Rationalization of Small Induction Machines

The work deals with the possibility ofassessment of optimal costs for a specific product. In thispaper it is described the sphere of costs, their segmentationand assessment. From the aspect of product pricecalculation it is very important to set a price level ofparticular costs. The price level must be acceptable from theaspect the whole company economics (returns)

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Association between low levels of Mannan-binding lectin and markers of autoimmune thyroid disease in pregnancy.

Functional deficiency of mannan-binding lectin (MBL) has been associated with adverse pregnancy outcome. Adverse events during pregnancy have also been described in women with autoimmune thyroid diseases (AITD), and thyroid hormones have been shown to influence serum levels of MBL. Therefore, the aim of this study was to analyse the impact of MBL-deficiency on the outcome of pregnancy in relation to the presence of AITD. Almost one year after delivery, we assessed serum MBL levels and MBL2-genotypes in 212 women positively screened for AITD in pregnancy. In 103 of these women, we could also measure MBL levels in frozen serum samples from the 9-12(th) gestational week, obtaining 96 pairs of MBL values (pregnancy vs. follow-up). As controls, 80 sera of pregnant women screened negatively for AITD were used. MBL2-genotyping was performed using multiplex PCR. Women with thyroid dysfunction and/or thyroid peroxidase antibodies (TPOAb) had lower MBL levels during pregnancy than controls, (3275 vs. 5000 ng/ml, p<0.05). The lowest levels were found in women with elevated thyroid-stimulating hormone (TSH) levels in the absence of TPOAb (2207 ng/ml; p<0.01 as compared to controls). MBL2 genotype distribution did not differ between subgroups. At a median follow-up period of 17 months (range: 3-78 months) after delivery, median MBL level had decreased further to 1923 ng/ml (p<0.0001) without significant changes in TSH. In an explorative survey, functional MBL-deficiency was neither linked to a history of spontaneous abortion, nor other obstetric complications, severe infections throughout life/pregnancy or antibiotics use in pregnancy. In conclusion, hypothyroidism during pregnancy is associated with decreased MBL levels, and the levels decreased further after delivery

Serum MBL levels in pregnant women screened for AITD.

<p>–1000 ng/ml and high: >1000 ng/ml. Low serum MBL levels: <100 ng/ml; intermediate: 100</p

Serum levels of MBL and thyroid parameters in pregnant women screened for autoimmune thyroid disorders in the 9-12^th gestational wks.

<p>^*(p<0.05), ^**(p<0.01), ^***(p<0.001) (Mann Whitney test). Positivity in screening: TSH<0.06 or >3.67 mIU/l and/or TPOAb>143 kU/l. TSH: thyroid stimulating hormone; FT4: free thyroxine; TPOAb: antibodies against thyroperoxidase. All 212 women included provided a blood sample for MBL analysis after delivery. In 103women, MBL could also be measured in a sample frozen at screening in pregnancy, which summed up to 96 pairs (pregnancy vs. follow-up). Statistical significances of comparison between values in positively vs. negatively screened women are marked by </p

Prevalence of atopy, asthma and allergy with regard to MBL status.

<p>–1000 ng/ml; high: >1000 ng/ml. MBL2 genotypes represent the allelic variations associated with low, intermediate or high MBL levels. Statistical analysis was performed using the Chi-square test. Serum MBL levels are regarded as low if they are <100 ng/ml; intermediate: 100</p

Clinical characteristics of the study group.

<p> AITD: autoimmune thyroid disorders. TPOAb: antibodies against thyroperoxidase. The data were obtained from questionnaires filled by the participating women.</p

MBL levels in pregnant women with and without autoimmune thyroid disorders.

<p>Overall, 103 women tested positively in a screening for AITD performed between the 9^th and 12^th gestational weeks (grouped together in the left column). They were found to be positive for TPOAb in 86 cases (of these, 12 had TSH elevation, 6 had TSH suppression; the rest was euthyroid). Of the 17 TPOAb-negative ones, 10 had TSH elevation and 7 had TSH suppression. Eighty women were negative for both parameters (right column). Horizontal bars represent median values of serum MBL.</p