Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

ACHENE CHARACTERISTICS OF TURKISH CENTAUREA (ASTERACEAE) AND THEIR SYSTEMATIC APPLICATION

This article investigates the exomorphic characteristics of the achenes which are achene size, color, and surface pattern, and pappus length, and colour. All these characteristics in seven taxa of Asteraceae namely, C. aggregata Fisch. & C.A. Mey. ex DC. subsp. aggregata, C. sivasica Wagenitz, C. polypodiifolia Boiss. var. polypodiifolia, C. polypodiifolia Boiss. var. szowitziana (Boiss.) Wagenitz, C. iberica Trev. ex Spreng, C. urvillei DC. subsp. stepposa Wagenitz, and C. carduiformis DC. subsp. carduiformis var. carduiformis in are described, illustrated and compared. The results of SEM at higher magnification showed three types of aehene surface patterns: glebulate-ruminate, smooth, and rugose. In these patterns, there were diagnostic characteristics and differences at the specific level for Centaurea. A key to the taxa has been provided on the basis of these achene characteristic

Centaurea goksivriensis (Asteraceae), a new species from Turkey

Centaurea goksivriensis M. Bona, a new species of C. sect. Acrocentron from Hatay Province of Turkey, is described and illustrated. It is morphologically similar to C. antiochia var. antiochia, C. carduiformis, and C. urvillei subsp. armata but differs mainly in its flower colour, indumentum and pappus. The IUCN conservation status of Critically Endangered (CR) should be applied to Centaurea goksivriensis

Centaurea amanosensis (Asteraceae), a new species from Turkey

Centaurea amanosensis M. Bona, a new species of Asteraceae from Hatay province of Turkey is described and illustrated. It is morphologically similar to C. cheirolopha (Fenzl) Wagenitz, C. lycopifolia Boiss. & Kotschy ex Boiss. & Kotschy, and C. stevenii Bieb. (Section Pseudoseridia), but it differs mainly in life form, general habit, leaves and achene characters. The IUCN conservation status of Critically Endangered (CR) should be applied to C. amanosensis

Seed-coat microsculpturing of Turkish Lepidium (Brassicaceae) and its systematic application

This article investigates the seed exomorphic characteristics of 14 taxa of Lepidium L. in Brassicaceae by light microscope and scanning electron microscope (SEM). The exomorphic characteristics of the seed are size, seed shape, seed colour, seed wings, and seed surface pattern. All characteristics of the seeds are described, illustrated, and compared in this article. The results of SEM at higher magnification showed 6 types of seed surface patterns: tuberculate, reticulate, ruminate, reticulate-tuberculate, reticulate-areolate, and reticulate-fovate. In these seed surface patterns, there were diagnostic characteristics and differences at the specific level for Lepidium