Metabolic and respiratory effects of infused sodium acetate in healthy human subjects.

The metabolic and respiratory effects of intravenous 0.5 M sodium acetate (at a rate of 2.5 mmol/min during 120 min) were studied in nine normal human subjects. O2 consumption (VO2) and CO2 production (VCO2) were measured continuously by open-circuit indirect calorimetry. VO2 increased from 251 +/- 9 to 281 +/- 9 ml/min (P < 0.001), energy expenditure increased from 4.95 +/- 0.17 kJ/min baseline to 5.58 +/- 0.16 kJ/min (P < 0.001), and VCO2 decreased nonsignificantly (211 +/- 7 ml/min vs. 202 +/- 7 ml/min, NS). The extrapulmonary CO2 loss (i.e., bicarbonate generation and excretion) was estimated at 48 +/- 5 ml/min. This observation is consistent with 1 mol of bicarbonate generated from 1 mol of acetate metabolized. Alveolar ventilation decreased from 3.5 +/- 0.2 l/min basal to 3.1 +/- 0.2 l/min (P < 0.001). The minute ventilation (VE) to VO2 ratio decreased from 22.9 +/- 1.3 to 17.6 +/- 0.9 l/l (P < 0.005), arterial PO2 decreased from 93.2 +/- 1.9 to 78.7 +/- 1.6 mmHg (P < 0.0001), arterial PCO2 increased from 39.2 +/- 0.7 to 42.1 +/- 1.1 mmHg (P < 0.0001), pH from 7.40 +/- 0.005 to 7.50 +/- 0.007 (P < 0.005), and arterial bicarbonate concentration from 24.2 +/- 0.7 to 32.9 +/- 1.1 (P < 0.0001). These observations indicate that sodium acetate infusion results in substantial extrapulmonary CO2 loss, which leads to a relative decrease of total and alveolar ventilation.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Weak recommendations (2) indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); and a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSIONS: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

Bioenergia e exclusão regional: a não política nacional agroenergética e os girassóis do RN

This doctoral thesis presents an analysis of the production of bicarbonates and related regional development in Brazil. It is widely believed that one of Brazil s vocations lies in the agro-energy sector. However, current national agro-energy policies, together with the experience of Petrobras (the national oil company) in rural settlements in the state of Rio Grande do Norte, show that Brazil has fallen short of effectively including the North and Northeast regions of the country, let alone small-scale rural producers (residing in rural settlements or not), in the development process and related benefits from the country s participation in the current world energy grid. The methodology entails secondary research related to the theme, such as books, official documents, websites and statistical databases from diverse sources, in addition to an analysis of statements from interviews of Petrobras representatives and other important scientific, institutional and labor union authorities, in relation to agro-energy issues and the socio-economic participation of family-based agriculture in this process. Principal findings show a correlation between agro-energy and regional development, creating the potential for numerous opportunities and challenges. Findings demonstrate the possibility of reversing/reducing historically rooted indices of hunger and poverty that continue to devastate the North and Northeast regions. At the same time, the thesis points to a potentially catastrophic increase in regional disparities, should the present historic moment not be seized upon so as to include these regions. Classic examples of non-policy at the federal level are presented as evidence of the absence of a regionally focused agroenergy policy in the current government, reinforced by the experiences of Petrobras in the Rio Grande do Norte rural settlements. Finally, the thesis concludes that there is an urgent need to create a government-sponsored enterprise (with a structure similar to Petrobras) with the purpose of implementing a truly broad and inclusive development process for the bicarbonates production sector, while remaining attentive to Brazil s opportune and critical role in the world s current agro-energy scenario.

Ação do Profident sobre os tecidos gengivais. 2. Efeitos da ação do jato de bicarbonato de sódio sobre os tecidos gengivais, sob variação do ângulo de incidência. Análise histológica.

The effect of sodium bicarbonate jet (Profident System) on the gingival tissue was tested with comparison of application from 2 different angles: the angulation recommended by the manufacturer and ponted to the occlusal surface. The results showed a definite influence of the angulation on tissue trauma, with lesser degrees of injury when the modified angulation was applied.

Dietary electrolyte balance for broiler chickens under moderately high ambient temperatures and relative humidities

Cobb male broiler chicks (1,000) on new litter were used to evaluate effects of dietary electrolyte balance [DEB; Na+K-Cl, milliequivalents (mEq) per kilogram] under tropical summer conditions. Corn-soybean meal-based mash diets had salt (NaCl) alone or in combination with one or more supplements: sodium bicarbonate (NaHCO3), ammonium chloride (NH4Cl), or potassium bicarbonate (KHCO3). A completely randomized design, with five starter and grower feed treatments (control: 145, then 130 mEq/kg; or 0, 120, 240, or 360 mEq/kg throughout) and four replicate pens (1.5 x 3.2 m) per treatment (50 chicks per pen), was used. Diets were analyzed for Na, K, and Cl for confirmation. There were no significant (P < 0.05) effects of treatments on mortality or processing parameters. Water intake increased linearly with increasing DEB, giving higher litter moistures and lower rectal temperatures. Blood HCO3 and pH increased with the highest DEB (360 mEq/kg) causing respiratory alkalosis. The DEB of 240 mEg/kg gave best weight gain and feed conversion ratio, and ideal DEB predicted by regression analyses were 186 and 197 mEq/kg from 0 to 21 d of age and 236 and 207 mEq/kg of feed from 0 to 42 d, respectively. These DEB corresponded to estimated (interpolated) values in predicted optimal 186 to 197 mEq/kg starter of Na 0.38 to 0.40% and Cl 0.405 to 0.39% (K = 0.52%), in 207 to 236 mEq/kg starter, Na 0.409 to 0.445% and Cl 0.326 to 0.372% Cl (K = 0.52%), and in grower Na 0.41 to 0.445%, Cl 0.315 to 0.267% (K = 0.47%).

Dietary electrolyte balance for broiler chickens exposed to thermoneutral or heat-stress environments

Ross male broiler chicks (n = 480) on new litter were used in a randomized block design with two blocks (environmental rooms) and four treatments having four replicate pens (1.0 × 2.5 m; 15 chicks) each to evaluate dietary electrolyte balance (DEB; P < 0.05). Two rooms were 1) thermoneutral (Weeks 1 through 6, with decreasing maximum from 32 to 25°C and minimum from 28 to 19°C; relative humidity 49 to 58%) and 2) cyclic daily heat stress (Weeks 1 and 2, thermoneutral; Weeks 2 through 6, maximum temperatures 35, 35, 33, and 33°C, respectively; and minimum temperatures 23, 20, 19, and 19°C, respectively; relative humidity 51 to 54%). The DEB treatments (0, 140, 240, or 340 mEq Na + K - Cl/kg) had NaHCO3 plus NH4Cl, or KHCO3, or both added to corn-soybean meal mash basal diets with 0.30% salt (NaCl). In the thermoneutral room, DEB 240 increased 42-d weight gain and 44-d lymphocyte percentage and decreased heterophil percentage and heterophil to lymphocyte ratio compared to the DEB 40 treatment. The DEB 240 diets had 0.35 and 0.35% Na and 0.37% and 0.29% Cl in starter (0.75% K) and grower (0.67% K) diets, respectively. No DEB treatment differences were found in the heat stress room. For combined rooms, 42-d feed intake was higher for DEB 240 than for DEB 40. The 21-d weight gain was higher for DEB 240 than for DEB 40 or 140; and 21-d feed/gain was lower for DEB 40 than for DEB 340. The predicted maximum point of inflection for 21- and 42-d weight gains were DEB 250 and 201, with highest 42-d feed intake at 220.

Hidroquímica do rio Solimões na região entre Manacapuru e Alvarães: Amazonas - Brasil

Este trabalho discute as características físico-químicas das águas dos rios Solimões, Purus e seus afluentes, coletadas em novembro de 2004 no Estado do Amazonas, entre as cidades de Manacapuru-Alvarães e Anamã-Pirarauara. Foram realizadas análises físico-químicas (temperatura, pH, condutividade elétrica, turbidez, Ca2+, Na+, K+, Mg2+, HCO3-, SO42-, Cl-), de elementos-traço (Li, B, Al, Sc, V, Cr, Mn, Fe, Co, Cu, Zn, As, Se, Rb, Sr, Mo, Cd, Sb, Cs, Ba, Pb, La, Ce e U) e isótopos de estrôncio. Os parâmetros analisados e a composição química mostram que as águas dos rios e igarapés da região central da Amazônia são quimicamente distintas entre si. As águas brancas do Solimões são cálcicas-bicarbonatadas e as do Purus bicarbonatadas, os respectivos afluentes são sódico-potássico-bicarbonatados e sódico-potássico-sulfatados. Isso acarreta águas brancas fracamente ácidas a neutras e mais condutivas, enquanto as pretas são menos mineralizadas, mais ácidas, especialmente as do Purus. O Ba, Sr, Cu, V e As mais elevados diferenciam as águas brancas do Solimões das do Purus, bem como os afluentes do primeiro em relação ao segundo. Esse conjunto de características indicam que tanto o Solimões, como o Purus e os respectivos afluentes, estão submetidos a condições geológicas/ambientais distintas. A influência do aporte de sedimentos dos Andes é diluída ao longo da bacia do Solimões e se reflete na formação das várzeas dos Solimões e Purus. Por outro lado as rochas crustais, representadas pelos escudos das Guianas e Brasileiro também contribuem, mas em menor proporção.

Estudo da qualidade da água distribuída pelo poço artesiano da FEG em relação à água servida pelo abastecimento público de Guaratinguetá

We conducted a study of the quality of water distributed by Artesian Well in relation to water supply served by the public for purposes of human consumption of UNESP Campus Guaratinguetá. Two sections of the network were randomly chosen and monitored for 105 days: the stretch of the pipeline started off the Water Treatment Station of the Autonomous Service of Water, Sewage and waste in the Municipality of Guaratinguetá and ended in a point consumption of the Child Family Center, while the section B began at the output of an artesian well and finished in a point of consumption of the Department of Civil Engineering. It is the deterioration of water quality in parts A and B, through comparative analysis of Bicarbonates, Total Hardness, Total Iron, free residual chlorine, pH, Total Residual, Turbidity, Conductivity, Color, Fecal Coliforms and Total Coliforms. Among the observations that can be highlighted: the Total Hardness was found in highest concentration in the extract; for Total Iron significant variations were obtained for both parts, and reduction of this parameter in two points of consumption analyzed, not the expected increase concentration, because the contact of water along the pipe, the CRL showed significant depletion to section A, which can be related to impurities in the water, the presence of biofilm on the walls of pipes, or because this is the stretch of greater extent to be covered by water for pH, this indicated that the water is alkaline and slightly acidic stretch in section B; Turbidity was found for the higher concentration to the passage, and a considerable reduction of this parameter at point consumption due to deposition of particulate matter along the stretch, the conductivity also showed a higher concentration in the extract, as well as an increase in this parameter at the point of consumption. Upon leaving ... (Complete abstract click electronic access below)

Caracterización química de efluentes de bodegas, Mendoza (Argentina)

La industria vitivinícola genera efluentes sólidos y líquidos en cantidad apreciable. Los sólidos son aprovechados en distintas aplicaciones e inclusive tienen valor comercial. En cambio, los líquidos pueden originar problemas cuando es necesario decidir cómo desecharlos o transformarlos en desechables. En Mendoza (Argentina), es común enviarlos después de su decantación a cauces y campos abiertos. En ambos casos aparece un serio riesgo de contaminación. Visto que generalmente se desconoce la composición de tales efluentes, este trabajo pretende caracterizarlos físico-químicamente en el período de elaboración de vinos, determinando: pH, conductividad eléctrica, DBO, DQO, cloruros, sulfatos, carbonatos y bicarbonatos, calcio, magnesio, sodio y potasio. La calidad de los efluentes varía notablemente con el agua empleada en los lavados, que aporta mayoritariamente aniones y cationes. Cuando el agua de lavado es abundante, los valores de pH, DBO y DQO de los efluentes permiten su eliminación junto con otros residuos cloacales o en campo abierto.

Impacto de la urbanización sobre las características hidroquímicas del acuífero libre : comparación estadística con el entorno rural, Coronel Moldes, Argentina

El objetivo consistió en evaluar el impacto que la actividad urbana ocasiona sobre la calidad del agua subterránea del área de Coronel Moldes. Se realizaron consideraciones geoquímicas en relación con el cálculo de línea de base hidroquímica, comparando con muestras extraídas del mismo acuífero en el entorno rural. Los indicadores de contaminación entre las distintas zonas rural y urbana (evaluados con la prueba t para muestras independientes y prueba no paramétrica de Mann- Whitney), indicaron que los valores de las componentes resultaban diferentes. Conductividad eléctrica, bicarbonatos, cloruros y nitratos mostraron en el área urbana valores medios superiores a aquellos del entorno rural que en general corresponden a los valores representativos del fondo natural regional de la calidad del agua subterránea. Se detectó en el área urbana un aumento en la dureza y Cl-/HCO3 - con importante contaminación microbiológica. Para evaluar el fondo regional se ajustaron los datos de los componentes iónicos analizados a las distribuciones teóricas (Normal, Laplace y f1). Se encontró que la distribución empírica presentaba un mejor acercamiento a f1 que a las otras dos, determinándose así como valor característico del fondo natural para cada ion, el estimador del parámetro de localización m* (combinación lineal entre la media y la mediana).

Concentration of total organic carbon in waters of the Atlantic Ocean

In pursuance of previous studies water samples were taken in the Atlantic and Mediterranean during the 12th, 14th and 15th cruises of RV Mikhail Lomonosov in 1962-1964 to determine total and particulate organic carbon and permanganate oxidizability. Preliminary processing of the water samples was carried out in the normal manner in the on-board laboratory immediately after they had been taken: destruction of bicarbonates and carbonates by precise addition of acid (by alkalinity) and evaporation to dryness at 50-60°C. It is quite probable that the corresponding volatile fraction of organic matter is lost under these conditions. In discussion it was demonstrated that it may now be assumed that the carbon of the volatile fraction averages approximately 15% of total carbon, i.e., 15% of the sum of organic carbon of the volatile and nonvolatile fractions. Oxidizability was determined in all samples in the on-board laboratory.

(Supplement) Groundwater quality in Lahore Pakistan: emphasis on Arsenic and Fluoride levels

The dataset provides detailed information on the study that was conducted in Lahore's 7 major towns. The sample was taken from 472 tubewells and analyzed for major cations and anions using APHA 2012 techniques as explained herein. Besides, E.coli determination was done to check for microbial contamination. The data includes results from PHREEQC modeling of As(III)/ As(V) species and saturation indices as well as Aquachem's computed hydrochemical water facies. The WHO (2011) and EPA standards included in Aquachem identified the parameters that where in violation. Bicarbonates dominated the groundwater types with 50.21% of the samples exceeding the EPA maximum permissible limit of 250 mg/L in drinking water. Similarly, 30.51% of the samples had TDS values greater than 500 mg/L while 85.38 % of the samples exceed 10 µg/L threshold limit value of arsenic. Also, instances of high magnesium hazard values were observed which requires constant assessment if the groundwater is used for irrigation. Higher than 50% MH values are detrimental to crops which may reduce the expected yields. The membrane filtration technique using m-Endo Agar indicated that 3.59% samples had TNC (too numerous to count) values for E.coli while 5.06% showed values higher than 0 cfu/ 100 ml acceptable value in drinking water. Any traces of E-coli in a groundwater sample indicate recent fecal contamination. Such outcomes signify presence of enteric pathogens. If the groundwater is not properly dosed with disinfectants it may cause harm to human health. It is concluded that more studies are needed and proper groundwater management implement to safeguard the lives of communities that depend solely on groundwater in the city.

Geochemistry of the water column of southern lake Baikal during 1967-2005

At present, when the influence of human economic activity is progressively increasing, significant attention is devoted to the state of water ecosystems. All researchers engaged in these problems agree that the state of the water system (pollution and eutrophication) can only be estimated on the basis of long-term researches. Systemic monitoring (at least once per month) of ionic components (Ca2+, Mg2+, Na+, K+, bicarbonates, sulfates, and chlorides) in unfiltered water of Lake Baikal and its tributaries had been carried out under the supervision of Votintsev since 1947. Based on the analysis of systematic data on trophic components obtained during 1965-2005, we tried to estimate the present-day trophic status of the pelagic zone in the lake, define the trend of long-term changes of trophic components and understand the reasons of the distortion of cyclicity in the development of spring diatom algae, which create a favorable environment in any water basin. It should be noted that the station near Cape Polovinnyi is located 20 km away from the town of Baikal'sk. Wastewaters of the Baikal'sk pulp and paper mill is the main source of dioxins and furans in Baikal. Based on the significant difference between sulfate contents in wastewaters of the plant (>300 mg/l), tributaries of Baikal (7.5 mg/l), and waters in the southern part of the lake (3.9 mg/l), we defined the following periods: (i) period of natural seasonal patterns until 1967-1968 (prior to putting the Baikal'sk Mill into operation; (ii) period of weak anthropogenic pollution (1969-1985); and (iii) period of strong anthropogenic pollution since 1986.