Avaliação não invasiva da pressão venosa central por ecocardiografia em cuidados intensivos : particularidades nos doentes com dilatação do ventrículo direito e exacerbação de doença pulmonar crónica

Copyright © 2006 Sociedade Portuguesa de Pneumologia/SPP. Published by Elsevier España, S.L.Objectives: To determine the possibility of non-invasive estimation of central venous pressure (CVP) through inferior vena cava (IVC) analysis, using transthoracic echocardiography (TTE). Design: A prospective 3-year study. Setting: A 16-bed medical/surgical Intensive Care Unit (ICU). Methods: Patients admitted to the ICU were enrolled. CVP measurement and TTE (determining cardiac chambers dimension and left ventricular shortening fraction) with IVC analysis (maximum dimension and IVC index) were performed simultaneously. Parametric and non-parametric statistical analysis was performed to establish correlations between variables. Results: 560 patients were admitted to the study, including 477 in whom IVC was analysed, aging 62.2 ± 17.3 years, a mean ICU stay 11.9 ± 18.7 days, a APACHE II score 23.9 ± 8.9 and a SAPS II score 55.7 ± 20.4. Through linear regression analysis CVP was influenced by IVC index (p=0.001), IVC maximum dimension (p=0.013) and presence of mechanical ventilation (p=0.002). A statistically significant correlation was found between the following parameters: an IVC index13mmHg; an IVC index and a CVP 26%-50%; an IVC index >51% and CVP 20mm and a CVP >13mmHg; an IVC maximum dimension 7mmHg was observed, and in patients with chronic respiratory failure (who presented a high prevalence of right ventricular enlargement) a lack of agreement between IVC index >50% and CVP 13mmHg; índice da VCI entre 26 e 50% e PVC entre 8 e 12mmHg; índice da VCI> 51% e PVC> 7mmHg; dimensão máxima da VCI> 20mmHg e PVC> 13 mmHg; dimensão máxima da VCI> 10mm e PVC> 7mmHg. Nos doentes com dilatação do ventrículo direito (VD) observou-se uma relação mais fraca entre a PVC 50%. A dimensão máxima da VCI, mas não o seu índice, correlacionou-se com a dilatação do VD e AD. Conclusões: A análise da VCI por ETT revelou-se útil na avaliação qualitativa da PVC em doentes admitidos numa UCIP. Em doentes com dilatação do VD e admitidos por exacerbação de doença pulmonar crónica, os métodos avaliados não foram fidedignos para valores baixos de PVC. A dilatação da VCI traduz melhor a cronicidade da doença, enquanto o índice da VCI reflecte melhor o estado de volemia.info:eu-repo/semantics/publishedVersio

Породы песчаники – редкие материалы высокой крепости – уникальные фрикционные материалы

Розглядаються питання при підготовці до відпрацювання пологих вугільних пластів на великих глибинах в умовах шахти «Довжанська Капітальна» ТОВ "ДТЕК Свердловантрацит". Проведено дослідження вміщуючих підготовчу виробку порід. Запропоновано можливості проектування комплексного видобутку супутніх корисних компонентів при підготовці Антрацитівського пластів до видобутку.The questions in preparation for mining of shallow coal seams at great depths in the mine "Dolzhanskaya Capital" LLC "DTEK Sverdlovantratsit." Investigations of host rocks of underground working. Suggested the possibility of designing an integrated co-production of useful components in preparation Antratsitovskogo of flat seam to production

The European Ryegrass Core Collection: A Tool to Improve the Use of Genetic Resources

A core collection of 162 populations of ryegrass (Lolium perenne) native to 18 European countries, is being evaluated across Europe in a multi-country trial. Each participating country contributed the lesser of 10% or 25 accessions from its collection of native populations. The accessions are being grown at 18 sites in 17 countries. Quick, cheap protocols were developed for evaluation. Preliminary results are presented for performance during the first winter. Populations of northern origin showed uniformly low winter damage and low winter growth at all evaluation sites. Populations of Mediterranean origin were more affected by the environment used for evaluation, developing higher winter yield at sites with mild winters, lower winter yield where winters were colder, and suffering severe damage at sites with the coldest winters

Programmatic Evaluation of a Combined Antigen and Antibody Test for Rapid HIV Diagnosis in a Community and Sexual Health Clinic Screening Programme

Background A substantial proportion of HIV-infected individuals in the UK are unaware of their status and late presentations continue, especially in low prevalence areas. Fourth generation antigen/antibody rapid test kits could facilitate earlier diagnosis of HIV in non-clinical settings but lack data on performance under programmatic conditions. Methods and Findings We evaluated the performance of Determine HIV-1/2 Ag/Ab Combo Test (Determine Combo), a rapid test with indicators for both HIV antibodies and p24 antigen, in participants recruited from community outreach and hospital-based sexual health clinics. HIV infection was confirmed using laboratory enzyme-linked immunosorbent assay (EIA), Line Immuno Assay (LIA) and quantitative polymerase chain reaction (PCR). In total, 953 people underwent HIV testing. HIV antibody (Ab) prevalence was 1.8% (17/953). Four false positive rapid tests were identified: two antibody and two p24 antigen (Ag) reactions. Of participants diagnosed as HIV Ab positive, 2/17 (12%) were recent seroconverters based on clinical history and HIV antibody avidity test results. However, none of these were detected by the p24 antigen component of the rapid test kit. There were no other true positive p24 Ag tests. Conclusion These data lend support to an increasing body of evidence suggesting that 4th generation rapid HIV tests have little additional benefit over 3rd generation HIV kits for routine screening in low prevalence settings and have high rates of false positives. In order to optimally combine community-based case-finding among hard-to-reach groups with reliable and early diagnosis 3rd generation kits should be primarily used with laboratory testing of individuals thought to be at risk of acute HIV infection. A more reliable point of care diagnostic is required for the accurate detection of acute HIV infection under programmatic conditions

Reference Gene Selection for Quantitative Real-time PCR Normalization in Quercus suber

The use of reverse transcription quantitative PCR technology to assess gene expression levels requires an accurate normalization of data in order to avoid misinterpretation of experimental results and erroneous analyses. Despite being the focus of several transcriptomics projects, oaks, and particularly cork oak (Quercus suber), have not been investigated regarding the identification of reference genes suitable for the normalization of real-time quantitative PCR data. In this study, ten candidate reference genes (Act, CACs, EF-1α, GAPDH, His3, PsaH, Sand, PP2A, ß-Tub and Ubq) were evaluated to determine the most stable internal reference for quantitative PCR normalization in cork oak. The transcript abundance of these genes was analysed in several tissues of cork oak, including leaves, reproduction cork, and periderm from branches at different developmental stages (1-, 2-, and 3-year old) or collected in different dates (active growth period versus dormancy). The three statistical methods (geNorm, NormFinder, and CV method) used in the evaluation of the most suitable combination of reference genes identified Act and CACs as the most stable candidates when all the samples were analysed together, while ß-Tub and PsaH showed the lowest expression stability. However, when different tissues, developmental stages, and collection dates were analysed separately, the reference genes exhibited some variation in their expression levels. In this study, and for the first time, we have identified and validated reference genes in cork oak that can be used for quantification of target gene expression in different tissues and experimental conditions and will be useful as a starting point for gene expression studies in other oaks

Effects of Pharmacogenetic Screening for CYP2D6 Among Elderly Starting Therapy With Nortriptyline or Venlafaxine:A Pragmatic Randomized Controlled Trial (CYSCE Trial)

PURPOSE/BACKGROUND: The duration of untreated depression is a predictor for poor future prognosis, making rapid dose finding essential. Genetic variation of the CYP2D6 isoenzyme can influence the optimal dosage needed for individual patients. The aim of this study was to determine the effectiveness of CYP2D6 pharmacogenetic screening to accelerate drug dosing in older patients with depression initiating nortriptyline or venlafaxine. METHODS/PROCEDURES: In this randomized controlled trial, patients were randomly allocated to one of the study arms. In the intervention arm (DG-I), the specific genotype accompanied by a standardized dosing recommendation based on the patients' genotype and the prescribed drug was directly communicated to the physician of the participant. In both the deviating genotype control arm (DG-C) and the nonrandomized control arm, the physician of the participants was not informed about the genotype and the associated dosing advise. The primary outcome was the time needed to reach adequate drug levels: (1) blood levels within the therapeutic range and (2) no dose adjustments within the previous 3 weeks. FINDINGS/RESULTS: No significant difference was observed in mean time to reach adequate dose or time to adequate dose between DG-I and DG-C. Compared with the nonrandomized control arm group, adequate drug levels were reached significantly faster in the DG-I group (log-rank test; P = 0.004), and there was a similar nonsignificant trend for the DG-C group (log-rank test; P = 0.087). IMPLICATIONS/CONCLUSIONS: The results of this study do not support pharmacogenetic CYP2D6 screening to accelerate dose adjustment for nortriptyline and venlafaxine in older patients with depression