Barbiturates for the treatment of intracranial hypertension after traumatic brain injury

In their article on the use of barbiturates for the treatment of intracranial hypertension after traumatic brain injury, Perez-Barcena and colleagues conclude that thiopental was more effective than pentobarbital in decreasing intracranial pressure. Here we discuss the limitations of this study and review areas of controversy surrounding barbiturate use in neurocritical care

Composting of domestic refuse and sewage sludge. I. Evolution of temperature, pH, C/N ratio and cation-exchange capacity

Peer reviewe

Somatic development long after the Fontan operation: Factors influencing catch-up growth

ObjectiveAs mortality and morbidity after the Fontan operation has improved, long-term outcome, including developmental aspects, have become more important. To understand the long-term effects of this operation, we followed somatic development for up to 15 years.MethodsWe evaluated 90 patients who underwent the Fontan operation between 1984 and 2004 (mean follow-up, 11.8 ± 4.2 years). The modified Fontan operations were atriopulmonary anastomosis (n = 19) and total cavopulmonary connection (n = 71). Mean age at the time of surgical intervention was 5.5 ± 4.8 years. Weight, height, and body mass index were evaluated preoperatively and postoperatively and given as percentiles on a normal growth curve.ResultsPostoperative weight, height, and body mass index reached the 47.2 ± 35.6, 37.9 ± 30.4, and 41.6 ± 31.2 percentiles, which were significantly better than preoperative values (the 21.6 ± 25.9, 25.9 ± 25.7, and 20.0 ± 25.1 percentiles). Although neither early surgical intervention nor anatomic features affected postoperative growth, early Fontan completion demonstrated better somatic development in subgroups of tricuspid atresia. Prior bidirectional Glenn shunting provided better weight gain before the Fontan operation. Prior atrioseptectomy, central shunt, and pulmonary artery reconstruction were associated with impaired somatic development. Reoperation and catheter-based intervention improved somatic development.ConclusionsLong-term catch-up growth can be observed in patients after the Fontan operation. Early volume-unloading procedures might lead to better somatic growth. Prior atrioseptectomy, central shunt, and pulmonary artery reconstruction are associated with impaired weight and height gain, implying that the severity of the underlying diseases affects postoperative somatic development

Влияние PR-технологий на расширение читательской аудитории районной газеты

рефератabstrac

Hyperammonemia: What Urea-lly Need to Know: Case Report of Severe Noncirrhotic Hyperammonemic Encephalopathy and Review of the Literature

Purpose. A 66-year-old man who presented with coma was found to have isolated severe hyperammonemia and diagnosed with a late-onset urea-cycle disorder. He was treated successfully and had full recovery. Methods. We report a novel case of noncirrhotic hyperammonemia and review the literature on this topic. Selected literature for review included English-language articles concerning hyperammonemia using the search terms “hyperammonemic encephalopathy”, “non-cirrhotic encephalopathy”, “hepatic encephalopathy”, “urea-cycle disorders”, “ornithine transcarbamylase (OTC) deficiency”, and “fulminant hepatic failure”. Results. A unique case of isolated hyperammonemia diagnosed as late-onset OTC deficiency is presented. Existing evidence about hyperammonemia is organized to address pathophysiology, clinical presentation, diagnosis, and treatment. The case report is discussed in context of the reviewed literature. Conclusion. Late-onset OTC deficiency presenting with severe hyperammonemic encephalopathy and extensive imaging correlate can be fully reversible if recognized promptly and treated aggressively

Роль таможенных органов в обеспечении экономической безопасности России

Актуальность выбранной темы дипломной работы определена имеющимися на данном этапе проблемами в обеспечении экономической безопасности, а также необходимостью совершенствования работы таможенных органов с целью повышения уровня экономической безопасности, так как это является стратегической целью таможенных органов России.Объектом исследования является сфера экономической безопасности России.Целью работы является определение роли таможенных органов в обеспечении экономической безопасности России.The research urgency is determined by the problems at the current stage in ensuring economic security, as well as the need to improve the work of customs authorities in order to improve the level of economic security, since this is a strategic goal of the Russian customs authorities.Object of a research is the sphere of economic security of the Russian Federation. The purpose of graduate qualification work is definition of the place of customs authorities of the Russian Federation in ensuring economic security of the state