The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Efeitos anestésicos da administração intranasal ou intramuscular de cetamina S+ e midazolam em pomba-rola (Streptotelia sp.)

A via intranasal é uma boa alternativa por ser indolor e de fácil aplicação em aves. O objetivo deste estudo foi avaliar os efeitos anestésicos da associação de cetamina S+ e midazolam pela via intranasal (IN) em comparação com a via intramuscular (IM) em pombos. Foram utilizados 12 pombos alocados em dois grupos com 15 dias de intervalo, os quais receberam: grupo IM: 20 mg/kg de cetamina S+ associada a 3,5 mg/kg de midazolam pela via intramuscular (musculatura do peito); e grupo IN, mesmo protocolo, porém, pela via intranasal. Os parâmetros avaliados foram: período de latência, tempo de duração em decúbito dorsal, tempo total de anestesia, tempo de recuperação e efeitos adversos. Para a análise estatística, empregou-se o teste de Wilcoxon, com as diferenças consideradas significativas quando P<0,05. O período de latência obtido foi de 30 [30-47,5] e 40 [30-50] segundos para IM e IN, respectivamente. O tempo de duração de decúbito dorsal foi de 59 [53,25-65] e 63 [37-71,25] minutos para IM e IN, respectivamente, sem diferenças significativas entre os grupos. Com relação à duração total de anestesia, foi observada diferença significativa, com 88 [86,25-94,5] e 68 [53,5-93] minutos para os grupos IM e IN, respectivamente. O tempo de recuperação foi mais curto no grupo IN (15 [4,25-19,5]) comparado ao IM (32 [28,25-38,25] minutos). Dois animais de cada grupo apresentaram regurgitação na fase de recuperação. Conclui-se que a administração de cetamina S+ e midazolam pela via intranasal é um método aceitável de administração de fármacos e produz anestesia rápida e eficaz em pombos

Aspects of imaging of the lower urinary tract in the dog

Available from British Library Document Supply Centre-DSC:DXN019518 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Estimation of the volume of the gall bladder of 32 dogs from linear ultrasonographic measurements

The maximum length and depth of the longitudinal section, and the maximum width and depth of the transverse section of the gall bladders of 32 dog cadavers were measured ultrasonographically; the contents of the gall bladder were then aspirated and its actual volume measured. The volume of the gall bladder was estimated from the ultrasonographic measurements by using formulae suggested for assessment of the volumes of the urinary bladder in human beings and the gall bladder of dogs, and these formulae were compared with a formula derived from the measurements made in this study. In 21 of the dogs, the measurements were repeated twice so that their reproducibility could be evaluated. All the formulae gave good estimations of the volume of the dogs' gall bladders, but the formula for the human urinary bladder volume was better than the other two. The actual volume of the gall bladder was related to the dogs' bodyweight. There were no significant differences between the repeated measurements of the maximum length and depth of the longitudinal section or the width of the transverse section of the gall bladder, but there were significant variations in the depth of the transverse section

Evaluation of Negative Cognitions in Children and Adolescents: Children&#146;s Automatic Thoughts Scale

Objective: Objective: The aim of the present study is to evaluate psychometric properties of the Children&#146;s Automatic Thoughts Scale to children and adolescents. Method: A total of 534 children and adolescents aged 9-16 participated in the study. They attended elementary schools in Ankara. Of these participants 276 were girls and 258 were boys. The mean age of the group was 12.30 (SD=1.26).They were attending 4th to 8th grade of the elementary schools. Results: Exploratory and Confirmatory factor analyses confirmed the four factor model (Schniering and Rapee 2002). The four factor model explained 50% of variance. The first factor was social threat and 31.72% of the total variance. Followed by personal failure, hostility and physical treat factors explaining 8.32%, 5.80% and 5.10 % of the total variance. Social threat was found to be explaining the higher variance in the present study while personal failure was the first factor explaining higher variance in the original study. Test-rest reliabilities with two weeks interval demonstrated that the Children&#146;s Automatic Thoughts Scale is a reliable instrument(r=.90). Cronbach Alpha was found to be and .94. These reliability and validity analyses supported that Children&#146;s Automatic Thoughts Scale could be used with Turkish children. Conclusion: Children&#146;s Automatic Thoughts Scale, evaluates the presence and severity of negative cognition in children and adolescents, could be utilized in research and clinical practice. It could also be used in educational settings where the thought content of children and adolescents are important in areas such as friendship, academic success and bullying. (Journal of Cognitive Behavioral Psychotherapy and Research 2013, 2: 72-77) [JCBPR 2013; 2(2.000): 72-77

Effect of time delay and storage temperature on blood gas and acid-base values of bovine venous blood

The aim of this study was to investigate possible changes in the gas composition and acid-base values of bovine venous blood samples stored at different temperatures (+4, 22 and 37 degreesC) for up to 48 h. Five healthy cattle were used in the study. A total of 15 blood samples collected from the animals were allocated into three groups, which were, respectively, then stored in a refrigerator adjusted to +4 degreesC (Group I, n = 5), at a room temperature of about 22 degreesC (Group II, n = 5) and in an incubator adjusted to 37 degreesC (Group 111; n = 5) for up to 48 It. Blood gas and acid-base values were analysed at 0 (baseline), 1, 2, 3, 4, 5, 6, 12, 24, 36 and 48 h of storage. A significant decrease (p < 0.001) was found, in the pH of the refrigerated blood after 5 h and its maximum decrease was recorded at 48 h as 0.04 unit. There were also significant alterations (p < 0.001) in the blood pH of the samples stored at room temperature and in the incubator after 2 and 3 h, respectively. The maximum mean alteration in pCO(2) value for Group I was -0.72 kPa during the assessment, while for groups II and III, maximum alterations in pCO(2) were detected as +2.68 and +4.16 kPa, respectively. Mean pO(2) values increased significantly (p < 0.001) for Group I after 24 It and for Group II after 6 h, while a significant decrease was recorded for Group III after 24 h (p < 0.001). Base excess (BE) and bicarbonate (HCO3) fractions decreased significantly for all the groups during the study, compared to their baseline values. In conclusion, acid-base values of the samples stored at 22 and +4 degreesC were found to be within normal range and could be used for clinical purposes for up to 12 and 48 h, respectively, although there were small statistically significant alterations. (C) 2003 Elsevier Ltd. All rights reserved