Impact of infection on the prognosis of critically ill cirrhotic patients: results from a large worldwide study.

BACKGROUND: Infections are a leading cause of death in patients with advanced cirrhosis, but there are relatively few data on the epidemiology of infection in intensive care unit (ICU) patients with cirrhosis. AIMS: We used data from the Extended Prevalence of Infection in Intensive Care (EPIC) II 1-day point-prevalence study to better define the characteristics of infection in these patients. METHODS: We compared characteristics, including occurrence and types of infections in non-cirrhotic and cirrhotic patients who had not undergone liver transplantation. RESULTS: The EPIC II database includes 13,796 adult patients from 1265 ICUs: 410 of the patients had cirrhosis. The prevalence of infection was higher in cirrhotic than in non-cirrhotic patients (59 vs. 51%, P < 0.01). The lungs were the most common site of infection in all patients, but abdominal infections were more common in cirrhotic than in non-cirrhotic patients (30 vs. 19%, P < 0.01). Infected cirrhotic patients more often had Gram-positive (56 vs. 47%, P < 0.05) isolates than did infected non-cirrhotic patients. Methicillin-resistant Staphylococcus aureus (MRSA) was more frequent in cirrhotic patients. The hospital mortality rate of cirrhotic patients was 42%, compared to 24% in the non-cirrhotic population (P < 0.001). Severe sepsis and septic shock were associated with higher in-hospital mortality rates in cirrhotic than in non-cirrhotic patients (41% and 71% vs. 30% and 49%, respectively, P < 0.05). CONCLUSIONS: Infection is more common in cirrhotic than in non-cirrhotic ICU patients and more commonly caused by Gram-positive organisms, including MRSA. Infection in patients with cirrhosis was associated with higher mortality rates than in non-cirrhotic patients.

A-7 Statistical Report On FIP Applications And Cases Discontinued, May 2004

Monthly statistical report on FIP by the Iowa Department of Human Services

Movement, impacts and management of plant distributions in response to climate change: insights from invasions

A major challenge in this era of rapid climate change is to predict changes in species distributions and their impacts on ecosystems, and, if necessary, to recommend management strategies for maintenance of biodiversity or ecosystem services. Biological invasions, studied in most biomes of the world, can provide useful analogs for some of the ecological consequences of species distribution shifts in response to climate change. Invasions illustrate the adaptive and interactive responses that can occur when species are confronted with new environmental conditions. Invasion ecology complements climate change research and provides insights into the following questions: i) how will species distributions respond to climate change? ii) how will species movement affect recipient ecosystems? and iii) should we, and if so how can we, manage species and ecosystems in the face of climate change? Invasion ecology demonstrates that a trait-based approach can help to predict spread speeds and impacts on ecosystems, and has the potential to predict climate change impacts on species ranges and recipient ecosystems. However, there is a need to analyse traits in the context of life-history and demography, the stage in the colonisation process (e.g., spread, establishment or impact), the distribution of suitable habitats in the landscape, and the novel abiotic and biotic conditions under which those traits are expressed. As is the case with climate change, invasion ecology is embedded within complex societal goals. Both disciplines converge on similar questions of "when to intervene?" and "what to do?" which call for a better understanding of the ecological processes and social values associated with changing ecosystems.

La Cohesió discursiva i l'espai en la llengua de signes catalana

Winston (1995) i Morgan (1999) són els dos estudis pioners que descriuen els mecanismes per a l’establiment de la referència espacial, en l’ASL i la BSL, respectivament. Prenent com a punt de partida els fenòmens descrits per a aquestes llengües, en aquest treball proposem una anàlisi descriptiva dels mecanismes de cohesió en llengua de signes catalana que deriven de la seva modalitat gestovisual. Els elements que aquí descrivim permeten l’enllaç entre les oracions a partir de les característiques articulatòries i perceptuals de la llengua, així com de l’ús de l’espai que envolta i conforma la llengua. Veurem com la realització espacial i la simultaneïtat és una part fonamental de l’estructura de les llengües de signes i una peça fonamental per a la creació de la textura discursiva.

"Il corpo de'pensieri" : la versificazione dei "Canti" leopardiani

L'objet de la thèse est l'étude de l'endecasillabo dans l'oeuvre poétique de Giacomo Leopardi. D'un point de vue méthodologique, ce travail s'appuie sur la recherche de Marco Praloran et Arnaldo Soldani dédiée à l'endecasillabo de Pétrarque. L'auteur a comparé les Canti de Leopardi avec la production des plus grands écrivains de la fin du XIXème siècle et du début du XXème siècle Melchiorre Cesarotti (Poesie di Ossian), Giuseppe Parini (Il Mattino), Vittorio Alfieri (Le Rime e il Saul), Vincenzo Monti (l'ouvre poétique), Ugo Foscolo (Le Rime) et Alessandro Manzoni (l'oeuvre poétique). Nous avons là un répertoire de plusieurs milliers de vers qui ont été scandés non pas par l'intermédiaire d'un ordinateur, mais un à un en fonction de leur intonation. La première partie de la thèse est dédiée à l'analyse du rythme des différents auteurs, à des statistiques générales qui permettent de comparer ces données entre elles et avec les anciens auteurs italiens tels Dante, Pétrarque, Arioste, etc. De cette façon, nous pouvons avoir une vision globale de la prosodie italienne des origines jusqu'au XIXème siècle -vision qui permet de focaliser de manière exhaustive la technique de Leopardi. Dans la deuxième partie, l'auteur propose texte après texte la scansion de toute l'oeuvre poétique de Leopardi. Nous avons donc une lecture interprétative du rythíne de tous les poèmes qui tient compte de l'année de composition et les différentes typologies métriques des textes : par exemple, les canzoni, les idilli, les canti pisano-recanatesi. Dans cette deuxième partie, il faut souligner l'effort de lier la partition du rythme au contenu des différents textes.

Genetic Studies in Cabo Verde Archipelago

Blood group of ABO and MN systems, hemoglobin and haptoglobin were studied among immigrants from Cabo Verde working in Portugal. The origin, admixture and differentiation of the of populations of the archipelago are discussed.

Evaluación del stock norte – centro de la anchoveta peruana (Engraulis ringens Jenyns) por un modelo estadístico estructurado por edades

Se empleó un modelo poblacional estructurado por edades para estimar la abundancia, biomasa, biomasa desovante y el reclutamiento medio del stock norte – centro de la anchoveta peruana entre los años biológicos (octubre a setiembre) 1962-63 y 2007-08. El modelo, basado en un enfoque hacia adelante, fue optimizado minimizando las diferencias de los estimados del modelo y observaciones independientes de biomasa, desembarque y estructuras por edades de los desembarques. Los resultados muestran que han existido tres regímenes de productividad de dicho stock: el primero, entre 1962-63 y 1970-71, con la abundancia, biomasa, biomasa desovante y reclutamiento medio más altos; el segundo, entre 1971- 72 y 1990-91 con los niveles poblacionales más bajos; y el tercero, entre 1991-92 y 2007-08, con niveles intermedios. Parece claro que luego del colapso de las décadas de 1970 y 1980 el stock se ha recuperado de manera significativa aunque sin alcanzar los niveles de la década de 1960. Desde el año 2001-02 la biomasa desovante se ha mantenido por encima de cinco millones de toneladas, y la mortalidad por pesca ha mostrado una tendencia decreciente. Se demostró que el presente modelo estuvo en capacidad de captar la dinámica poblacional del stock norte – centro de la anchoveta validando su utilidad en las evaluaciones y monitoreo de la población de anchoveta.

Estandarización de la captura por unidad de esfuerzo (CPUE) de la flota industrial de cerco del stock norte-centro de la anchoveta peruana (Engraulis ringens Jenyns)

Se trabajó utilizando una metodología basada en Modelos Lineales Generalizados (MLG). La CPUE fue expresada en toneladas por duración de viaje. Las variables explicativas utilizadas fueron el año, mes, capacidad de bodega, latitud, inercia espacial y distancia a la costa. El modelo tuvo un coeficiente de determinación de 0,485, explicando casi la mitad de la variabilidad de la CPUE observada. La variable con mayor influencia en el modelo fue la capacidad de bodega (49% de la varianza explicada), debido posiblemente a que la flota anchovetera posee una capacidad elevada de captura y que los recursos pelágicos tienden a hiper-agregarse, incluso cuando están siendo fuertemente explotados. La correlación entre la CPUE estandarizada y biomasa estimada por un modelo de captura a la edad (r=0,74) indica que el método basado en MLG es recomendable para la estandarización de la CPUE. Se propone a esta CPUE como una alternativa para monitorear la biomasa de la anchoveta.

Domprosten Eino Sares 23.3.1964 Helsingfors

Kirje

Contaminación sobre el macrobentos en las Bahías de Mollendo, Ilo, e Ite en marzo y agosto de 1996

Expone los resultados de los muestreos realizados en marzo y agosto de 1996 en las bahías de Mollendo, Ilo, e Ite con el objeto de evaluar los efectos de la contaminación sobre el macrobentos de fondos blandos sublitorales.

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study.

OBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use.

Prospección pesquera costera del recurso calamar gigante o pota, Dosidicus gigas, Crucero BIP IMARPE V 9703-04

Presenta los resultados de la prospección pesquera, en lo referente a aspectos biológico-poblacionales y oceanográficos del calamar gigante o pota entre el 28 de marzo al 14 de abril de 1997.