Clinical relevance of L-carnitine-supplemented total parenteral nutrition in postoperative trauma. Metabolic effects of continuous or acute carnitine administration with special reference to fat oxidation and nitrogen utilization.

Carnitine-free total parenteral nutrition (TPN) is claimed to result in a carnitine deficiency with subsequent impairment of fat oxidation. The present study was designed to evaluate the possible benefit of carnitine supplementation on postoperative fat and nitrogen utilization. Sixteen patients undergoing total esophagectomy were evenly randomized and received TPN without or with L-carnitine supplementation (74 mumol.kg-1.d-1) during 11 postoperative days. On day 11, a 4-h infusion of L-carnitine (125 mumol/kg) was performed in both groups. The effect of supplementation was evaluated by indirect calorimetry, N balance, and repeated measurements of plasma lipids and ketone bodies. Irrespective of continuous or acute supplementation, respiratory quotient and fat oxidation were similarly maintained throughout the study in both groups whereas N balance appeared to be more favorable without carnitine. We conclude that carnitine-supplemented TPN does not improve fat oxidation or promote N utilization in the postoperative phase.

Ureia de liberação lenta em substituição ao farelo de soja na terminação de bovinos confinados

Resumo: O objetivo deste trabalho foi avaliar o efeito da substituição da proteína bruta do farelo de soja pela ureia de liberação lenta sobre o desempenho, as características de carcaça e o custo alimentar de bovinos Nelore terminados em confinamento. Foram utilizados 48 machos inteiros da raça Nelore, com idade média de 22 meses e peso inicial de 367,95±18,52 kg. Utilizou-se o delineamento inteiramente casualizado com quatro tratamentos: FS, 8,91% de farelo de soja e 0% de ureia de liberação lenta (ULL); OP33, 6,01% de farelo de soja e 0,46% de ULL; OP67, 2,94% de farelo de soja e 0,94% de ULL; e OP100, 0% de farelo de soja e 1,41% de ULL. Não houve diferença entre os tratamentos para as variáveis peso inicial, peso final, ganho médio diário, ganho de carcaça, consumo de matéria seca, conversão alimentar, eficiência biológica, peso de carcaça quente, rendimento de carcaça e custo alimentar da arroba produzida. A ureia de liberação lenta, usada em substituição parcial ou total à proteína do farelo de soja na dieta, não altera o desempenho, as características de carcaça e a eficiência econômica de bovinos de corte confinados.

Total synthesis of aeruginazole A

The first total synthesis of Aeruginazole A, prepared via a convergent strategy that involved both solid-phase peptide synthesis and solution phase chemistry and that enabled conservation of the stereochemistry of the intermediates, is reported.

Soft tissue artifact assessment during treadmill walking in subjects with total knee arthroplasty.

Accurate measurement of knee kinematics during functional activities suffers mainly from soft tissue artifact (STA): the combination of local surface deformations and rigid movement of markers relative to the underlying bone (also called rigid STA movement: RSTAM). This study proposes to assess RSTAM on the thigh, shank, and knee joint and to observe possible features between subjects. Nineteen subjects with knee arthroplasty were asked to walk on a treadmill while a biplane fluoroscopic system (X-rays) and a stereophotogrammetric system (skin markers) recorded their knee movement. The RSTAM was defined as the rigid movement of the cluster of skin markers relative to the prosthesis. The results showed that RSTAM amplitude represents approximately 80-100% of the STA. The vertical axis of the anatomical frame of the femur was influenced the most by RSTAM. Combined with tibial error, internal/external rotation angle and distraction-compression were the knee kinematics parameters most affected by RSTAM during the gait cycle, with average rms values of 3.8° and 11.1 mm. This study highlighted higher RSTAM during the swing phase particularly in the thigh segment and suggests new features for RSTAM such as the particular shape of some RSTAM waveforms and the absence of RSTAM in certain kinematics during the gait phases. The comparison of coefficient of multiple correlations showed some similarities of RSTAM between subjects, while some correlations were found with gait speed and BMI. These new insights could potentially allow the development of new methods of compensation to avoid STA.

El análisis de la comunicación, en todos sus vectores, de la marca Custo – Barcelona, España 2010 – 2013

El present projecte final de carrera analitza dos aspectes importants que influeixen en la societat actual, la Moda i la Comunicació, i intenta ser una eina útil per entendre la relació existent entre tots dos. En concret s’ha realitzat el estudi amb el fenòmen Custo Barcelona en tots els seus aspectes. La considerada firma espanyola ha aconseguit posicionar-se com un referent en innovació, tant en les seves tècniques tèxtils com en termes de marketing i comunicació, i aconsegueix crear un sentiment de pertinença a la marca per l’exclusivitat en les seves accions. D’aquesta manera, podem parlar de “Custofilosofía”.

Applying the Total Quality Management Method in ICT Business

Kokonaisvaltaisen laatujohtamisen malli TQM (Total Quality Management) on noussut yhdeksi merkittävimmistä konsepteista globaalissa liiketoiminnassa, missä laatu on tärkeä kilpailutekijä. Tämä diplomityö pureutuu nykyaikaiseen kokonaisvaltaisen laatujohtamisen konseptiin, joka nostaa perinteisen laatuajattelun uudelle tasolle. Moderni laatujohtamisajattelu on kasvanut koskemaan yrityksen toiminnan kaikkia osa-alueita. Työn tavoitteena on TietoEnator Käsittely ja Verkkopalvelut liiketoiminta-alueen osalta laadun sekä liiketoiminnallisen suorituskyvyn parantaminen kokonaisvaltaisesti. Ennen varsinaisen laatujohtamis-konseptin käsittelyä työ esittelee ensin yleisellä tasolla perinteistä laatu käsitettä sekä käsittelee lyhyestiICT-liiketoimintaa ja siihen liittyviä standardeja. Lopuksi tutkimus esittelee priorisoituja parannusehdotuksia ja askeleita jotka auttavat organisaatiota saavuttamaan kokonaisvaltaisen laatujohtamiskonseptin mukaisia pyrkimyksiä.

Outcome after proximal femoral fractures during primary total hip replacement by the direct anterior approach.

BACKGROUND: The literature suggests that intraoperative fractures of the greater trochanter and the metaphysis are increased with uncemented stems and the direct anterior approach. This study aims to determine the incidence and assess the functional and radiological outcome after such fractures. METHODS: 484 consecutive total hip replacements (THR) (64 ± 12 years) were analyzed. We treated trochanteric fractures conservatively without any further denuding, and secured metaphyseal fissures with cerclages. Postoperative X-rays and at the latest follow-up were compared to assess secondary fracture displacement and stem subsidence. Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores after 1 year were analyzed. For each patient sustaining a fracture, two patients without fractures were matched in terms of age, body mass index and gender. RESULTS: 13 (2.7 %, 5 male, 68 ± 9 years) patients with intraoperative fractures of the greater trochanter (n = 8) or the metaphysis (n = 5) were analyzed. Consolidation was observed in 7/8 patients sustaining a trochanteric fracture while secondary displacement of the fragment occurred in one case. Stem subsidence was observed in 2/5 cases (5 and 7 mm). Patients who sustained a fracture showed a trend towards poorer WOMAC scores at 1 year postoperatively, compared to patients without fractures. A significantly increased joint stiffness was also observed. CONCLUSION: The intraoperative fracture risk in this series of THR through a direct anterior approach was 2.7 %. Trochanteric fractures do heal without primary fixation. Metaphyseal fractures heal well if immediately stabilized with a cerclage.

Outcome of unilateral ankle arthrodesis and total ankle replacement in terms of bilateral gait mechanics.

Previous studies assessed the outcome of ankle arthrodesis (AA) and total ankle replacement (TAR) surgeries; however, the extent of postoperative recovery towards bilateral gait mechanics (BGM) is unknown. We evaluated the outcome of the two surgeries at least 2 years post rehabilitation, focusing on BGM. 36 participants, including 12 AA patients, 12 TAR patients, and 12 controls were included. Gait assessment over 50 m distance was performed utilizing pressure insoles and 3D inertial sensors, following which an intraindividual comparison was performed. Most spatiotemporal and kinematic parameters in the TAR group were indicative of good gait symmetry, while the AA group presented significant differences. Plantar pressure symmetry among the AA group was also significantly distorted. Abnormality in biomechanical behavior of the AA unoperated, contralateral foot was observed. In summary, our results indicate an altered BGM in AA patients, whereas a relatively fully recovered BGM is observed in TAR patients, despite the quantitative differences in several parameters when compared to a healthy population. Our study supports a biomechanical assessment and rehabilitation of both operated and unoperated sides after major surgeries for ankle osteoarthrosis.

Isolation, structural assignment and total synthesis of Barmumycin

Barmumycin was isolated from an extract of the marine actinomycete Streptomyces sp. BOSC-022A and found to be cytotoxic against various human tumor cell lines. Based on preliminary one- and two-dimensional 1H- and 13C-NMR spectra, the natural compound was initially assigned the structure of macrolactone-type compound 1, which was later prepared by two different routes. However, major spectroscopic differences between isolated barmumycin and 1 led to revision of the proposed structure as E-16. Based on synthesis of this new compound, and subsequent spectroscopic comparison of it to an authentic sample of barmumycin, the structure of the natural compound was indeed confirmed as that of E-16.

Adverse tissue reaction to corrosion at the neck-stem junction after modular primary total hip arthroplasty.

Complications related to the neck-stem junction of modular stems used for total hip arthroplasty (THA) are generating increasing concern. A 74-year-old male had increasing pain and a cutaneous reaction around the scar 1 year after THA with a modular neck-stem. Imaging revealed osteolysis of the calcar and a pseudo-tumour adjacent to the neck-stem junction. Serum cobalt levels were elevated. Revision surgery to exchange the stem and liner and to resect the pseudo-tumour was performed. Analysis of the stem by scanning electron microscopy and by energy dispersive X-ray and white light interferometry showed fretting corrosion at the neck-stem junction contrasting with minimal changes at the head-neck junction. Thus, despite dry assembly of the neck and stem on the back table at primary THA, full neck-stem contact was not achieved, and the resulting micromotion at the interface led to fretting corrosion. This case highlights the mechanism of fretting corrosion at the neck-stem interface responsible for adverse local tissue reactions. Clinical and radiological follow-up is mandatory in patients with dual-modular stems.

Técnica e custo para o ensacamento de frutos de pêra japonesa

A técnica de ensacamento da pêra japonesa, além de evitar a poluição ambiental causada por defensivos agrícolas, ainda proporciona melhoria na qualidade organoléptica dos frutos, reduzindo os danos provocados por mosca-das-frutas e grafolita. No presente trabalho, utilizaram-se as cultivares Hosui e Nijisseiki, cujos frutos foram ensacados logo após o raleio para evitar-se o desenvolvimento do "russeting" e o contato com insetos. Para a 'Housui', foi necessário um só ensacamento, ao custo de R$ 4.075,00/ha, considerando 110.000 frutos/ha. Já para a 'Nijisseiki', são necessários dois ensacamentos, resultando um custo de R$ 4.118,00/ha, considerando-se 73.370 frutos/ha. O custo aproximado do ensacamento em 'Housui' foi de R$ 0,04/fruto e em 'Nijisseiki', R$ 0,06/fruto. Mesmo sendo maior o custo do ensacamento para a 'Nijisseiki', esta cultivar obteve preços comerciais inferiores ao da 'Housui' no mercado brasileiro. O aumento do custo de produção devido ao ensacamento é passível de ser assimilado pelo produtor, desde que obtenha frutos de maior qualidade para, assim, vender os frutos ensacados com preços superiores.

Qualidade de frutos de videira 'Niagara Rosada' em cultivo intercalar com gramínea e leguminosas

Devido ao aumento do custo de produção com a utilização de cobertura morta com capim nas ruas da videira, no presente estudo, objetivou-se a possibilidade de substituição dessa cobertura morta por adubação verde intercalar, sem interferência nas características qualitativas dos frutos da videira 'Niagara Rosada', em experimentos realizados em Indaiatuba e Jundiaí-SP, de 1999 a 2002. Nas ruas da videira, instalaram-se seis tratamentos, em blocos ao acaso e 4 repetições, constando de testemunha no limpo; vegetação espontânea roçada; cobertura com capim braquiária; aveia-preta ou chícharo ou tremoço, de março a outubro, seguidos de mucuna-anã de outubro a março. Determinaram-se teores de sólidos solúveis totais (SST), pH, acidez total titulável (ATT) e relação SST/ATT no suco. Os resultados obtidos com a cobertura verde, na média dos anos para os parâmetros, foram similares ou mais favoráveis do que os da cobertura com capim, podendo-se substituí-la pela adubação verde intercalar com gramínea e leguminosas, o ano todo, sem interferência negativa na qualidade dos frutos, que foi influenciada pelas condições climáticas anuais das regiões de cultivo.