Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Genetic variability of hepatitis A virus strain HAF-203 isolated in Brazil and expression of the VP1 gene in Escherichia coli

Submitted by Sandra Infurna ([email protected]) on 2019-12-26T12:52:44Z No. of bitstreams: 1 AnaMGaspar_RicardoGaller_etal_IOC_2006.pdf: 1229215 bytes, checksum: 257323348a52d4c7bc7d9cb98b9ae28f (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-12-26T13:25:20Z (GMT) No. of bitstreams: 1 AnaMGaspar_RicardoGaller_etal_IOC_2006.pdf: 1229215 bytes, checksum: 257323348a52d4c7bc7d9cb98b9ae28f (MD5)Made available in DSpace on 2019-12-26T13:25:20Z (GMT). No. of bitstreams: 1 AnaMGaspar_RicardoGaller_etal_IOC_2006.pdf: 1229215 bytes, checksum: 257323348a52d4c7bc7d9cb98b9ae28f (MD5) Previous issue date: 2006Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hepatites Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Virologia. Laboratório de Desenvolvimento Tecnológico. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Bioquímica e Biologia Molecular. Laboratório de Biologia Molecular de Flavivírus. Rio de Janeiro, RJ, Brasil.The hepatitis A virus (HAV) HAF-203 strain was isolated from an acute case of HAV infection. The primary isolation of HAF-203 in Brazil and its adaptation to the FRhK-4 cell lineage allowed the production of large amounts of viral particles enabling molecular characterization of the first HAV isolate in Brazil. The aim of our study was to determine the nucleotide sequence of the HAF-203 strain genome, compare it to other HAV genomes and highlight its genetic variability. The complete nucleotide sequence of the HAF-203 strain (7472 nucleotides) was compared to those obtained earlier by others for other HAV isolates. These analyses revealed 19 HAF-specific nucleotide sequence differences with 10 amino acid substitutions. Most of the non-conservative changes were located at VP1, 2C, and 3D genes, but the 3B region was the most variable. The availability of HAF-203 complementary DNA was useful for the production of the recombinant VP1 protein, which is a major determinant of viral infectivity. This recombinant protein was shown by enzyme-linked immunoassay and blotting, to be immunogenic and resemble the native protein, therefore suggesting its value as a reagent for incorporation into diagnostic tests

Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications

Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT &lt; 6) and normal central retinal thickness (CRT); B, low MAT (&lt;6) and increased CRT, and C, high MAT (&ge;6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p &lt; 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications

Модель интерпретации литературного текста

The article discloses the main text categories and defines their interweaving with the most important stylistics’ aspects, forming a detailed literary text interpretation model. The main categories of a literary text, which will be analyzed in the article, are: conceptuality, discreteness, implicitness, integration, modality and personality/impersonality of the author’s image. And as the most colorful semasiological expressive means, the figures of qualification (metonymy, metaphor and irony), opposition (antithesis and oxymoron) and some figures of inequality (pun and zeugma) will be described below.Стаття розкриває основні текстові категорії і визначає їх переплетіння з найважливішими стилістичними аспектами, формируючи модель детальної інтерпретації літературного тексту. Основні текстові категорії, що будуть проаналізовані в даній статті, наступні: концептуальність, дискретність, імпліцитність, інтеграція, модальність й індивідуальність чи безособистість наявності автора. І, як найяскравіші семасіологічні засоби експресії, фігури якісності (метонімія, метафора, іронія), фігури опозиції (оксюморон й антитеза) та деякі фігури нерівності (зевгма і каламбур) будуть описані нижче.Статья раскрывает основные текстовые категории и рассматривает их переплетение с важнейшими стилистическими аспектами, формируя модель детальной интерпретации литературного текста. Основные текстовые категории, которые проанализированы в данной статье, следующие: концептуальность, дискретность, имплицитность, интеграция, модальность и индивидуальность или безличность присутствия автора

Structural and functional mechanisms of Desulfovibrio vulgaris cytochrome c3 revealed by site specific mutagenesis

The structural basis for the redox properties of the tetrahaem Desulfovibrio vulgaris cytochrome c3, has been investigated by site specific mutagenesis. Thermodynamic and structural characterisation of mutated cytochromes revealed the functional role of Lys45 and Thr24 in the wild type protein. Mutation of Lys45, located in the vicinity of the propionates of haem I, by the uncharged residues Thr and Gin, allowed to conclude that Lys45 controls the pKa of such propionate groups and confirms the involvement of this residue in the redox-Bohr effect ~. More recently, the replacement of Thr24, located in the vicinity ofhaem III, by Val showed how crucial Thr24 is for the stabilisation of the oxidised form of the protein. This single mutation increases the microscopic redox potential ofhaem III by 106 mV. This mutation also destabilizes the concerted two-electron step between the intermediate oxidation stages, 1 and 3, which can occur in the wild type protein. Therefore, Thr24 is responsible for the balance of the global network of cooperativities tuned to control thermodynamically the directionality of the stepwise electron transfer 2

Chironomidae (Insecta: Diptera) no Estado do Rio de Janeiro, Brasil: situa\ue7\ue3o atual, lista de esp\ue9cies e novos registros

Volume: 67Start Page: 337End Page: 34