Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Patients undergoing neurosurgery are predisposed to a variety of complications related to mechanical ventilation (MV). There is an increased incidence of extubation failure, pneumonia, and prolonged MV among such patients. The aim of the present study was to assess the influence of extubation failure and prolonged MV on the following variables: postoperative pulmonary complications (PPC), mortality, reoperation, tracheostomy, and duration of postoperative hospitalization following elective intra-cranial surgery. The study involved a prospective observational cohort of 317 patients submitted to elective intracranial surgery for tumors, aneurysms and arteriovenous malformation. Preoperative assessment was performed and patients were followed up for the determination of extubation failure and prolonged MV (>48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2%) experienced extubation failure and 30 (9.5%) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.

A study on the short-term effect of cafeteria diet and pioglitazone on insulin resistance and serum levels of adiponectin and ghrelin

The interaction between ghrelin and adiponectin is still controversial. We investigated the effect of cafeteria diet and pioglitazone on body weight, insulin resistance, and adiponectin/ghrelin levels in an experimental study on male Wistar rats. The animals were divided into four groups of 6 rats each, and received balanced chow with saline (CHOW-O) or pioglitazone (CHOW-P), or a cafeteria diet with saline (CAFE-O) or pioglitazone (CAFE-P). The chow/cafeteria diets were administered for 35 days, and saline/pioglitazone (10 mg·kg body weight-1·day-1) was added in the last 14 days prior to euthanasia. CAFE-O animals had a higher mean final weight (372.5 ± 21.01 g) than CHOW-O (317.66 ± 25.11 g, P = 0.017) and CHOW-P (322.66 ± 28.42 g, P = 0.035) animals. Serum adiponectin levels were significantly higher in CHOW-P (55.91 ± 20.62 ng/mL) than in CHOW-O (30.52 ± 6.97 ng/mL, P = 0.014) and CAFE-O (32.54 ± 9.03 ng/mL, P = 0.027) but not in CAFE-P. Higher total serum ghrelin levels were observed in CAFE-P compared to CHOW-P animals (1.65 ± 0.69 vs 0.65 ± 0.36 ng/mL, P = 0.006). Likewise, acylated ghrelin levels were higher in CAFE-P (471.52 ± 195.09 pg/mL) than in CHOW-P (193.01 ± 87.61 pg/mL, P = 0.009) and CAFE-O (259.44 ± 86.36 pg/mL, P = 0.047) animals. In conclusion, a cafeteria diet can lead to a significant weight gain. Although CAFE-P animals exhibited higher ghrelin levels, this was probably related to food deprivation rather than to a direct pharmacological effect, possibly attenuating the increase in adiponectin levels.

The consensus sequence of FAMLF alternative splice variants is overexpressed in undifferentiated hematopoietic cells

The familial acute myeloid leukemia related factor gene (FAMLF) was previously identified from a familial AML subtractive cDNA library and shown to undergo alternative splicing. This study used real-time quantitative PCR to investigate the expression of the FAMLF alternative-splicing transcript consensus sequence (FAMLF-CS) in peripheral blood mononuclear cells (PBMCs) from 119 patients with de novo acute leukemia (AL) and 104 healthy controls, as well as in CD34+cells from 12 AL patients and 10 healthy donors. A 429-bp fragment from a novel splicing variant of FAMLF was obtained, and a 363-bp consensus sequence was targeted to quantify total FAMLF expression. Kruskal-Wallis, Nemenyi, Spearman's correlation, and Mann-Whitney U-tests were used to analyze the data. FAMLF-CS expression in PBMCs from AL patients and CD34+ cells from AL patients and controls was significantly higher than in control PBMCs (P<0.0001). Moreover,FAMLF-CS expression in PBMCs from the AML group was positively correlated with red blood cell count (rs=0.317, P=0.006), hemoglobin levels (rs=0.210, P=0.049), and percentage of peripheral blood blasts (rs=0.256, P=0.027), but inversely correlated with hemoglobin levels in the control group (rs=–0.391, P<0.0001). AML patients with high CD34+ expression showed significantly higherFAMLF-CS expression than those with low CD34+ expression (P=0.041). Our results showed thatFAMLF is highly expressed in both normal and malignant immature hematopoietic cells, but that expression is lower in normal mature PBMCs.

Parboiled rice: chemical composition and the occurrence of mycotoxins

The objective of this work was to evaluate the incidence of aflatoxin B1 (AFB B1), deoxynivalenol (DON), ochratoxin A (OTA), and zearalenone (ZEA) in parboiled rice with respect to its chemical composition. Eight lots from five different brands of parboiled rice were collected in four samplings, at different seasons, until the amount of 32 lots. It was observed that: DON was present in 22% of the samples (from 180 to 400 ppb); ZEA in 19% (from 317 to 396 ppb); OTA in 12.5% (from 13 and 26 ppb); and AFB B1 in 9% (from 11 to 74 ppb). The results of the chemical composition were not different from those previously mentioned in the literature concerning parboiled rice. The ash and phenol levels in the contaminated parboiled rice samples suggested that those compounds had a relation to the occurrence of OTA, DON and ZEA mycotoxins.

Lectio praecursoria : rajaturvallisuuden käsite : kielellistä vallankäyttöä vai pelon maantiedettä?

HTT Markus Heiskasen hallintotieteen alaan kuuluva väitöskirja "Rajakeisarin uudet (v)aatteet. Käsiteanalyysi rajaturvallisuudesta" tarkastettiin 8.6.2013 Lapin yliopistossa.

Qualidade de vida de pacientes renais crônicos em diálise peritoneal e hemodiálise

ResumoIntrodução:Há controvérsias quanto à qualidade de vida (QV) de pacientes renais crônicos tratados com diferentes métodos dialíticos.Objetivo:Comparar a QV de pacientes renais crônicos em diálise peritoneal (DP) e hemodiálise (HD).Métodos:Estudo transversal nos três centros de diálise de Pelotas/RS. Pacientes em DP foram entrevistados após consulta mensal de rotina e os em HD, entre 1ª-2ª horas da sessão dialítica, com questionário estruturado. QV foi avaliada com Short-Form Health Survey (SF-36). Médias dos oito domínios do SF-36 foram comparadas entre os grupos.Resultados:Dos 345 pacientes elegíveis (63 em DP e 282 em HD), foram entrevistados 317 (8% de perdas/recusas). Cerca da metade nos dois grupos estava em diálise há no máximo 3 anos. Havia maioria de mulheres em DP e de homens em HD. Pacientes em DP relataram menos "dor" do que os em HD (escores médios 76,5 e 64,3, respectivamente; p = 0,0040). Não houve diferença nos demais domínios do SF-36.Discussão:A utilização de HD em Pelotas é um pouco menor que a detectada pelo Censo Brasileiro de Diálise (2011), sendo o uso de DP semelhante ao de alguns países europeus. Melhor escore no domínio "dor" entre pacientes em DP é consistente com o observado em outros estudos, embora haja também relatos de nenhuma diferença entre as modalidades e de vantagens da DP em outros domínios que não foram detectados no atual estudo.Conclusão:É semelhante a QV dos pacientes em DP ou HD, exceto no domínio dor, que foi menos intensa entre os pacientes em DP.

Componentes do rendimento e produção de sementes de Adesnia latifolia (Spreng.) em duas regiões fisiográficas do Rio Grande do Sul

Com o objetivo de estudar os componentes do rendimento de sementes e a produção de sementes de Adesmia latifolia em duas regiões fisiográficas do Rio Grande do Sul (Depressão Central - DC, 30°S, 51°W, e Encosta Superior do Nordeste - ESN, 28°S, 51°W), nos anos de 98/99 e 99/00, conduziu-se trabalho na Estação Experimental Agronômica (EEA) da Universidade Federal do Rio Grande do Sul (UFRGS), em Eldorado do Sul, e no Centro de Pesquisa da Pequena Propriedade da Fundação Estadual de Pesquisa Agropecuária (FEPAGRO), em Veranópolis. No primeiro ano, as maiores produções de sementes foram observadas na ESN, alcançando produções de até 317 kg.ha-1 em 12/12/98, enquanto que na DC isto foi verificado em 22/12/98, com 110 kg.ha-1. Ao contrário, no segundo ano, as maiores produções foram obtidas na DC (97 kg.ha-1) em 30/11/99, enquanto que na ESN as produções obtidas foram inferiores (56 kg.ha-1) em 26/11/99. Verifica-se que no primeiro ano as produções de sementes, em ambas as regiões foram superiores as do segundo ano. Isto ocorreu principalmente porque os componentes do rendimento, número de flores/inflorescência, número de frutos maduros/inflorescência e peso de 1000 sementes foram superiores no primeiro ano.

Rymättylän ja Merimaskun yleissuunnitelma : Rantojen monikäyttö, luonnon monimuotoisuus, kosteikot ja suojavyöhykkeet

Naantalissa, Rymättylän ja Merimaskun alueella tehtiin kesällä ja syksyllä 2015 maatalousalueiden kosteikkojen, suojavyöhykkeiden ja luonnon monimuotoisuuskohteiden sekä ranta-alueiden monikäytön yleissuunnitelma. Ranta-alueiden suunnittelussa tarkastellaan ranta-alueiden monikäyttöä ja arvioidaan erityisesti ruovikoihin liittyviä toimenpiteitä. Suunnittelun tavoitteena oli löytää potentiaalisia rantaniittyjä ja ruovikoita hoi-don piiriin. Maatalousalueiden yleissuunnittelussa tuodaan näkyväksi alueet, joilla luonnon monimuotoisuutta tai vesien tilaa voidaan kohentaa. Suunnitelmassa on selvitetty alueen suojavyöhyketarpeet, esitetty maata-louskosteikkojen perustamispaikkoja sekä tuotu esille luonnon ja maiseman monimuotoisuuskohteita sekä perinnebiotooppeja. Ranta-alueiden monikäytön yleissuunnittelun kohteena olivat ranta-alueet Rymättylän pohjoisosassa ja Merimaskun länsiosan alueella. Maatalousalueiden kosteikkojen, suojavyöhykkeiden ja luonnon monimuotoisuus-kohteiden yleissuunnittelu kattaa Rymättylän pohjoisosan lisäksi Airismaan sekä Aaslaluodon. Monimuotoisuusalueiden, kosteikkojen ja suojavyöhykkeiden kartoitukset pohjautuivat ProAgria Suomen Talousseuran aikaisempiin tarvekartoitushavaintoihin, joita tehtiin hankkeen Tasapainoa luontoon aikana vuosina 2010–2014. Kartoituksen yhteydessä tarkasteltiin myös Turun AMK:n Niukonlahden vesiensuojeluohjelmaa 2013. Suunnitelmalla pyritään auttamaan viljelijää hyödyntämään maatalouden ympäristökorvausjärjestelmää. Kohteiden maininta suunnitelmassa ei sido eikä velvoita maanomistajaa toimenpiteisiin vaan yleissuunnitelman tietoja voidaan hyödyntää kohteiden kunnostusta ja hoitoa suunniteltaessa.