8 research outputs found
The relevance of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration for postoperative infections and postoperative organ dysfunctions in cardiac surgery patients : the eVIDenCe study
Background & aims: Recent studies indicate that vitamin D deficiency is associated with increased morbidity and mortality in critically ill patients. Knowledge about the functional role and clinical relevance of vitamin D for patients undergoing cardiac surgery is sparse. Therefore, we investigated the clinical significance of vitamin D levels on outcome of cardiac surgery patients.
Methods: 92 patients undergoing elective cardiac surgery with cardiopulmonary arrest were included in this prospective observational pilot study. 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (1,25(OH)2D) levels were measured prior to surgery, immediately postoperatively as well as 6, 12 and 24 h after surgery. We assessed postoperative organ dysfunctions, infections and death until hospital discharge.
Results: The serum concentration of 1,25(OH)2D significantly decreased intraoperatively by 29.3% (p < 0.001) and was significantly lower at any postoperative time point compared to baseline values, whereas 25OHD levels did not show significant changes during the observation period. Coronary artery bypass graft (CABG) patients had significant higher baseline 1,25(OH)2D values than patients with valve surgery (39.7 ± 13.9 ng/l vs. 30.1 ± 14.1 ng/l, p = 0.010) or CABG + valve surgery (39.7 ± 13.9 ng/l vs. 32.6 ± 11.8 ng/l, p = 0.044).
Our data showed a significant odds ratio to develop postoperative organ dysfunction (OR 0.95; p = 0.009) and PCT levels â„5 ÎŒg/l (OR 0.94; p = 0.046) for every ng/l increment in 1,25(OH)2D, when performing multivariable analysis and after adjusting for preoperative illness and demographics. In addition, multivariable-adjusted statistical analyses revealed that patients stayed significantly shorter on ICU (â0.21 h; p = 0.001) and in hospital (â2.6 days; p = 0.009) for every ng/l increment in 1,25(OH)2D.
Conclusion: Our data highlight important evidence about the clinical significance of 1,25(OH)2D levels in cardiac surgery patients. Higher levels were associated with significantly less postoperative organ dysfunctions, elevated PCT levels, death and prolonged hospital stay. 1,25(OH)2D levels decreased significantly intra- and postoperatively, while serum levels of 25OHD did not.
Trial registration: clinicaltrials.gov (NCT 02488876), registered May 1, 2015
The relevance of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration for postoperative infections and postoperative organ dysfunctions in cardiac surgery patients : The eVIDenCe study
Background & aims: Recent studies indicate that vitamin D deficiency is associated with increased morbidity and mortality in critically ill patients. Knowledge about the functional role and clinical relevance of vitamin D for patients undergoing cardiac surgery is sparse. Therefore, we investigated the clinical significance of vitamin D levels on outcome of cardiac surgery patients.
Methods: 92 patients undergoing elective cardiac surgery with cardiopulmonary arrest were included in this prospective observational pilot study. 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (1,25(OH)2D) levels were measured prior to surgery, immediately postoperatively as well as 6, 12 and 24 h after surgery. We assessed postoperative organ dysfunctions, infections and death until hospital discharge.
Results: The serum concentration of 1,25(OH)2D significantly decreased intraoperatively by 29.3% (p < 0.001) and was significantly lower at any postoperative time point compared to baseline values, whereas 25OHD levels did not show significant changes during the observation period. Coronary artery bypass graft (CABG) patients had significant higher baseline 1,25(OH)2D values than patients with valve surgery (39.7 ± 13.9 ng/l vs. 30.1 ± 14.1 ng/l, p = 0.010) or CABG + valve surgery (39.7 ± 13.9 ng/l vs. 32.6 ± 11.8 ng/l, p = 0.044).
Our data showed a significant odds ratio to develop postoperative organ dysfunction (OR 0.95; p = 0.009) and PCT levels â„5 ÎŒg/l (OR 0.94; p = 0.046) for every ng/l increment in 1,25(OH)2D, when performing multivariable analysis and after adjusting for preoperative illness and demographics. In addition, multivariable-adjusted statistical analyses revealed that patients stayed significantly shorter on ICU (â0.21 h; p = 0.001) and in hospital (â2.6 days; p = 0.009) for every ng/l increment in 1,25(OH)2D.
Conclusion: Our data highlight important evidence about the clinical significance of 1,25(OH)2D levels in cardiac surgery patients. Higher levels were associated with significantly less postoperative organ dysfunctions, elevated PCT levels, death and prolonged hospital stay. 1,25(OH)2D levels decreased significantly intra- and postoperatively, while serum levels of 25OHD did not.
Trial registration: clinicaltrials.gov (NCT 02488876), registered May 1, 2015
Characterization of berkelium(III) dipicolinate and borate compounds in solution and the solid state
Electronic Structure and Properties of Berkelium Iodates
The
reaction of <sup>249</sup>BkÂ(OH)<sub>4</sub> with iodate under
hydrothermal conditions results in the formation of BkÂ(IO<sub>3</sub>)<sub>3</sub> as the major product with trace amounts of BkÂ(IO<sub>3</sub>)<sub>4</sub> also crystallizing from the reaction mixture.
The structure of BkÂ(IO<sub>3</sub>)<sub>3</sub> consists of nine-coordinate
Bk<sup>III</sup> cations that are bridged by iodate anions to yield
layers that are isomorphous with those found for Am<sup>III</sup>,
Cf<sup>III</sup>, and with lanthanides that possess similar ionic
radii. BkÂ(IO<sub>3</sub>)<sub>4</sub> was expected to adopt the same
structure as MÂ(IO<sub>3</sub>)<sub>4</sub> (M = Ce, Np, Pu), but instead
parallels the structural chemistry of the smaller Zr<sup>IV</sup> cation.
Bk<sup>III</sup>âO and Bk<sup>IV</sup>âO bond lengths
are shorter than anticipated and provide further support for a postcurium
break in the actinide series. Photoluminescence and absorption spectra
collected from single crystals of BkÂ(IO<sub>3</sub>)<sub>4</sub> show
evidence for doping with Bk<sup>III</sup> in these crystals. In addition
to luminescence from Bk<sup>III</sup> in the BkÂ(IO<sub>3</sub>)<sub>4</sub> crystals, a broad-band absorption feature is initially present
that is similar to features observed in systems with intervalence
charge transfer. However, the high-specific activity of <sup>249</sup>Bk (<i>t</i><sub>1/2</sub> = 320 d) causes oxidation of
Bk<sup>III</sup> and only Bk<sup>IV</sup> is present after a few days
with concomitant loss of both the Bk<sup>III</sup> luminescence and
the broadband feature. The electronic structure of BkÂ(IO<sub>3</sub>)<sub>3</sub> and BkÂ(IO<sub>3</sub>)<sub>4</sub> were examined using
a range of computational methods that include density functional theory
both on clusters and on periodic structures, relativistic <i>ab initio</i> wave function calculations that incorporate spinâorbit
coupling (CASSCF), and by a full-model Hamiltonian with spinâorbit
coupling and SlaterâCondon parameters (CONDON). Some of these
methods provide evidence for an asymmetric ground state present in
Bk<sup>IV</sup> that does not strictly adhere to RusselâSaunders
coupling and Hundâs Rule even though it possesses a half-filled
5<i>f</i> <sup>7</sup> shell. Multiple factors contribute
to the asymmetry that include 5<i>f</i> electrons being
present in microstates that are not solely spin up, spinâorbit
coupling induced mixing of low-lying excited states with the ground
state, and covalency in the Bk<sup>IV</sup>âO bonds that distributes
the 5<i>f</i> electrons onto the ligands. These factors
are absent or diminished in other <i>f</i><sup>7</sup> ions
such as Gd<sup>III</sup> or Cm<sup>III</sup>