41 research outputs found

    Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

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    BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

    Plasmid electrotransfer of eye ciliary muscle: principles and therapeutic efficacy using hTNF-alpha soluble receptor in uveitis.

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    Due to its small size and particular isolating barriers, the eye is an ideal target for local therapy. Recombinant protein ocular delivery requires invasive and painful repeated injections. Alternatively, a transfected tissue might be used as a local producer of transgene-encoded therapeutic protein. We have developed a nondamaging electrically mediated plasmid delivery technique (electrotransfer) targeted to the ciliary muscle, which is used as a reservoir tissue for the long-lasting expression and secretion of therapeutic proteins. High and long-lasting reporter gene expression was observed, which was restricted to the ciliary muscle. Chimeric TNF-alpha soluble receptor (hTNFR-Is) electrotransfer led to elevated protein secretion in aqueous humor and to drastic inhibition of clinical and histological inflammation scores in rats with endotoxin-induced uveitis. No hTNFR-Is was detected in the serum, demonstrating the local delivery of proteins using this method. Plasmid electrotransfer to the ciliary muscle, as performed in this study, did not induce any ocular pathology or structural damage. Local and sustained therapeutic protein production through ciliary muscle electrotransfer is a promising alternative to repeated intraocular protein administration for a large number of inflammatory, degenerative, or angiogenic diseases

    Energia de briquetes produzidos com rejeitos de resĂ­duos sĂłlidos urbanos e madeira de Eucalyptus grandis Energy from briquettes produced from remains of urban solid residues and wood of Eucalyptus grandis

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    O incentivo ao consumo e Ă  produção em grande quantidade na sociedade atual gera, exageros de resĂ­duos sĂłlidos urbanos que, em alguns casos, podem ser utilizados para a geração de energia. Neste sentido e visando reduzir os resĂ­duos dos aterros municipais e gerar energia, buscou-se produzir briquetes com mistura de rejeitos de resĂ­duos sĂłlidos urbanos (RRSU) e resĂ­duos de madeira de Eucalyptus grandis. Os briquetes foram fabricados com 0, 5, 10, 15, 20 e 25% de RRSU na mistura com resĂ­duos madeireiros contendo 12% de umidade. Os parĂąmetros analisados para a escolha da melhor mistura, foram: anĂĄlise de combustibilidade x cinzas, resistĂȘncia e energia utilizĂĄvel. Os briquetes com atĂ© 10% de RRSU se mostraram com baixa resistĂȘncia e os acima de 15% apresentaram grande aumento no teor de cinzas; portanto, os que melhor atenderam aos requisitos combustibilidade x cinzas e resistĂȘncia mecĂąnica, foram aqueles com 15% de RRSU, pois nĂŁo se conhece a procedĂȘncia das cinzas. Considerando-se a energia utilizĂĄvel, o briquete com 25% de RRSU Ă© o que apresenta maior poder calorĂ­fico Ăștil na ordem de 17.175 kJ kg-1 motivo pelo qual se indica a produção de briquetes com adição RRSU; ressalta-se, porĂ©m, a necessidade de estudos sobre a emissĂŁo de gases.<br>The incentive for consumption and production in large quantity in modern society generates enormous amounts of urban solid residues in the form of municipal solid waste (MSW). With the intention of reducing these residues of the municipal waste tips and to generate energy, briquettes with mixtures of MSW and residues of Eucalyptus grandis were produced. The briquettes were manufactured with 0, 5, 10, 15, 20 and 25% of MSW in the mixture with wood waste and 12% of moisture content. The analyzed parameters used to choose the best treatments were combustion analysis versus ash content, mechanical strength and energy content. The briquettes up to 10% of MSW showed low resistance, and above 15% showed large increase in ash content. Therefore, the treatment that fulfilled the requirements for combustion versus ash content and mechanical resistance was of at least 15% of MSW, since the source of the ash is unidentified. Considering the net energy content, the best treatment was 25% of MSW, with 17,175 kJ kg-1. Nevertheless, it is strongly advised that further studies related to gas emissions are necessary
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