PbtO2 responses can help guide therapy.

Too cold may not be so cool: spontaneous hypothermia as a marker of poor outcome after cardiac arrest.

In a recent issue of Critical Care, den Hartog and colleagues show an association between spontaneous hypothermia, defined by an admission body temperature < 35°C, and poor outcome in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). Given that TH alters neurological prognostication, studies aiming to identify early markers of injury severity and outcome are welcome, since they may contribute overall to optimize the management of comatose CA patients. This study provides an important message to clinicians involved in post-resuscitation care and raises important questions that need to be taken into account in future studies.

Dissimilaridade de porta-enxertos da laranjeira 'folha murcha' sob dois sistemas de manejo de cobertura permanente do solo

Os porta-enxertos de citros são dependentes do sistema de manejo do solo nas entrelinhas. Este trabalho foi realizado com o objetivo de identificar a dissimilaridade de sete porta-enxertos para a laranjeira 'Folha Murcha' em dois sistemas de manejo da cobertura de um Argissolo Vermelho distrófico latossólico. O estudo foi realizado na Estação Experimental do IAPAR, em Paranavaí. O delineamento experimental foi de blocos ao acaso com quatro repetições, com gramínea mato-grosso ou batatais (Paspalum notatum Flügge) em três blocos e leguminosa amendoim forrageiro (Arachis pintoi Krap. & Greg.) em um bloco. A produção, o desenvolvimento vegetativo e os nutrientes nas folhas da laranjeira 'Folha Murcha' foram avaliados anualmente (1997 a 2002). As análises multivariadas basearam-se nas variáveis canônicas e nos componentes principais, agrupando-os pelo método Tocher. O manejo da cobertura do solo com a leguminosa amendoim forrageiro Arachis pintoi diminui a dissimilaridade dos grupos de porta-enxertos da laranjeira 'Folha Murcha'. O manejo da cobertura do solo com a gramínea Paspalum notatum aumenta a dissimilaridade dos grupos de porta-enxertos da laranjeira 'Folha Murcha' com a inclusão dos teores dos nutrientes foliares, da produção de frutos e do desenvolvimento vegetativo das plantas. A gramínea Paspalum notatum é o melhor sistema de manejo da cobertura do solo para avaliação do comportamento de porta-enxertos da laranjeira 'Folha Murcha'.

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.