Endocarditis infecciosa : significado de la disfunción renal

Objetivo: Determinar la significación clínica y pronóstica de la disfunción renal en pacientes con Endocarditis Infecciosa (EI) Material y método: Estudio protocolizado, descriptivo, observacional y transversal de pacientes con EI diagnosticados según criterios de Duke. Se realizó un análisis comparativo entre los pacientes con EI sin (Grupo Sin) y con Disfunción Renal (Grupo DR), que se definió en base a uremia > 0.60 g/l y/o creatininemia > 1.5 mg/dl y/o hematuria o proteinuria. Fueron analizados en EPI info 6.04. Resultados: De un total de 110 EI incluidas, 58 (52.7%) presentaron DR principalmente secundaria a glomerulonefritis (n 22), sepsis (n 14), insuficiencia renal crónica (n 5), insuficiencia cardíaca, nefropatía diabética y nefrotoxicidad (n 4 cada una) y embólica (n 1). No hubo diferencias en la permanencia media hospitalaria (32 DS±23.3 vs 26.32 DS±17.28 días), el sexo (masculino: 60.3 vs 71.25%) y la demora diagnóstica (5.5 (DS±7.23) vs. 5.4 (DS±7.64 días)(pNS). La edad media fue mayor en el grupo DR en el LS (49.62 DS±15.71 vs 43.53 DS±17.94 años). El Grupo DR tuvo mas frecuentemente EI Definida (87.9 vs 67.3%) (p=0.0089) y no hubo diferencias en la localización Mitral (48.3 vs 48.1%) y Aórtica (44.8 vs 34.6%). La valvulopatía degenerativa se presentó en el LS en DR (34.5 VS 19.6%)(p=0.07). No hubo diferencias en la presencia de comórbidas (62.1 vs 71.2%) (pNS) pero la enfermedad últimamente fatal ocurrió mas frecuentemente en DR (51.4 vs 21.6%)(p=0.05). Al ingreso sólo la presencia de rales pulmonares (53.4 vs 32.7%) y púrpura cutánea (27.6 vs 13.5%) fueron más frecuentes en DR (p=0.05). La sepsis no controlada (34.5 vs 15.7%), insuficiencia cardíaca (51.7 vs 32.7%), encefalopatía (50 vs 27.5%), shock séptico (24.1 vs 7.8%) y fallo multiorgánico (34.5 vs 3.9%) fueron complicaciones más frecuentes en DR (p<0.05). La fiebre persistente se encontró en el LS en el grupo de DR (48.3 vs 32.7%)(p=0.09). No hubo diferencias en el hallazgo de vegetaciones por ecocardiografía (83.3 vs 75.6%). La anemia (Hb<9 mg/dl) (31.86 DS±53.41 vs 35.21 DS±7.85)(p=0.009), hipergammaglobulinemia (58.5 vs 29.8)(p=0.006) e hiperglucemia (36.1 vs 18.5)(p=0.03) se asociaron a DR. En el grupo con DR fue mas común la EI con cultivos negativos (31.5 vs 0%)(p=0.001) y el predominio de las infecciones por S. aureus Meticilino Resistente (MRSA)(21.6 vs 2.7%) (p=0.02). No hubo diferencias en la indicación de cirugía (31 vs 36.5%). La mortalidad hospitalaria fue significativamente mayor en DR (51.7 vs 25%)(p=0.0041)(OR 3.2, IC95%1.42-7.24). Conclusión: En los pacientes con EI la disfunción renal resultó ser un indicador de desarrollo de complicaciones infecciosas y cardíacas, de infección por MRSA y de mortalidad cruda hospitalaria.-

Pollen record from Golkow, Poland

Janczyk-Kopikowa (1966): The series of the organic deposits, developed in the vicinity of Golkow near Warsaw as oil shales and peats, was laid down in a grough valley and now rests on the deposits of the Middle Polish Glaciation (Riss). The organic deposits are overlain by the fluviale deposits of the North Polish Glaciation (Würm). The locality Golkow occurs beyond the extent of the continental glacier of this glaciation. Polen analysis completed by microfloristic examinations allows to determine the age of the organic series that is thought to be Eemian. The pollen diagram from Golkow does not call in question the stratigraphical position of the deposits investigated mainly due to its characteristic features such as minimum content of coniferous trees in the climatic optimum - about 5%, high percentage of Corylus - 77.5% and well developed phase of hornbeam. It may be well compared with other Eemian diagrams from the area of Poland and reveals much similar features. The development of vegetation at Golkow has depended upon the prevailing climate. At first, the cool climate brings about the development of plants having small thermal requirements. Here belong thin, park-like forests with pine and birch (Pinus, Betula) accompanied by the heliophilic plants such as Hippohäe and Ephedra. Improvement of climate that becomes warm and humid provides for development of deciduous forests prevailing in the climatic optimum, of the interglacial. Decrease of temperature causes a repeated change in the type of forest. This latter changes into coniferous forest with prevailing spruce (Picea) and fir (Abies) at the beginning, and then with pine (Pinus) and birch (Betula). During the Eemian Interglacial, the development of plants at Golkow terminates with a new and long-lasting predominance of pine-birch forests. However, such a longevity may be apparent only. Apparent character of this phenomenon is proved by a fact that the pollen spectra of the warm climatic periods have found their reflex in the oil shale that increased considerably slower than the layers off feebly decomposed peat evidencing the existence of cool pine-birch forests from the decline of the Interglacial. The water basin, in which the polen grains were laid down from surrounding plants is characterized by a calm sedimentation as proved by the occurrence of the oil shale. An insignificant water flow left behind some thin sand laminae. The not too deep basin becomes shallower owing to the growing water vegetation, and marshy vegetation. The growing of the plants causes a complete shallowing of the basin and formation of peat bog in situ, as proved by the peat beds occurring in the section. ---- Gadomska (1966): In the vicinity of Golków a series of organic deposits occurs amounting to 6.5-9.3 m in thickness, and consisting of oil shales, lacustrine silts and sands, as well as peats and peaty silts. The organic deposits fill up an old, small, but fairly deep lake basin, probably of finger-lake origin. It may be seen to-day as a slight lowering of the relief, filled up with soaked ground, stretching from north to south. On the basis of palaeobotanical examinations the organic deposits considered are of Eemian Interglacial age (Z. Janczyk-Kopikowa, 1063). The lower part of the organic series consists of a compact oil shale horizon, the maximum thickness of which may attain up to 8 m. The oil shales contain particularly in their upper part, numerous intercalations of arenaceous silts, dark grey or black in colour, or of sands mainly of lacustrine provenance. At the top of the oil shales are found peats, up to 2.5 m in thickness, covered by black, humus silts with numerous plant remains. The Eemian Interglacial deposits are covered by a series of fluviatile sands belonging partly to the Baltic Glaciation (bottom part of the series), partly to the Holocene (top part of the series). The thickness of the sands is 0.5-3.7 m. Higher up, there are found the Holocene and present-day deposits developed as clayey alluvion, or arenaceous slide rocks, or arenaceous-silty soil.

Flow separation and roughness lengths over large bedforms in a tidal environment

This study characterises the shape of the flow separation zone (FSZ) and wake region over large asymmetric bedforms under tidal flow conditions. High resolution bathymetry, flow velocity and turbulence data were measured along two parallel transects in a tidal channel covered with bedforms. The field data are used to verify the applicability of a numerical model for a systematic study using the Delft3D modelling system and test the model sensitivity to roughness length. Three experiments are then conducted to investigate how the FSZ size and wake extent vary depending on tidally-varying flow conditions, water levels and bathymetry. During the ebb, a large FSZ occurs over the steep lee side of each bedform. During the flood, no flow separation develops over the bedforms having a flat crest; however, a small FSZ is observed over the steepest part of the crest of some bedforms, where the slope is locally up to 15°. Over a given bedform morphology and constant water levels, no FSZ occurs for velocity magnitudes smaller than 0.1 m s**-1; as the flow accelerates, the FSZ reaches a stable size for velocity magnitudes greater than 0.4 m s**-1. The shape of the FSZ is not influenced by changes in water levels. On the other hand, variations in bed morphology, as recorded from the high-resolution bathymetry collected during the tidal cycle, influence the size and position of the FSZ: a FSZ develops only when the maximum lee side slope over a horizontal distance of 5 m is greater than 10°. The height and length of the wake region are related to the length of the FSZ. The total roughness along the transect lines is an order of magnitude larger during the ebb than during the flood due to flow direction in relation to bedform asymmetry: during the ebb, roughness is created by the large bedforms because a FSZ and wake develops over the steep lee side. The results add to the understanding of hydrodynamics of natural bedforms in a tidal environment and may be used to better parameterise small-scale processes in large-scale studies.

Nd bulk isotopes and 40Ar/39Ar ages of individual minerals from Aurora and Wilkes sub-glacial basin sediments

The Wilkes and Aurora basins are large, low-lying sub-glacial basins that may cause areas of weakness in the overlying East Antarctic ice sheet. Previous work based on ice-rafted debris (IRD) provenance analyses found evidence for massive iceberg discharges from these areas during the late Miocene and Pliocene. Here we characterize the sediments shed from the inferred areas of weakness along this margin (94°E to 165°E) by measuring40Ar/39Ar ages of 292 individual detrital hornblende grains from eight marine sediment core locations off East Antarctica and Nd isotopic compositions of the bulk fine fraction from the same sediments. We further expand the toolbox for Antarctic IRD provenance analyses by exploring the application of 40Ar/39Ar ages of detrital biotites; biotite as an IRD tracer eliminates lithological biases imposed by only analyzing hornblendes and allows for characterization of samples with low IRD concentrations. Our data quadruples the number of detrital 40Ar/39Ar ages from this margin of East Antarctica and leads to the following conclusions: (1) Four main sectors between the Ross Sea and Prydz Bay, separated by ice drainage divides, are distinguishable based upon the combination of 40Ar/39Ar ages of detrital hornblende and biotite grains and the e-Nd of the bulk fine fraction; (2) 40Ar/39Ar biotite ages can be used as a robust provenance tracer for this part of East Antarctica; and (3) sediments shed from the coastal areas of the Aurora and Wilkes sub-glacial basins can be clearly distinguished from one another based upon their isotopic fingerprints.

Chemial and isotope compositions of rocks from the West Antarctic

The paper is devoted to a marine geophysical-geological research in the West Antarctic. This researche contributed to establishing the base geodesic network of the West Antarctic and supplemented geokinematic monitoring based on this network with geophysical and geologic information on structure and features of geomorphological and tectonic development of the South Ocean floor. Collected materials allow to conclude about the inhomogeneity of the Scotia Sea floor and about combination of fragments of a continental massif with young rift structures in conditions of the upwelling mantle. The ancient continental bridge, faunal connections between the South America and the West Antarctic has been destroyed by processes of destruction, taphrogeny and sea floor spreading. Structures of the Scotia and Caribbean Seas, North Fiji and Arctic Basins are similar.

Crustaceans and fish abundances and species at and around artificially introduced tetrapod fields in the southern North Sea, 2010-2011

In the coming decades, artificial defence structures will increase in importance worldwide for the protection of coasts against the impacts of global warming. However, the ecological effects of such structures on the natural surroundings remain unclear. We investigated the impact of experimentally introduced tetrapod fields on the demersal fish community in a hard-bottom area in the southern North Sea. The results indicated a significant decrease in fish abundance in the surrounding area caused by migration effects towards the artificial structures. Diversity (HB) and evenness (E) values exhibited greater variation after the introduction of the tetrapods. Additionally, a distinct increase in young-of-the-year (YOY) fish was observed near the structures within the second year after introduction. We suggest that the availability of adequate refuges in combination with additional food resources provided by the artificial structures has a highly species-specific attraction effect. However, these findings also demonstrate that our knowledge regarding the impact of artificial structures on temperate fish communities is still too limited to truly understand the ecological processes that are initiated by the introduction of artificial structures. Long-term investigations and additional experimental in situ work worldwide will be indispensable for a full understanding of the mechanisms by which coastal defence structures interact with the coastal environment.

Chemical and isotopic compositions of groundwaters in the Badain Jaran Desert, Northern China

Despite its extreme aridity the Badain Jaran Desert is rich in groundwater. In the southeastern part of this desert it is characterized by coexistence of high megadunes and a great number of lakes. Deuterium and oxygen 18 isotope compositions as well as hydrochemistry of groundwater, lake water, soil water and river water were investigated in detail to gain an insight into their relationships and the origin of the groundwater. The results show that the groundwater and the lake water are genetically related, but unrelated to local precipitation and the leakage of Heine River at the northern slope of the Qilian mountain. dD and d18O values of deep soil water (deeper than 40 cm) and groundwater plot on the same evaporation line E11, which shows that they have the same recharge source. The point of intersection between E11 and LMWL suggests that the groundwater originates from a water resource, which has a weighted mean value that is lighter by some 6 per mil d18O than local precipitation in Badain Jaran Desert. 3H data of water samples show that the groundwater in the Badain Jaran Desert originates from water recharged after the nuclear test. The deep fault zone underground maybe a water circulation channel based on helium analysis of groundwater. The result has guiding significance to rational exploitation and utilization of the local groundwater.

Flow conditions, bed form dimensions and shear stress experiments

Large asymmetric bed forms commonly develop in rivers. The turbulence associated with flow separation that develops over their steep lee side is responsible for the form shear stress which can represent a substantial part of total shear stress in rivers. This paper uses the Delft3D modeling system to investigate the effects of bed form geometry and forcing conditions on flow separation length and associated turbulence, and bed form shear stress over angle-of-repose (30 lee side angle) bed forms. The model was validated with lab measurements that showed sufficient agreement to be used for a systematic analysis. The influence of flow velocity, bed roughness, relative height (bed form height/water depth), and aspect ratio (bed form height/length) on the variations of the normalized length of the flow separation zone, the extent of the wake region (where the turbulent kinetic energy (TKE) was more than 70% of the maximum TKE), the average TKE within the wake region and the form shear stress were investigated. Form shear stress was found not to scale with the size of the flow separation zone but to be related to the product of the normalized extent of the wake region (extent of the wake region/extent of water body above the bed form) and the average TKE within the wake region. The results add to understanding of the hydrodynamics of bed forms and may be used for the development of better parameterizations of smallscale processes for application in large-scale studies.

Bacterioplankton and bacteriobenthos in surface layer waters and sediments between the Sakhalin Island and the Eastern Asia in June 2006

This work presents results of a study of plankton and benthic microbiocenoses of the Amur River estuary. It is shown that distribution of total abundance and indicator groups of bacteriobenthos are characterized by stronger heterogeneity compared with bacterioplankton and that it depends on the Amur River runoff and bottom type. The river runoff helps by increasing overall bacterioplankton abundance in the near-mouth part of the estuary. Microorganisms utilizing low concentrations of organic matter (OM) play major role in processes of OM utilization in water and bottom sediments. Saprophytic bacteria play a significant role in OM utilization only in water at certain sampling sites in the Tatarsky Strait and Sakhalin Bay and in bottom sediments sampled in the mouth part of the estuary. Some parts of the estuary subjected to organic contamination are found according to microbiological characteristics. It is shown that fluctuation of salinity leads to change of the role of bacteria with different food demands in the microbial community.