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.-

Diatom abundance and paleo-temperature reconstruction for sediment cores from the southeast Norwegian Sea

Although the pulsating nature and the abruptness of the last deglaciation are well documented in marine and land records, very few marine records have so far been able to capture the high-frequency climatic changes recorded in the Greenland ice core Dye 3. We studied high-resolution sediment cores from SE Norwegian Sea, which display a detailed climatic record during the last deglaciation comparable to that of Dye 3. Accelerator mass spectrometry age control of the cores enables us to correlate this record in detail with continental records. The results indicate that the surface waters of the SE Norwegian Sea were seasonally ice free after 13,400 B.P. The Bølling/Allerød interstadial complex (13,200-11,200 B.P.) was a climatically unstable period with changing Arctic-Subarctic conditions. This period was punctuated by four progressively more severe sea surface temperature (SST) minima: between 12,900-12,800 B.P. (BCP I); 12,500-12,400 B.P. (BCP II); 12,300-12,000 B.P. (OD I); and 11,800-11,500 B.P. (OD II). The Younger Dryas (YD) (11,200-10,200 B.P.) represents the severest and most prolonged cold episode of this series of climatic deteriorations. It was bounded by very rapid SST changes and characterized by Arctic-Polar conditions. The first true warm Atlantic water incursion to the SE Norwegian Sea took place around 10,100 B.P., followed by a brief cooler condition between 9900-9600 B.P. (YD II). The early Holocene climatic optimum occurred between 8000-5000 B.P. A conceptual model is proposed where meltwater fluxes are suggested to cause the observed instability in the SST record.

Animations of micro-computed tomography of a pleistocene terebratulid brachiopod

The dorsal valve of a Pleistocene terebratulid brachiopod, Terebratula scillae Seguenza, 1871, has developed a malignant cyst due to colonization in vivo by an endolithic sponge.This trace fossil is a compound boring and bioclaustration structure, representing a boring that has grown in unison with the growth of the cyst. The brachiopod has grown to adult size and growthlines indicate that it was colonised by the sponge when about half grown. Malformation of the shell may not have caused the death of the brachiopod and the sponge does not appear to have outlived its host; both symbionts seem to have died more or less simultaneously. This minus-minus relationship of two symbionts is considered to be a case of 'accidental symbiosis'.

Geochemistry, physical properties, diatom abundance and datums of ODP Site 186-1150 and Hole 186-1151A

Detection of climate response to orbital forcing during Cenozoic long-term global cooling is a key to understanding the behavior of Earth's icehouse climate. Sedimentary rhythm, which is a rhythmic or cyclic variation in the sequence of sediments and sedimentary rocks, is useful for quantitative reconstruction of Earth's evolution during geological time. In this study, we attempt to (1) identify sources of natural gamma ray (NGR) emissions of core recovered during Ocean Drilling Program (ODP) Leg 186 by analyses of physical properties, major element concentrations, diatom abundances, and total organic carbon contents, (2) integrate whole-core NGR intensity of recovered core with wireline logging NGR measurements in order to construct a continuous sedimentary sequence, and (3) discuss changes in the NGR signal in the time domain. This attempt gives us preliminary information to discuss climate stability in relation to orbital forcing thorough geologic time. NGR values are obtained mainly by indirectly measuring the amount of terrigenous minerals including potassium and related elements in the sediments. NGR intensity is also affected by high porosity, which in these sediments was related to the amount of diatom valves. NGR signals might be a proxy of the intensity of the East Asian monsoon off Sanriku. A continuous sedimentary record was constructed by integration of the whole-core NGR intensity measured in sediments obtained from the drilled holes with that measured directly in the borehole by wireline logging, then using a stratigraphic age model to convert to a time series covering 1.3-9.7 Ma with a short break at ~5 Ma. High sedimentation rate (H) stages were identified in the sequence, related to intervals of low-amplitude precession and eccentricity variations. The transition of the dominant periodicities through the four H stages may correlate to major shifts in the climate system, including the onset of major Northern Hemisphere glaciation, the initial stage of the East Asian monsoon intensification, and the onset of the East Asian monsoon with uplift of the Himalayas and the Tibetan Plateau.

Water chemistry and sediment age of lake Terrasovoje, Amery Oasis, East Antarctica

The late Quaternary palaeoenvironmental history of the southern Windmill Islands, East Antarctica, has been reconstructed using diatom assemblages from two long, well-dated sediment cores taken in two marine bays. The diatom assemblage of the lowest sediment layers suggests a warm climate with mostly open water conditions during the late Pleistocene. During the following glacial, the Windmill Islands were covered by grounded ice preventing any in situ bioproductivity. Following deglaciation, a sapropel with a well-preserved diatom assemblage was deposited from ~10?500 cal yr BP. Between ~10?500 and ~4000 cal yr BP, total organic carbon (Corg) and total diatom valve concentrations as well as the diatom species composition suggest relatively cool summer temperatures. Hydrological conditions in coastal bays were characterised by combined winter sea-ice and open water conditions. This extensive period of glacial retreat was followed by the Holocene optimum (~4000 to ~1000 cal yr BP), which occurred later in the southern Windmill Islands than in most other Antarctic coastal regions. Diatom assemblages in this period suggest ice-free conditions and meltwater-stratified waters in the marine bays during summer, which is also reflected in high proportions of freshwater diatoms in the sediments. The diatom assemblage in the upper sediments of both cores indicates Neoglacial cooling from ~1000 cal yr BP, which again led to seasonally persistent sea-ice on the bays. The Holocene optimum and cooling trends in the Windmill Islands did not occur contemporaneously with other Antarctic coastal regions, showing that the here presented record reflects partly local environmental conditions rather than global climatic trends.

Water chemistry, sediment radiocarbon age and diatom zonation at Peterson Inlet and Browning Bay, Antarctica

The late Quaternary palaeoenvironmental history of the southern Windmill Islands, East Antarctica, has been reconstructed using diatom assemblages from two long, well-dated sediment cores taken in two marine bays. The diatom assemblage of the lowest sediment layers suggests a warm climate with mostly open water conditions during the late Pleistocene. During the following glacial, the Windmill Islands were covered by grounded ice preventing any in situ bioproductivity. Following deglaciation, a sapropel with a well-preserved diatom assemblage was deposited from ~10500 cal yr BP. Between ~10500 and ~4000 cal yr BP, total organic carbon (Corg) and total diatom valve concentrations as well as the diatom species composition suggest relatively cool summer temperatures. Hydrological conditions in coastal bays were characterised by combined winter sea-ice and open water conditions. This extensive period of glacial retreat was followed by the Holocene optimum (~4000 to ~1000 cal yr BP), which occurred later in the southern Windmill Islands than in most other Antarctic coastal regions. Diatom assemblages in this period suggest ice-free conditions and meltwater-stratified waters in the marine bays during summer, which is also reflected in high proportions of freshwater diatoms in the sediments. The diatom assemblage in the upper sediments of both cores indicates Neoglacial cooling from ~1000 cal yr BP, which again led to seasonally persistent sea-ice on the bays. The Holocene optimum and cooling trends in the Windmill Islands did not occur contemporaneously with other Antarctic coastal regions, showing that the here presented record reflects partly local environmental conditions rather than global climatic trends.

Marine diatoms in deep sea sediments

Long-term evolution is thought to take opportunities that arise as a consequence of mass extinction (as argued, for example, by Gould, 2002) and the following biotic recovery, but there is absolutely no evidence for this being the case. However, our study shows that eutrophication by oceanic mixing also played a part in the enhancement of several evolutionary events amongst marine organisms, and these results could indicate that the rates of oceanic biodiversification may be slowed if upwelling becomes weakened by future global warming. This paper defines three distinct evolutionary events of resting spores of the marine diatom genus Chaetoceros, to reconstruct past upwelling through the analysis of several DSDP, ODP and land-based successions from the North, South and equatorial Pacific as well as the Atlantic Ocean during the past 40 million years. The Atlantic Chaetoceros Explosion (ACE) event occurred across the E/O boundary in the North Atlantic, and is characterized by resting spore diversification that occurred as a consequence of the onset of upwelling following changes in thermohaline circulation through global cooling in the early Oligocene. Pacific Chaetoceros Explosion events-1 and -2 (PACE-1 and PACE-2) are characterized by relatively higher occurrences of iron input following the Himalayan uplift and aridification at 8.5 Ma and ca. 2.5 Ma in the North Pacific region. These events not only enhanced the diversification and increased abundance of primary producers, including that of Chaetoceros, other diatoms and seaweeds, but also stimulated the evolution of zooplankton and larger predators, such as copepods and marine mammals, which ate these phytoplankton and plants. Current thinking suggests new evolutionary niches open up after a mass extinction, but our study finds that eutrophication can also stimulate evolutionary diversification. Moreover, in the opposite fashion, our results show that as thermohaline circulation abates, global warming progresses and the ocean surface becomes warmer, many marine organisms will be affected by the environmental degradation.

(Tables 1+4) Sample site substratum and morphometrics and damage levels of different populations of Laternula elliptica around Antarctica

We document differences in shell damage and shell thickness in a bivalve mollusc (Laternula elliptica) from seven sites around Antarctica with differing exposures to ice movement. These range from 60% of the sea bed impacted by ice per year (Hangar Cove, Antarctic Peninsula) to those protected by virtually permanent sea ice cover (McMurdo Sound). Patterns of shell damage consistent with blunt force trauma were observed in populations where ice scour frequently occurs; damage repair frequencies and the thickness of shells correlated positively with the frequency of iceberg scour at the different sites with the highest repair rates and thicker shells at Hangar Cove (74.2% of animals damaged) compared to the other less impacted sites (less than 10% at McMurdo Sound). Genetic analysis of population structure using Amplified Fragment Length Polymorphisms (AFLPs) revealed no genetic differences between the two sites showing the greatest difference in shell morphology and repair rates. Taken together, our results suggest that L. elliptica exhibits considerable phenotypic plasticity in response to geographic variation in physical disturbance.

Composition of suspended matter and bottom sediments from the Atlantic Ocean and its seas

The book summarizes data on distribution and composition of sedimentary material suspended in waters of the Atlantic Ocean and its seas. Results of observations of Soviet and foreign expeditions are given. Distribution of suspended matter in sections across the ocean, as well as in the most studied seas are shown. New data on grain size, mineral and chemical composition of suspended matter are published. Summary of history of investigation of bottom sediments from the Atlantic Ocean from the first scientific cruises to the present is done. A brief description of sediment types in the ocean and a detailed description of Mediterranean Sea sediments are given.

Sediment Trap Data in the northwest Mediterranean Sea from the MedFlux project (2003 - 2005)

MedFlux sampling was carried out at the French JGOFS DYFAMED (DYnamique des Flux Atmospheriques en MEDiterranee) site in the Ligurian Sea (northwestern Mediterranean), 52km off Nice (431200N, 71400E) in 2300m water depth. In 2003, a mooring with sediment trap arrays was deployed 6 March (day of year, DOY 65) and recovered 6 May (DOY 126); this trap deployment will be referred to as Period 1 (P1). The array was redeployed a week later on 14 May (DOY 134) and recovered again on 30 June (DOY 181); this trap deployment will be referred to as Period 2 (P2). Indented-rotating sphere (IRS) valve traps were fitted with TS carousels to determine temporal variability of particulate matter flux. TS traps were fitted with ''dimpled'' spheres. Vertical flux at 200m depth is considered to be equivalent to new or export production, and traps sampled at 238 and 117m during P1 and P2, respectively. We also collected TS material at 711m during P1 and at 1918m during P2. Upon recovery, samples were split using a McLaneTM WSD splitter to allow multiple chemical analyses. Here we report 2003 data on TS particulate mass, and the contributions of organic carbon (OC), opal, lithogenic material and calcium carbonate to mass. In 2005, traps were deployed as described above for 55 d during a single period from 4 March (DOY 63) to 1 May (DOY 121). TS traps were fitted with ''dimpled'' spheres. TS particulate matter was collected from 313 to 924 m.