Postoperative Cognitive Dysfunction (POCD) and Inflammatory Markers in Elderly Patients

Introduction: Particularly in elderly patients, the brain responds to a systemic inflammatory response with an increased production of inflammatory mediators. This has hypothetically been linked to the development of postoperative cognitive dysfunction (POCD). Methods: We investigated 31 patients aged >65 yrs undergoing elective major surgery under standardized general anaesthesia (thiopental, sevoflurane, fentanyl, atracurium). Cognitive function was measured preoperatively and 7 days postoperatively using the extended version of the Consortium to Establish a Registry for Alzheimer's Disease - Neuropsychological Assessment Battery (CERAD-NAB, validated German version) for which we developed a diagnostic cut-off in healthy elderly volunteers. Systemic C-reactive protein (CRP) and interleukin 6 (IL-6) were measured preoperatively, 2 days postoperatively, and 7 days postoperatively. Values for CRP, IL-6, operative characteristics and hospital length of stay in patients with POCD and without POCD were compared using the Mann- Whitney U test and are shown as median [range]. Results: Fourteen patients (45%) developed POCD. Values for CRP were not statistically different in patients with POCD and without POCD but tended to be higher in patients with POCD 2 days postoperatively. Patients with POCD had significantly higher IL-6 values on postoperative days 2 and 7 (table 1). These patients also had a significantly longer duration of anaesthesia (305 [195-620] vs.190 [150-560] min, p = 0.034), larger intraoperative blood loss (425 [0-1600] vs. 100 [0-1500] ml, p = 0.018) and longer hospital stays (15 [8-45] vs. 8 [4-40] days, p = 0.008). Table 1 POCD (n = 14) No POCD (n = 17) p value CRP (mg/dl) preop. 4.0 [1.0-245] 4.2 [0.3-36.2] 0.6 2 days postop. 223 [20-318] 98 [4.5-384] 0.07 7 days postop. 58 [15-147] 44 [11-148] 0.2 IL-6 (U/ml) preop. 2[2-28.1] 2 [2-7.3] 0.8 2 days postop. 56 [17-315] 20 [2-123] 0.009 7 days postop. 9[2-77] 4 [2-16] 0.03 Interpretation: In this small group of patients, high IL-6 values postoperatively were associated with POCD supporting a role for systemic inflammation in the development of POCD. In patients with POCD, duration of anaesthesia was significantly longer, and intraoperative blood losses were larger. These risk factors will need to be confirmed in a larger group of patients. The difference in length of stay may be indicative of postoperative complications, which have been linked to POCD earlier.

Curva de retenção de água no solo pelo método do papel-filtro

O método mais tradicional para determinação da curva de retenção de água no solo emprega a câmara de pressão de Richards. Por questões práticas, a busca por métodos alternativos ao de Richards, financeiramente mais acessíveis e menos morosos, faz-se interessante. Diante disso, desenvolveu-se o presente trabalho com o objetivo de avaliar o uso do método do papel-filtro. Para isso, realizou-se inicialmente coleta, caracterização física e preparo de amostras indeformadas de um Latossolo Vermelho distroférrico típico e ensaio em câmara de Richards, utilizando pressões de 0, 10, 30, 60, 100, 300, 500, 1000 e 1500 kPa. No ensaio com o papel-filtro, mediu-se o potencial matricial da água em amostras cujas umidades foram previamente estabelecidas, utilizando-se curva de calibração adequada. Os ensaios resultaram em pontos de pressão versus umidade, que foram ajustados pelo modelo de van Genuchten, utilizando o programa RETC. Realizou-se uma análise comparativa de valores de umidade volumétrica estimados pelo modelo ajustado nos ensaios com o papel-filtro com a curva de retenção ajustada obtida pela câmara de Richards. Por meio dessa comparação, verificou-se a aplicabilidade do método do papel-filtro para determinação da curva de retenção de água no solo agrícola utilizado.

Nitrate role in basic cation leaching under no-till

Especially under no-tillage, subsuface soil acidity has been a problem, because it depends on base leaching, which has been associated with the presence of low molecular weigth organic acids and companion anions. The objective of this study was to evaluate exchangeable base cation leaching as affected by surface liming along with annual urea side-dressing of maize and upland rice. Treatments consisted of four lime rates (0, 1500, 3000, and 6000 kg ha-1) combined with four nitrogen rates (0, 50, 100, and 150 kg ha-1) applied to maize (Zea mays) and upland rice (Oryza sativa), in two consecutive years. Maize was planted in December, three months after liming. In September of the following year, pearl millet (Pennisetum glaucum) was planted without fertilization and desiccated 86 days after plant emergence. Afterwards, upland rice was grown. Immediately after upland rice harvest, 18 months after surface liming, pH and N-NO3-, N-NH4+, K, Ca, and Mg levels were evaluated in soil samples taken from the layers 0-5, 5-10, 10-20 and 20-40 cm. Higher maize yields were obtained at higher N rates and 3000 kg ha-1 lime. Better results for upland rice and pearl millet yields were also obtained with this lime rate, irrespective of N levels. The vertical mobility of K, Ca and Mg was higher in the soil profiles with N fertilization. Surface liming increased pH in the upper soil layers causing intense nitrate production, which was leached along with the base cations.

Audit report on Indian Hills Community College in Ottumwa, Iowa for the year ended June 30, 2011

Audit report on Indian Hills Community College in Ottumwa, Iowa for the year ended June 30, 2011

[Illustrations de Le Chevalier délibéré] / [Non identifié] ; Olivier de La Marche, aut. du texte

Comprend : [Fig. à la Page de titre : le Chevalier Délibéré et armoiries.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. folio aiii : le Chevalier Délibéré participe à joute sur son cheval nommé Vouloir. ] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : le Chevalier Délibéré et un hermite. ] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. au folio bii : l'hermite présente des reliques.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : le Chevalier Délibéré et son vainqueur.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. folio Ci : le Chevalier Délibéré devant le château d'Amour qui l'enjoint à rentrer. Il en est détourné par Souvenir.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : Frâîche Mémoire montre des tombes au Chevalier Délibéré.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. folio Ei : le duc Philippe de Bourgogne et Débile.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : le duc Philippe de Bourgogne combat messire Accident.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : Accident et la duchesse d'Autriche.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. en reg. folio Fii : Fraîche Mémoire ramène le Chevalier Délibéré chez lui.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : Entendement enseigne le maniement des armes au Chevalier Délibéré.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. : joute de chevaliers.] [Cote : Res Ye 249/Microfilm R 33639] ; [Fig. au verso du dernier folio : marque typographique de Jean Trepperel avec armoiries et devise.] [Cote : Res Ye 249/Microfilm R 33639]

Thin silicon films ranging from amorphous to nanocrystalline obtained by Hot-Wire CVD

In this paper, we have presented results on silicon thin films deposited by hot-wire CVD at low substrate temperatures (200 °C). Films ranging from amorphous to nanocrystalline were obtained by varying the filament temperature from 1500 to 1800 °C. A crystalline fraction of 50% was obtained for the sample deposited at 1700 °C. The results obtained seemed to indicate that atomic hydrogen plays a leading role in the obtaining of nanocrystalline silicon. The optoelectronic properties of the amorphous material obtained in these conditions are slightly poorer than the ones observed in device-grade films grown by plasma-enhanced CVD due to a higher hydrogen incorporation (13%).