Full- Scale Load Test of Caisson on Chicago Hardpan

The results of a full-scale load test on a belled caisson bearing on hardpan in the downtown Chicago area are presented herein and are discussed in terms of current design practice and the results of other pertinent full-scale tests and a small-scale model test. Current specifications for allowable bearing pressures are shown to be conservative, and previously established settlement limits required to mobilize side resistance are reconfirmed. The settlement measured during the test is in good agreement with that predicted by use of pressuremeter test data. The confinement of the bell in a hard clay layer appears to be beneficial in that it serves to limit the development of major cracking at the base

Ground Response to Sheet Pile Installation in Clay

The effects of sheet pile installation on an adjacent cohesive soil mass are described herein. Observations indicate that driving sheet pile caused pore pressures to double at some locations. These pore pressures extended further than reported in previous studies concerning driven piles. Initially pore pressures rapidly dropped, but dissipation slowed after this initial adjustment. Inclinometer and extensometer data indicate that the clay was laterally displaced up and away from the sheeting causing the ground surface to heave. The impact of this behavior on subsequent stress changes during excavation is discussed

Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients

AIM: To examine whether hemodialysis (HD) patients with restless legs syndrome (RLS) are subjects of greater fatigue and impaired quality of life (QoL) compared to HD patients without RLS. METHODS: Eighty five stable HD patients participated in this study. According to their RLS status, the patients were divided into the RLS group (n = 23) and the non-RLS group (n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS: The HD patients with RLS scored worse in all the questionnaires used in the study (P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality (P < 0.05). CONCLUSION: HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers

Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method.Methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed.Results: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients.Discussion: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.<br /

CO2 Pneumoperitoneum Prolongs Survival in an Animal Model of Peritonitis Compared to Laparotomy

Background: The advantages of laparoscopic surgery have been well documented. However, the impact of pneumoperitoneum on sepsis sequelae is still equivocal. This study aimed to evaluate the effect of CO2 pneumoperitoneum, applied under different pressures and exposure times, on sepsis cascade and mortality. Material and methods: In 42 New Zealand rabbits, peritonitis was induced by the cecum ligation and puncture model. After 12 h, the animals were randomized in seven groups: a control group, four groups with pneumoperitoneum (10-15 mmHg for 60-180 min), and two groups with laparotomy (for 60 and 180 min). Blood samples were collected before cecum ligation and puncture, 12 h later and 1, 3, and 6 h after pneumoperitoneum desufflation or abdominal trauma closure to evaluate bacteremia, endotoxemia, white blood cells count, C-reactive protein, and procalcitonin levels. Furthermore, the mortality time was recorded in all animals. Results: Bacteremia and endotoxemia were induced in all groups. Endotoxemia levels were significantly more elevated in the group where pneumoperitoneum was performed under 15 mmHg for 180 min compared with all other groups at 1 and 3 h after pneumoperitoneum desufflation (P &amp;lt; 0.05), except when compared with the group where pneumoperitoneum was performed under 10 mmHg for 180 min. White blood cell and C-reactive protein levels showed similar trends for all groups. However, serum procalcitonin reached statistically higher levels (P &amp;lt; 0.05) in groups with laparotomy compared with groups with pneumoperitoneum and with the control group at 6 h. Survival was lower in the laparotomy groups compared with the pneumoperitoneum groups and with the control group (P &amp;lt; 0.05). Conclusions: In the presence of peritonitis, CO2 pneumoperitoneum applied in clinically standard pressures, even for extended time intervals, reduces the severity of sepsis and prolongs survival. © 2009 Elsevier Inc. All rights reserved

Clarithromycin modulates immune responses in experimental peritonitis

Based on clinical data revealing a promising immunomodulatory effect of clarithromycin in sepsis due to ventilator-associated pneumonia, the efficacy of clarithromycin in experimental peritonitis and sepsis was assessed with particular emphasis on immune function. Cecal puncture and ligation was performed in rabbits assigned to the following groups: Group A, controls (n = 12); Group B, intravenous clarithromycin treatment (n = 15); Group C, piperacillin/tazobactam (TZP) treatment (n = 10); Group D, clarithromycin + TZP combination treatment (n = 12). Blood was sampled at serial time intervals and peripheral blood mononuclear cells (PBMCs) were isolated. Apoptosis of lymphocytes and monocytes was measured by flow cytometric analysis. PBMCs were stimulated with lipopolysaccharide (LPS) and Pam3Cys for the release of tumour necrosis factor-alpha (TNFα). Tissue bacterial growth was quantitatively measured after death or sacrifice. Survival in Group D after 10 days was prolonged compared with the other groups. Early apoptosis of lymphocytes in Group B was lower compared with Group D at 2 h and compared with Group C at 4 h. Early apoptosis of monocytes in Group B was lower compared with Group C at 24 h. Following stimulation of PBMCs with LPS, release of TNFα was decreased in Group B compared with Groups A and D at 2 h. Bacterial growth in tissues of Groups C and D was decreased compared with Group A. It is concluded that clarithromycin modulates the function of the immune response in experimental peritonitis by decreasing the rate of early apoptosis of lymphocytes and monocytes and by decreasing the ex vivo release of TNFα by blood monocytes. © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved

Detrimental effect of apoptosis of lymphocytes at an early time point of experimental abdominal sepsis

Background: Apoptosis of lymphocytes is considered a late sequelum in the sepsis cascade. The role of apoptosis of lymphocytes as a driver of final outcome was investigated.Methods: Abdominal sepsis was induced after cecal ligation and puncture (CLP) in 31 rabbits. Blood was sampled at serial time intervals and peripheral blood mononuclear cells (PBMCs) were isolated. Apoptosis of lymphocytes and monocytes was measured through flow cytometric analysis. PBMCs were stimulated with LPS and Pam3Cys for the release of tumor necrosis factor-alpha (TNFα). Tissue bacterial growth was quantitatively measured. In a second set of experiments, CLP was performed in another 40 rabbits; 20 received single intravenous infusions of ciprofloxacin and of metronidazole 4 hours after surgery.Results: Animals were divided into two groups based on the percentage of lymphocyte apoptosis at 4 hours after surgery; less than or equal to 32% and more than 32%. Survival of the former was shorter than the latter (p: 0.017). Tissue growth was similar between groups. Apoptosis of lymphocytes and of monocytes was lower in the former group over follow-up. Release of ΤNFα did not differ. The above findings on survival were repeated in the second set of experiments. Administration of antimicrobials prolonged survival of the former group (p: 0.039) but not of the latter group (pNS).Conclusions: Lymphocyte apoptosis at an early time point of experimental peritonitis is a major driver for death. A lower percentage of apoptosis leads earlier to death. Antimicrobials were beneficial even at that disease state. © 2011 Atmatzidis et al; licensee BioMed Central Ltd