Incorporation and washout of n-3 PUFA after high dose intravenous and oral supplementation in healthy volunteers.

BACKGROUND & AIMS: Although the physiological effects of n-3 polyunsaturated fatty acids (n-3PUFA) are generally thought to require several weeks of exposure to allow their incorporation into plasma membranes, intravenous (IV) n-3PUFA attenuate the cardiovascular and neuroendocrine response to stress within 3 h. Whether oral n-3 PUFA exert similar early effects remains unknown. OBJECTIVE: To assess whether acute IV or short term oral n-3PUFA administration reproduces the metabolic effects of long term oral supplements during exercise, and how it relates to their incorporation into platelets and red blood cells (RBC) membranes. DESIGN: Prospective single center open label study in 8 healthy subjects receiving a 3-h infusion of 0.6 g/kg body weight n-3PUFA emulsion, followed one week later by an oral administration of 0.6 g/kg over 3 consecutive days. Maximal power output (cycling exercise), maximal heart rate (HR), blood lactate at exhaustion, and platelet function were measured at baseline and after IV or 3-day oral supplementation; platelet and RBC membrane composition were assessed until 15 days after n-3PUFA administration. RESULTS: Both IV and oral n-3PUFA significantly decreased maximal HR (-6% and -5%), maximal power output (-10%) and peak blood lactate (-47% and -52%) Platelet function tests were unchanged. The EPA and DHA membrane contents of RBC and platelets increased significantly, but only to 1.7-1.9% of fatty acid content. CONCLUSION: The cardiovascular and metabolic effects of n-3 PUFA during exercise occur already within 1-3 days of exposure, and may be unrelated to changes in membranes composition. Effects occur within hours of administration and are unrelated to lipid membrane composition. Trial registered at clinicaltrials.gov as NCT00516178.

Bowel ischemia: a rare complication of thiopental treatment for status epilepticus.

BACKGROUND: Refractory status epilepticus (RSE) treatment is usually performed with coma induction using an appropriate general anesthetic. Most frequent complications are represented by hypotension and infection. Other side-effects may however be encountered. OBSERVATIONS: We describe two patients suffering from acute bowel ischemia after thiopental (THP) treatment for RSE. A 73-year-old man with a complex-patial RSE following an acute stroke received THP (303 mg/kg over 48 h); 36 h after THP discontinuation, he presented abdominal tenderness and lactate elevation. Necrosis of the terminal ileum and colon was seen during surgical exploration; he deceased shortly thereafter. A 21 year-old woman had a cryptogenic de novo generalized-convulsive RSE resistant to 5 attempts of EEG burst-suppression. During the 6th attempt, after THP (840 mg/kg over 150 h) together with mild hypothermia, she developed an ileus with elevated serum lactate; caecum necrosis was observed during surgery. Hypernatremia, acidosis and hyperlactatemia heralded this complication in both patients. CONCLUSION: In these two patients, mechanical vascular ischemia may have resulted from drug-induced paralytic ileus. To our knowledge, this is the first report describing this potential fatal side effect in adults with RSE.

Magnetoelectricity in the ferrimagnetic Cu2OSeO3: symmetry analysis and Raman scattering study

sublattices ferrimagnet Cu2OSeO3 with a cubic symmetry and a linear magnetoelectric effect. There is no spectroscopic evidence for structural lattice distortions below T-C=60 K, which are expected due to magnetoelectric coupling. Using symmetry arguments we explain this observation by considering a special type of ferrimagnetic ground state which does not generate a spontaneous electric polarization. Interestingly, Raman scattering shows a strong increase of electric polarization of media through a dynamic magnetoelectric effect as a remarkable enhancement of the scattering intensity below T-C. New lines of purely magnetic origin have been detected in the magnetically ordered state. A part of them are attributed as scattering on exchange magnons. Using this observation and further symmetry considerations we argue for strong Dzyaloshinskii-Moriya interaction existing in the Cu2OSeO3. (c) 2010 American Institute of Physics. [doi:10.1063/1.3455808]

Iowa Historic Property Study of the Zeman Barn, 2009

The Zeman Barn (86-00028) is an early twentieth-century example of a gothic roofed barn and is part of the Zeman Farmstead located along U.S. Highway 30 in Otter Creek Township (Township 38N, Range 14W), Tama County, Iowa (Figures 1 and 2). The farmstead was initially evaluated in a reconnaissance architectural survey conducted in 1998 by The Louis Berger Group, Inc (Berger). An intensive architectural survey of the property by Berger’s Principal Architectural Historian, Martha H. Bowers, evaluated the farmstead as not being eligible for listing in the National Register of Historic Places (National Register) but noted that the barn appears to be eligible for listing in the National Register under Criterion C (Bowers 1998). At the request of the Iowa Department of Transportation, Berger completed the recordation project to provide a documentary record of the Zeman Barn in accordance with the guidelines set forth by the Iowa State Historic Preservation Office regarding historic property studies for barns. Background research for this project was conducted in September 2008 and April 2009. The property was inspected and photographed in May 2008. Information on the property was gathered through background research, interviews with Zeman family members, field investigation, and photo documentation. Historical maps of the project area were used to collect data necessary for developing regional and local historic contexts. The research for this report was conducted at the Tama County Courthouse and the Tama County Historical Museum Genealogical Library, both in Toledo. Much of the background research for the project was conducted by Camilla Deiber and Michael Dulle. Ms. Deiber also prepared the photographic documentation, plan drawings, and the graphics used in this report. Mr. Roger L. Ciuffo conducted interviews with Zeman family members and wrote this report.

How to prescribe nutritional support using computers.

As other intensive care unit (ICU) therapies, nutritional support has become more complex requiring tight supervision and monitoring. It has repeatedly been shown that despite awareness of guidelines and prescription of the recommended amounts of energy (25 kcal/kg), underfeeding remains a prominent problem worldwide. In patients with prolonged stays, overfeeding has also become an issue. This lack of fit between prescription and delivery is largely caused by the lack of visibility of the nutritional results to nurses and clinicians. Computerized systems have brought major improvements, mainly through the customization of nutrition relevant variables in a single place, making them visible. Another important point is the possibility to change the ICU time constant to days and weeks which is the delay relevant for nutritional changes to appear, instead of minutes and hours which are more relevant for critical care.

Resiliència i èxit escolar en l’alumnat de secundària de procedència estrangera. Diagnòstic i línies d’intervenció

L’estudi realitzat aborda i caracteritza des de l’enfocament de la resiliència com l’alumnat de procedència estrangera s’enfronta a una etapa d’alt risc d’abandonament escolar com és l’Educació Secundària Obligatòria (ESO) –especialment en el segon cicle– i el moment de transició acadèmica cap a la Postobligatòria (PO). En altres paraules, s’analitzen i valoren els mecanismes resilients desplegats per l’alumnat immigrant que donen llum sobre com aconseguir que processos, a priori, qualificats com a problemàtics o dificultosos per aquests grups degut a la seva situació de major vulnerabilitat esdevinguin una xarxa protectora que afavoreixi trajectòries d’èxit escolar. L’emmarcament conceptual des de la resiliència educativa, en general, ha centrat la seva atenció en la capacitat de l’individu per “compensar” certes limitacions amb altres habilitats. Tanmateix, la definició de resiliència a la qual ens hem aferrat té un caire més ecològic i culturalment sensible. És la definició proposada pel Resilience Research Centre (RRC) i encunyada pel seu co-director Michael Ungar: In the context of exposure to significant adversity, resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided in culturally meaningful ways (Ungar, 2012). Entesa d’aquesta manera, la resiliència és un constructe social que identifica els processos i resultats relacionats amb allò que la gent conceptualitza com a “benestar”. Així, es més probable que la resiliència aparegui quan es proporcionin els serveis, suports i recursos que garanteixen el benestar de tots els nens/es des d’una perspectiva que sigui significativa tant per a l’individu, com per la seva família i comunitat...

Déterminants précoces de la mortalité du patient âgé gravement brûlé

Introduction : Avec le vieillissement de la population, le nombre de patients brûlés âgés a augmenté. La prise en charge médicale et chirurgicale globale des brûlés s'est nettement améliorée mais demeure difficile dans cette population vulnérable. Il manque des facteurs prédictifs précoces pour prédire la mortalité de ces patients. Cette étude a pour objectif d'essayer d'en identifier certains. Méthodes : Etude descriptive rétrospective de données collectées prospectivement dans un système informatisé (MetaVision®) sur une période qui s'étend de janvier 2001 à décembre 2010: 53 variables sont colligées et soumises à des analyses univariées en fonction du devenir chez des patients âgés de plus de 50ans. Résultats : 101 patients sur 363 admissions pendant la même période ont été étudiés : ils sont âgés de 66.6 ± 11.9 ans, brûlés sur 21.5 ± 14.9 % surface corporelle (BSA), et 16 sont décédés (15.8%). Vingt variables sont statistiquement significativement associées avec un décès : BSA, % de brûlure chirurgicale, score de BAUX, BAUX modifié, abbreviated burn severity index (ABSI), SAPS II, insuffisance rénale aiguë et chronique, cardiopathie ischémique, pression intra-abdominale élevée (y.c. syndrome du compartiment abdominal), bilan liquidien cumulé à J5 et à J10, sur-réanimation liquidienne, usage de plasma frais congelé, albuminémie, CRP, bicarbonates, créatinine et nutrition entérale. Conclusion : Plusieurs variables cliniques , certains déjà identifiés, mais également plusieurs nouveaux liés à la réponse physiologique du patient. Une étude ont été identifiées comme étant associés à un pronostic défavorable des patients brûlés âgés incluant un nombre plus élevé de patients permettrait de faire des analyses multivariées et de dégager des facteurs prédictifs combinés.

Impact of antiviral preventive strategies on the incidence and outcomes of cytomegalovirus disease in solid organ transplant recipients.

We assessed the impact of antiviral prophylaxis and preemptive therapy on the incidence and outcomes of cytomegalovirus (CMV) disease in a nationwide prospective cohort of solid organ transplant recipients. Risk factors associated with CMV disease and graft failure-free survival were analyzed using Cox regression models. One thousand two hundred thirty-nine patients transplanted from May 2008 until March 2011 were included; 466 (38%) patients received CMV prophylaxis and 522 (42%) patients were managed preemptively. Overall incidence of CMV disease was 6.05% and was linked to CMV serostatus (D+/R- vs. R+, hazard ratio [HR] 5.36 [95% CI 3.14-9.14], pâeuro0/00<âeuro0/000.001). No difference in the incidence of CMV disease was observed in patients receiving antiviral prophylaxis as compared to the preemptive approach (HR 1.16 [95% CI 0.63-2.17], pâeuro0/00=âeuro0/000.63). CMV disease was not associated with a lower graft failure-free survival (HR 1.27 [95% CI 0.64-2.53], pâeuro0/00=âeuro0/000.50). Nevertheless, patients followed by the preemptive approach had an inferior graft failure-free survival after a median of 1.05 years of follow-up (HR 1.63 [95% CI 1.01-2.64], pâeuro0/00=âeuro0/000.044). The incidence of CMV disease in this cohort was low and not influenced by the preventive strategy used. However, patients on CMV prophylaxis were more likely to be free from graft failure.