Analysis of adverse events in patients admitted to an intensive care unit

Objective: To assess the incidence of adverse events and associate them with nursing workload, nursing team staffing and the severity of the patients. Method: A quantitave, cross-sectional, prospective study was conducted with 304 consecutive patients admitted to the General Intensive Care Unit of a private hospital between September and December 2013 (four months). Results: There were 39 adverse events, and the most prevalent was pressure sore. Patients who presented an event had a higher mean age, higher prevalence of clinical admissions, longer hospital stay, higher scores in the Acute Physiology and Chronic Health Evaluation (APACHE) II and in the Nursing Activities Score (NAS) and lower score in the Braden scale and in the Glasgow scale. There was no significant difference regarding nursing team staffing. Conclusion: There was a higher incidence of adverse events in patients who presented a profile of greater risk and severity identified by predictive scales.Objetivo: Avaliar a incidência de eventos adversos e associá-los com a carga de trabalho de enfermagem, o dimensionamento da equipe de enfermagem e o perfil de gravidade do paciente. Métodos: Foi realizado um estudo transversal, prospectivo, com abordagem quantitativa, em 304 pacientes consecutivos internados em Unidade de Terapia Intensiva geral de um hospital privado, admitidos entre setembro e dezembro de 2013 (quatro meses). Resultados: Ocorreram 39 eventos adversos sendo a lesão por pressão a mais prevalente. Os pacientes que apresentaram algum evento tiveram maior média de idade, maior prevalência de internações clínicas, internações mais prolongadas, maior escala Acute Physiology and Chronic Health Evaluation (APACHE) II, maior pontuação do Nursing Activities Score (NAS), menor escore na escala de Braden e menor escala de Glasgow e não tiveram diferenças significantes em relação ao dimensionamento da equipe de enfermagem. Conclusão: Houve maior incidência de eventos adversos em pacientes que exibiram um perfil de maior risco e gravidade identificados por meio de escalas preditoras.Univ Fed Sao Paulo, Escola Paulista Enfermagem, Sao Paulo, SP, Brazil|Sao Camilo Hosp, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Enfermagem, Sao Paulo, SP, BrazilWeb of Scienc

Bioconversion of ovine scotta into lactic acid with pure and mixed cultures of lactic acid bacteria.

Abstract Scotta is the main by-product in the making of ricotta cheese. It is widely produced in southern Europe and particularly in Italy where it represents a serious environmental pollutant due to its high lactose content. With the aim of evaluating whether scotta bioconversion into lactic acid can be considered as an alternative to its disposal, besides providing it with an added value, here the growth, fermentative performances, and lactic acid productions of pure and mixed cultures of Lactobacillus casei, Lactobacillus helveticus, and Streptococcus thermophilus were evaluated on ovine scotta-based media, without and with the addition of nutritional supplements. The outcomes indicate that ovine scotta can be utilized for the biotechnological production of lactic acid with yields up to 92%, comparable to those obtained on cheese-whey. Indeed, the addition of nutritional supplements generally improves the fermentative performances of lactic acid bacteria leading to about 2 g l−1 h−1 of lactic acid. Moreover, the use of mixed cultures for scotta bioconversion reduces the need for nutritional supplements, with no detrimental effects on the productive parameters compared to pure cultures. Finally, by using L. casei and S. thermophilus in pure and mixed cultures, up to 99% optically pure l-lactic acid can be obtained

Sedimentary provenance analysis of the Early Paleozoic units of the arroyo El Leoncito area, Southern Precordillera, province of San Juan

En el área del arroyo El Leoncito, en el ámbito de la Precordillera Sur, afloran la Formación Cabeceras y el Grupo Ciénaga del Medio. Ambas unidades consisten en sucesiones silicoclásticas marinas asociadas espacialmente a rocas máficas toleíticas depositadas en un margen continental sometido a extensión, el cual se desarrolló durante el Ordovícico-Devónico a lo largo del margen occidental del terreno Cuyania previo a la colisión del terreno Chilenia. A fines de caracterizar este ambiente y sus áreas de aporte, este trabajo presenta un análisis de procedencia sedimentaria mediante conteo modal de componentes de metareniscas de la Formación Cabeceras, Grupo Ciénaga del Medio y otras unidades de la Precordillera Sur (formaciones Portezuelo del Tontal, Peñasco, Garganta del León y Sandalio). Las modas analizadas sugieren que las rocas que actuaron como fuente fueron principalmente metamorfitas de bajo grado y sedimentitas. En menor proporción, participaron rocas ígneas de composición intermedia-ácida y/o rocas metamórficas de grado medio a alto. El aporte de rocas volcánicas fue subordinado. Los diagramas de discriminación señalan a un orógeno reciclado como la principal zona de aporte, con participación de una zona de arco disectado. Estos resultados pueden explicarse en un contexto donde el orógeno Oclóyico habría actuado como área de aporte y, a la vez, como barrera orográfica ante el transporte de material desde el este (arco Famatiniano y áreas cratónicas). La proveniencia de detritos desde el oeste no es totalmente descartada. La similitud de las modas analizadas sugiere que no hubo cambios significativos en las áreas de aporte para el segmento de la Precordillera analizado (31°45´S-32°15´S) durante el período Ordovícico-Devónico.In the Arroyo El Leoncito area, northern sector of the Southern Precordillera, the Cabeceras Formation and Ciénaga del Medio Group crop out. These units consist of marine siliciclastic successions and tholeiitic mafic rocks developed on a continental margin during the Ordovician-Devonian. In order to characterize this setting and its source areas, this work presents a sedimentary provenance analysis using modal composition of metasandstones of the Cabeceras Formation and Ciénaga del Medio Group, as well as other units of the Southern Precordillera (Portezuelo del Tontal, Peñasco, Garganta del León and Sandalio formations). Analyzed detrital modes suggest that mainly low-grade metamorphic and sedimentary rocks acted as source. To a lesser extent, intermediate-acid igneous rocks and/or medium- to high-grade metamorphic rocks of similar composition also participated. The contribution of volcanic rocks was subordinated. Discrimination diagrams indicate a recycled orogen as the main provenance zone, with the participation of a dissected arc zone. These results can be explained in a context where the Ocloyic orogen would have acted as source and, at the same time, as a barrier that prevented the transport of detritus from regions located further east (i.e. Famatinian arc and/or cratonic areas). Detritus provenance from the west is not totally ruled out. The similarity of the detrital modes of the formations involved in the analyzed segment of the Southern Precordillera (31°45'-32°15'S) suggests that there were no significant changes in source areas during the Ordovician-Devonian.Fil: Giunta, Agostina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias Geológicas; ArgentinaFil: Schmidt, Daniela Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias Geológicas; ArgentinaFil: Boedo, Florencia Lucila. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; ArgentinaFil: Vujovich, Graciela Irene. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; Argentina. Secretaría de Industria y Minería. Servicio Geológico Minero Argentino; Argentin

T-Cell Lymphoblastic Lymphoma Arising in the Setting of Myeloid/Lymphoid Neoplasms with Eosinophilia: LMO2 Immunohistochemistry as a Potentially Useful Diagnostic Marker

Simple Summary Rarely, T-lymphoblastic lymphoma (T-LBL) may develop in the setting of myeloid/lymphoid neoplasms with eosinophilia. Given important therapeutic implications, it is crucial to identify T-LBL arising in this particular context. LIM domain only 2 (LMO2) is known to be overexpressed in almost all sporadic T-LBL and not in immature TdT-positive T-cells in the thymus and in indolent T-lymphoblastic proliferations. We retrospectively evaluated the clinical, morphological, immunohistochemical and molecular features of 11 cases of T-LBL occurring in the setting of myeloid/lymphoid neoplasms with eosinophilia and investigated the immunohistochemical expression of LMO2 in this setting of T-LBL. Interestingly, 9/11 cases were LMO2 negative, with only 2 cases showing partial expression. In our study, we would suggest that LMO2 immunostaining, as part of the diagnostic panel for T-LBL, may represent a useful marker to identify T-LBL developing in the context of myeloid/lymphoid neoplasms with eosinophilia. Background: Rarely, T-lymphoblastic lymphoma (T-LBL) may develop in the setting of myeloid/lymphoid neoplasms with eosinophilia (M/LNs-Eo), a group of diseases with gene fusion resulting in overexpression of an aberrant tyrosine kinase or cytokine receptor. The correct identification of this category has relevant therapeutic implications. LIM domain only 2 (LMO2) is overexpressed in most T-LBL, but not in immature TdT-positive T-cells in the thymus and in indolent T-lymphoblastic proliferations (iT-LBP). Methods and Results: We retrospectively evaluated 11 cases of T-LBL occurring in the context of M/LNs-Eo. Clinical, histological, immunohistochemical and molecular features were collected and LMO2 immunohistochemical staining was performed. The critical re-evaluation of these cases confirmed the diagnosis of T-LBL with morphological, immunohistochemical and molecular features consistent with T-LBL occurring in M/LNs-Eo. Interestingly, LMO2 immunohistochemical analysis was negative in 9/11 cases, whereas only 2 cases revealed a partial LMO2 expression with a moderate and low degree of intensity, respectively. Conclusions: LMO2 may represent a potentially useful marker to identify T-LBL developing in the context of M/LNs-Eo. In this setting, T-LBL shows LMO2 immunohistochemical profile overlapping with cortical thymocytes and iT-LBP, possibly reflecting different molecular patterns involved in the pathogenesis of T-LBL arising in the setting of M/LNs-Eo

Ozonated autohemotherapy: protection of kidneys from ischemia in rats subjected to unilateral nephrectomy

<p>Abstract</p> <p>Background</p> <p>Ozonated autohemotherapy (OA) has been previously successfully used in the treatment of patients affected by peripheral occlusive arterial disease. OA consists of an intrafemoral reinfusion of autologous blood previously exposed to a mixture of oxygen/ozone (O₂/O₃). This study analyzes the effects of OA in protecting rat kidney from ischemia and ischemia/reperfusion damage.</p> <p>Methods</p> <p>We performed OA 30 min before the induction of 60 min renal ischemia or at the induction of 60 min postischemic reperfusion in rats subjected to unilateral nephrectomy. In addition, to evidence the possible protection induced by O₂/O₃on endothelial functions, the present study analyzes the in vitro effects of O₂/O₃on oxygen consumption by human umbilical vein endothelial cells (HUVEC).</p> <p>Results</p> <p>1) OA preserves rat kidney functions and architecture, as demonstrated by the improved levels of serum creatinine and blood urea nitrogen and by histology; 2) such protection does not correlate with the increase of plasmatic nitric oxide, but is compatible with a focal renal increase of renal βNADPH-diaphorase; 3) treatment of HUVEC with O₂/O₃significantly increases both the rate of oxygen consumption and the mitochondrial activity assessed by confocal microscopy.</p> <p>Conclusion</p> <p>The preservation of the mitochondrial activity of endothelium could in vivo limit the endothelial dysfunction provoked by the Isc or Isc/R processes.</p

Poetics/Poelitics of materiality in latin american digital poetry

Este artículo propone leer la poesía digital latinoamericana en vinculación con el acontecimiento poético-político que emerge cuando se considera su materialidad. Dar visibilidad a la materialidad habilita limitar la naturalización de los sentidos que vienen asociados a la cultura digital hegemónica contemporánea. Esto se logra desde procedimientos que ponen de relieve tanto los diversos niveles de materialidad inherentes a cada evento artístico literario digital —materialidad textual de superficie, materialidad relacional de las interfaces tanto de software como de hardware, materialidad del código— como los modos convencionales de ser con y hacer sentido de los entramados técnicos digitales que organizan nuestra vida cotidiana.This paper aims to read Latin American digital poetry in regards to the poetic-political event that emerges whenever its materiality is considered. To make materiality visible enables one to restrict the naturalization of meanings associate with contemporary hegemonic digital culture. This is accomplished through artistic procedures that emphasize, on the one hand, the multiple levels of materiality inherent to digital literary works— surface/textual materiality, software and hardware interface relational materiality, code materiality—and, on the other hand, the conventional ways to interact with and build meaning within the digital space that organize everyday life.Fil: Kozak, Claudia. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani". Estudios Culturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Tres de Febrero; Argentin

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients