Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review

Abstract OBJECTIVE Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults. METHOD The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12). Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22;p=0.82); Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03); in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82;p=0.90) and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19) also showed no difference. CONCLUSION Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2006

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2006

Audit report on the Iowa Department of Human Services – Central Distribution Center for the year ended June 30, 2006

Audit report on the Iowa Department of Human Services – Central Distribution Center for the year ended June 30, 2006

Comunidade de formigas que nidificam em pequenos galhos da serrapilheira em floresta da Amazônia Central, Brasil

Community of ants that nest in dead twigs on the ground of Central Amazonian forest, Brazil. A total area of 2,880 m² in four forest sites, near Manaus, Brazil, was searched for ant colonies nesting in dead twigs on the ground. An amount of 3,706 twigs (0.5-5 cm in diameter) were gathered, of which only 623 (16.8%) had ants, which is equivalent to a density of 0.22 nests per m². Seventy species have been found. The predominant genera were Pheidole (Westwood), Crematogaster (Lund), and Solenopsis (Westwood). For most species, many of the nests found had only workers and brood, suggesting that colonies either use multiple twigs to nest or do not live exclusively in the twigs, using other types of substrate (e.g., leaf-litter, soil, fruit pods) to nest. Most colonized twigs were hollow or partially hollow inside and relatively easy to break apart. There were significant differences among species with respect to the size (diameter) of twig used as nest. No correlation was found between the number of twigs available and the number colonized by ants, suggesting that ant populations were not limited by the amount of nesting sites (twigs). The three most common Pheidole species had small colonies with less than 200 workers. Colony size was not related to twig size (volume), for any of these three species.

Distribuição de abundância e tamanho do corpo de invertebrados do folhiço em uma floresta de terra firme na Amazônia Central, Brasil

Abundace and body size distribution of invertebrates of leaf litter in Amazonian forest, Brazil. Based on 605 invertebrates sampled of the litter in an Amazonian Forest, some basic macroecological patterns for this assemblage were described. The relationship between abundance and body size, at logarithmic scale, was triangular, and the distribution of species was constrained in an asymmetric triangular envelope, that was tested using null model procedures in ECOSIM (P= 0,0002). The most abundant species were at an intermediated body size. The relationship between maximum abundance with different mean body size classes confirmed the Energetic Equivalent Rule (b = -1,069; t-0,75 = -2,13; P = 0.079). This way, species tend to consume energy from the community independent of their body size, since requirements are compensated by local population density.

Clinical Proton MR Spectroscopy in Central Nervous System Disorders.

A large body of published work shows that proton (hydrogen 1 [(1)H]) magnetic resonance (MR) spectroscopy has evolved from a research tool into a clinical neuroimaging modality. Herein, the authors present a summary of brain disorders in which MR spectroscopy has an impact on patient management, together with a critical consideration of common data acquisition and processing procedures. The article documents the impact of (1)H MR spectroscopy in the clinical evaluation of disorders of the central nervous system. The clinical usefulness of (1)H MR spectroscopy has been established for brain neoplasms, neonatal and pediatric disorders (hypoxia-ischemia, inherited metabolic diseases, and traumatic brain injury), demyelinating disorders, and infectious brain lesions. The growing list of disorders for which (1)H MR spectroscopy may contribute to patient management extends to neurodegenerative diseases, epilepsy, and stroke. To facilitate expanded clinical acceptance and standardization of MR spectroscopy methodology, guidelines are provided for data acquisition and analysis, quality assessment, and interpretation. Finally, the authors offer recommendations to expedite the use of robust MR spectroscopy methodology in the clinical setting, including incorporation of technical advances on clinical units. © RSNA, 2014 Online supplemental material is available for this article.

An illustrated key to nymphs of Perlidae (Insecta, Plecoptera) genera in Central Amazonia, Brazil

An illustrated key to nymphs of Perlidae collected in streams of Central Amazonia, Brazil is provided. Three genera are reported for this region: Macrogynoplax Enderlein, Anacroneuria Klapálek and Enderleina Jewett. Additional diagnostic characters are provided for Enderleina nymphs.

Activities of tabanids (Diptera, Tabanidae) attacking domestic duck-Cairina moschata (Linnaeus) (Aves, Anatidae), introduced in a forest area in the Central Amazon, Manaus, Brazil

Presented here are the feeding habits, attack behavior, daily and annual activity of adult of Phorcotabanus cinereus (Wiedeman, 1821), Chrysops laetus (Fabricius, 1805) and Phaeotabanus cajennensis (Fabricius, 1787), while biting a domestic duck, Cairina moschata (Linnaeus, 1758). The last two species were recorded for the first time attacking birds. This study comprehended monthly observations of two consecutive days from April/97 to March/98 between 5:30 a.m. and 6:30 p.m. at the Army Instructional Base ((BI-2/CIGS) near Manaus. Annual occurrence of P. cinereus was from July to September, with a daily occurrence between 9:00 a.m. and 5:00 p.m. and highest activity at 12:00 a.m. and 2:00 p.m. C. laetus ocurred from June to October; with a daily occurrence between 8:00 a.m. and 3 p.m. and highest activity at 11:00 and 12:00 a.m. Occurrence of P. cajennensis with one specimen only, was in July between 10:00 and 11:00 a.m.

Variscan lamprophyres in the Lower Penninic domain (Central Alps): age and tectonic significance

Lamprophyre dykes have been recently discovered in blocks of gneiss embedded in a calcschist formation of wildflysch type that forms the top of the Mesozoic-Tertiary metasedimentary cover of the Antigorio nappe (the Teggiolo zone) in the Val Bavona (Lower Penninic, NW Ticino, Switzerland). The presence of the lamprophyres gives a clue to the possible source of these blocks. Similar dykes occur in the N part of the Maggia nappe where they are intruded into the Matorello granite and the surrounding gneisses. We studied these lamprophyres at two localities in the Teggiolo zone (Tamierpass and Lago del Zott) and at one locality in the Maggia nappe (Laghetti). Detailed mineralogical and geochemical investigations confirm their great similarity, particularly between the Tamier and Laghetti dykes. They all recrystallized during Alpine metamorphism under amphibolite facies conditions and lost their primary mineral assemblages and textures. The chemistry reveals a calc-alkaline affinity, a limited differentiation range, features of mineral accumulation and intense remobilization in some cases. The lamprophyres are characterized by a high mg# and relatively low contents in REE and other incompatible elements. In situ SHRIMP and LA-ICPMS U-Pb zircon dating yielded ages of 284.8 +/- 1.7 Ma (Tamier), 290.0 +/- 1.3 Ma (Zott) and 290.5 +/- 3.7 Ma (Laghetti). These ages are compatible with the general late- to post-Variscan magmatic evolution of the Helvetic and Lower Penninic domains. The lamprophyres are considered as melts derived from the lithospheric Variscan mantle, variously hybridized and differentiated at the contact with crustal material during late- to post-orogenic extension. These lamprophyres are chemically distinct from earlier lamprophyres of Visean age, emplaced together with their associated granites in transcurrent fault zones during the Variscan orogenic compression. The similarity of these different dykes suggests that the front of the Maggia nappe is a likely source of the gneissic blocks embedded in the calcschists at the top of the Teggiolo zone. They would have been provided by the advancing Maggia nappe during its thrusting over the Antigorio nappe and simultaneous closure of the Teggiolo sedimentary basin.

Chaves de identificação de larvas para famílias e gêneros de Trichoptera (Insecta) da Amazônia Central, Brasil

Chaves de identificação de larvas aos níveis de família e gênero de Trichoptera da Amazônia Central são apresentadas.

Trabecular bone score is associated with volumetric bone density and microarchitecture as assessed by central QCT and HRpQCT in Chinese American and white women.

Although high-resolution peripheral quantitative computed tomography (HRpQCT) and central quantitative computed tomography (QCT) studies have shown bone structural differences between Chinese American (CH) and white (WH) women, these techniques are not readily available in the clinical setting. The trabecular bone score (TBS) estimates trabecular microarchitecture from dual-energy X-ray absorptiometry spine images. We assessed TBS in CH and WH women and investigated whether TBS is associated with QCT and HRpQCT indices. Areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry, lumbar spine (LS) TBS, QCT of the LS and hip, and HRpQCT of the radius and tibia were performed in 71 pre- (37 WH and 34 CH) and 44 postmenopausal (21 WH and 23 CH) women. TBS did not differ by race in either pre- or postmenopausal women. In the entire cohort, TBS positively correlated with LS trabecular volumetric bone mineral density (vBMD) (r = 0.664), femoral neck integral (r = 0.651), trabecular (r = 0.641) and cortical vBMD (r = 0.346), and cortical thickness (C/I; r = 0.540) by QCT (p < 0.001 for all). TBS also correlated with integral (r = 0.643), trabecular (r = 0.574) and cortical vBMD (r = 0.491), and C/I (r = 0.541) at the total hip (p < 0.001 for all). The combination of TBS and LS aBMD predicted more of the variance in QCT measures than aBMD alone. TBS was associated with all HRpQCT indices (r = 0.20-0.52) except radial cortical thickness and tibial trabecular thickness. Significant associations between TBS and measures of HRpQCT and QCT in WH and CH pre- and postmenopausal women demonstrated here suggest that TBS may be a useful adjunct to aBMD for assessing bone quality.

Diversidade de Chironomidae (Diptera) em dois córregos de baixa ordem na região central do Estado de São Paulo, através da coleta de exúvias de pupa

Estimamos a diversidade e a riqueza de Chironomidae (Diptera) em dois diferentes córregos através da análise de exúvias de pupa. As coletas realizadas no período de estiagem (agosto/2001) foram feitas com auxílio de redes de deriva e de mão, em trechos de 100 metros de cada córrego. Foram analisadas e identificadas 1264 exúvias de 61 táxons (36 no Córrego do Fazzari e 31 no trecho do Rio do Monjolinho). Ambos os sistemas apresentaram baixa similaridade faunística refletindo as diferentes características do substrato, da cobertura vegetal e da água de cada sistema. Possivelmente a maior riqueza faunística e a ocorrência de táxons minadores, como Stenochironomus spp., Xenochironomus spp. e Endotribelos spp. refletem a presença da mata ciliar no córrego do Fazzari que resulta em maior heterogeneidade ambiental e maior disponibilidade de alimento para esses grupos. O método de coleta e análise de exúvias de pupa de Chironomidae mostrou-se eficiente para estudos de caracterização ambiental de levantamentos da biodiversidade de sistemas lóticos de baixa ordem.