Incidence and prognosis of dysnatraemia in critically ill patients: Analysis of a large prevalence study

Background: The objective of this study is to assess the impact of dysnatraemia on mortality among intensive care unit (ICU) patients in a large, international cohort. Material and methods: Analysis of the Extended Prevalence of Infection in Intensive Care (EPIC II) study, a 1-day (8 May 2007) worldwide multicenter, prospective point prevalence study. Hyponatraemia was categorized as mild (130-134 mM/L), moderate (125-129 mM/L) or severe ( 155 mM/L). Patients with normal serum sodium (135-145 mM/L) constituted the reference group. The main outcome was hospital mortality. Analysis was conducted separately for patients admitted on the study day (25·8%) and those already present on the ICU (74·2%). Results: Serum sodium was measured in 13 276 of the 13 796 patients (96·2%). A total of 3815 patients (28·7%) had dysnatraemia: 12·9% with hyponatraemia and 15·8% with hypernatraemia. The prevalence of dysnatraemia was significantly greater in patients already present on the ICU prior to the study day than for those just admitted (13·1% vs. 12·3% for hyponatraemia and 17·1% vs. 12·1% for hypernatraemia, both P < 0·001). Hospital mortality rates were higher in patients with dysnatraemia than in those with normal sodium levels and were directly related to the severity of hypo- and hypernatraemia. This association between dysnatraemia and mortality was similar in infected and noninfected patients (P = 0·061). Conclusions: Dysnatraemia is more frequent during the ICU stay than on the day of admission. Dysnatraemia in the ICU - even mild - is an independent predictor of increased hospital mortality

Synaptic Vesicle Docking: Sphingosine Regulates Syntaxin1 Interaction with Munc18

Consensus exists that lipids must play key functions in synaptic activity but precise mechanistic information is limited. Acid sphingomyelinase knockout mice (ASMko) are a suitable model to address the role of sphingolipids in synaptic regulation as they recapitulate a mental retardation syndrome, Niemann Pick disease type A (NPA), and their neurons have altered levels of sphingomyelin (SM) and its derivatives. Electrophysiological recordings showed that ASMko hippocampi have increased paired-pulse facilitation and post-tetanic potentiation. Consistently, electron microscopy revealed reduced number of docked vesicles. Biochemical analysis of ASMko synaptic membranes unveiled higher amounts of SM and sphingosine (Se) and enhanced interaction of the docking molecules Munc18 and syntaxin1. In vitro reconstitution assays demonstrated that Se changes syntaxin1 conformation enhancing its interaction with Munc18. Moreover, Se reduces vesicle docking in primary neurons and increases paired-pulse facilitation when added to wt hippocampal slices. These data provide with a novel mechanism for synaptic vesicle control by sphingolipids and could explain cognitive deficits of NPA patients

Scenario-Based Design Theorizing:The Case of a Digital Idea Screening Cockpit

As ever more companies encourage employees to innovate, a surplus of ideas has become reality in many organizations – often exceeding the available resources to execute them. Building on insights from a literature review and a 3-year collaboration with a banking software provider, the paper suggests a Digital Idea Screening Cockpit (DISC) to address this challenge. Following a design science research approach, it suggests a prescriptive design theory that provides practitioner-oriented guidance for implementing a DISC. The study shows that, in order to facilitate the assessment, selection, and tracking of ideas for different stakeholders, such a system needs to play a dual role: It needs to structure decision criteria and at the same be flexible to allow for creative expression. Moreover, the paper makes a case for scenario-based design theorizing by developing design knowledge via scenarios

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Herodoto e a "nação" ateniense : analise da construção de uma ferramenta cultural

Orientador: Pedro Paulo A. FunariDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias HumanasResumo: Esta dissertação é um estudo analítico de um espectro da tradição britânica de interpretação das Histórias de Heródoto. Levado a termo sob a perspectiva de que a herança cultural ocidental é parte de um esforço maior, formalizado, de construção das identidades nacionais européias, busca-se, aqui, compreender como se constituíram os modelos de interpretação de Heródoto, analisando, depois, que juízos de valor eles articularamAbstract: This is an analytical study on some aspects in the British tradition of interpretation of Herodotus' Histories. Developed in the presumption that the western cultural heritage is part of a major and formalised effort in the construction of western national identities, I intend to understand the way this tradition of interpretation was build up, analysing, furthermore, their understanding of Herodotus' effortsMestradoMestre em Históri

Hellenism and imperialism

Orientador: Pedro Paulo Abreu FunariTese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias HumanasResumo: Esta tese é um estudo acerca dos Estudos Clássicos britânicos, no período de Consolidação Imperial (1875-1914). Busca-se entender como se estabeleceu a autoridade que legitimou uma versão acerca da Grécia Antiga afeita às oposições entre Oriente e Ocidente formalizadas desde o século XVIII. A análise da Arqueologia do período é instrumental para se compreender o espírito da época e a Helenomania que foi contemporânea a esse processo. Por meio de um referencial teórico pós-colonial esboça-se inclusive uma apreciação acerca dos desenvolvimentos contemporâneos do tópico em questãoAbstract: This is a study about the field of Classics in Britain during the period of consolidation of imperial power (1875-1914). I try to understand how the authority that worked to legitimise the old traditional view of Classical Greece as the one had sprung from the victory against Orient was formed. The Archaeology of the period is studied as a way to understand Hellenomania in Britain. I use post-colonial theory to understand the late developments of the topic in contemporary worldDoutoradoHistoria CulturalDoutor em Históri

The Chan Hol cave near Tulum (Quintana Roo, Mexico): evidence for long‐lasting human presence during the early to middle Holocene

Numerous charcoal accumulations discovered in the submerged Chan Hol cave near Tulum, Quintana Roo, Mexico, have been 14C-dated revealing ages between 8110 ± 28 14C a BP (9122–8999 cal a BP) and 7177 ± 27 14C a BP (8027–7951 cal a BP). These charcoal concentrations, interpreted here as ancient illumination sites, provide strong evidence that the Chan Hol cave was dry and accessible during that time interval. Humans used the cave for at least 1200 years during the early and middle Holocene, before access was successively interrupted by global sea level rise and flooding of the cave system. Our data thus narrow the gap between an early settlement in the Tulum area reaching from the late Pleistocene (∼13 000 a) to middle Holocene (e.g. 7177 14C a BP), and the Maya Formative period at approximately 3000 a bp. Yet, no evidence has been presented to date for human settlement during the ∼4000-year interval between 7000 and 3000 a. This is remarkable as settlement in other areas of south-eastern Mexico (e.g. Chiapas, Tabasco) and in Guatemala was apparently continuous

Incidence and prognosis of dysnatraemia in critically ill patients: analysis of a large prevalence study.

The objective of this study is to assess the impact of dysnatraemia on mortality among intensive care unit (ICU) patients in a large, international cohort.Journal ArticleFLWINSCOPUS: ar.jinfo:eu-repo/semantics/publishe