227 research outputs found
ε-Aminocaproic acid does not increase adverse effects in cardiac surgery: an analysis of 2,852 cases
Influence of spin fluctuations on the superconducting transition temperature and resistivity in the t-J model at large N
Spin fluctuations enter the calculation of the superconducting transition
temperature T only in the next-to-leading order (i.e., in O(1/N) of the
1/N expansion of the t-J model. We have calculated these terms and show that
they have only little influence on the value of T obtained in the leading
order O(1/N) in the optimal and overdoped region, i.e., for dopings larger than
the instability towards a flux phase. This result disagrees with recent
spin-fluctuation mediated pairing theories. The discrepancies can be traced
back to the fact that in our case the coupling between electrons and spins is
determined by the t-J model and not adjusted and that the spin susceptibility
is rather broad and structureless and not strongly peaked at low energies as in
spin-fluctuation models. Relating T and transport we show that the
effective interactions in the particle-particle and particle-hole channels are
not simply related within the 1/N expansion by different Fermi surface averages
of the same interactin as in the case of phonons or spin fluctuations. As a
result, we find that large values for T and rather small scattering rates
in the normal state as found in the experiments can easily be reconciled with
each other. We also show that correlation effects heavily suppress transport
relaxation rates relative to quasiparticle relaxation rates in the case of
phonons but not in the case of spin fluctuations.Comment: 16 pages, 10 figures, will appear in Phys. Rev.
The World Karst Aquifer Mapping project : concept, mapping procedure and map of Europe
Karst aquifers contribute substantially to freshwater supplies in many regions of the world, but are vulnerable to contamination and difficult to manage because of their unique hydrogeological characteristics. Many karst systems are hydraulically connected over wide areas and require transboundary exploration, protection and management. In order to obtain a better global overview of karst aquifers, to create a basis for sustainable international water-resources management, and to increase the awareness in the public and among decision makers, the World Karst Aquifer Mapping (WOKAM) project was established. The goal is to create a world map and database of karst aquifers, as a further development of earlier maps. This paper presents the basic concepts and the detailed mapping procedure, using France as an example to illustrate the step-by-step workflow, which includes generalization, differentiation of continuous and discontinuous carbonate and evaporite rock areas, and the identification of non-exposed karst aquifers. The map also shows selected caves and karst springs, which are collected in an associated global database. The draft karst aquifer map of Europe shows that 21.6% of the European land surface is characterized by the presence of (continuous or discontinuous) carbonate rocks; about 13.8% of the land surface is carbonate rock outcrop
Arterial dP/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved
Background: Peak first derivative of femoral artery pressure (arterial dP/dt
max) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dt
maxis reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced shock and catecholamine infusion.Methods: Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated pigs. After a stabilization period, endotoxin was infused to induce shock. Catecholamines were transiently administrated during shock. Arterial dP/dt
maxwas compared to end-systolic elastance (Ees), the gold standard method for assessing LV contractility.Results: Endotoxin-induced shock and catecholamine infusion lead to significant variations in LV contractility. Overall, significant correlation (r = 0.51; p < 0.001) but low agreement between the two methods were observed. However, a far better correlation with a good agreement were observed when positive-pressure ventilation induced an arterial pulse pressure variation (PPV) ≤ 11% (r = 0.77; p < 0.001).Conclusion: While arterial dP/dt
maxand Ees were significantly correlated during various hemodynamic conditions, arterial dP/dt
maxwas more accurate for assessing LV contractility when adequate vascular filling, defined as PPV ≤ 11%, was achieved. © 2012 Morimont et al; licensee BioMed Central Ltd
Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial
Abstract\ud
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Introduction\ud
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Several studies have shown that maximizing stroke volume (or increasing it until a plateau is reached) by volume loading during high-risk surgery may improve post-operative outcome. This goal could be achieved simply by minimizing the variation in arterial pulse pressure (ΔPP) induced by mechanical ventilation. We tested this hypothesis in a prospective, randomized, single-centre study. The primary endpoint was the length of postoperative stay in hospital.\ud
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Methods\ud
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Thirty-three patients undergoing high-risk surgery were randomized either to a control group (group C, n = 16) or to an intervention group (group I, n = 17). In group I, ΔPP was continuously monitored during surgery by a multiparameter bedside monitor and minimized to 10% or less by volume loading.\ud
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Results\ud
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Both groups were comparable in terms of demographic data, American Society of Anesthesiology score, type, and duration of surgery. During surgery, group I received more fluid than group C (4,618 ± 1,557 versus 1,694 ± 705 ml (mean ± SD), P < 0.0001), and ΔPP decreased from 22 ± 75 to 9 ± 1% (P < 0.05) in group I. The median duration of postoperative stay in hospital (7 versus 17 days, P < 0.01) was lower in group I than in group C. The number of postoperative complications per patient (1.4 ± 2.1 versus 3.9 ± 2.8, P < 0.05), as well as the median duration of mechanical ventilation (1 versus 5 days, P < 0.05) and stay in the intensive care unit (3 versus 9 days, P < 0.01) was also lower in group I.\ud
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Conclusion\ud
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Monitoring and minimizing ΔPP by volume loading during high-risk surgery improves postoperative outcome and decreases the length of stay in hospital.\ud
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Trial registration\ud
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NCT00479011The authors thank Maria De Amorim (Paris, France) and Julia Fukushima (São Paulo, SP, Brazil) for help in data analysis, Dr Julia Wendon (London, UK) for reviewing the manuscript, and Dixtal (Sao Paulo, SP, Brazil) for providing the software for the automatic calculation of ?PP.The authors thank Maria De Amorim (Paris, France) and Julia Fukushima (São Paulo, SP, Brazil) for help in data analysis, Dr Julia Wendon (London, UK) for reviewing the manuscript, and Dixtal (Sao Paulo, SP, Brazil) for providing the software for the automatic calculation of ?PP
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