45 research outputs found

    Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy

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    Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy.BackgroundCritical illness leading to multi-organ dysfunction syndrome (MODS) and associated acute renal failure (ARF) is less common in children compared to adult patients. As a result, many issues plague the pediatric ARF outcome literature, including a relative lack of prospective study, a lack of modality stratification in subject populations and inconsistent controls for patient illness severity in outcome analysis.MethodsWe now report data from the first multicenter study to assess the outcome of pediatric patients with MODS receiving continuous renal replacement therapy (CRRT). One hundred twenty of 157 Registry patients (63 male/57 female) experienced MODS during their course.ResultsOne hundred sixteen patients had complete data available for analysis. The most common causes leading to CRRT were sepsis (N = 47; 39.2%) and cardiogenic shock (N = 24; 20%). Overall survival was 51.7%. Pediatric Risk of Mortality (PRISM 2) score, central venous pressure (CVP), and% fluid overload (%FO) at CRRT initiation were significantly lower for survivors versus nonsurvivors. Multivariate analysis controlling for severity of illness using PRISM 2 at CRRT initiation revealed that%FO was still significantly lower for survivors versus nonsurvivors (P < 0.05) even for patients receiving both mechanical ventilation and vasoactive pressors. We speculate that increased fluid administration from PICU admission to CRRT initiation is an independent risk factor for mortality in pediatric patients with MODS receiving CRRT.ConclusionWe suggest that after initial resuscitative efforts, an increased emphasis should be placed on early initiation of CRRT and inotropic agent use over fluid administration to maintain acceptable blood pressure

    New games, new rules: big data and the changing context of strategy

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    Big data and the mechanisms by which it is produced and disseminated introduce important changes in the ways information is generated and made relevant for organizations. Big data often represents miscellaneous records of the whereabouts of large and shifting online crowds. It is frequently agnostic, in the sense of being produced for generic purposes or purposes different from those sought by big data crunching. It is based on varying formats and modes of communication (e.g., texts, image and sound), raising severe problems of semiotic translation and meaning compatibility. Crucially, the usefulness of big data rests on their steady updatability, a condition that reduces the time span within which this data is useful or relevant. Jointly, these attributes challenge established rules of strategy making as these are manifested in the canons of procuring structured information of lasting value that addresses specific and long-term organizational objectives. The developments underlying big data thus seem to carry important implications for strategy making, and the data and information practices with which strategy has been associated. We conclude by placing the understanding of these changes within the wider social and institutional context of longstanding data practices and the significance they carry for management and organizations

    Influence of animal fat substitution by vegetal fat on Mortadella-type products formulated with different hydrocolloids

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    Meat has played a crucial role in human evolution and is an important component of a healthy and well-balanced diet on account of its nutritional properties, its high biological value as a source of protein, and the vitamins and minerals it supplies. We studied the effects of animal fat reduction and substitution by hydrogenated vegetal fat, sodium alginate and guar gum. Fatty acid composition, lipid oxidation, color and instrumental texture as well as the sensorial difference between low, substituted-fat and the traditional formulations for mortadella-type products were analyzed. Both substitution and reduction of animal fat decreased the saturated fatty acids percentage from 40% down to 31%. A texture profile analysis showed differences between the formulations. Furthermore, lipid oxidation values were not significant for treatments as regards the type and quantity of fat used while the use of sodium alginate and guar gum reduced the amounts of liquid released after cooking. Animal fat substitution does cause, however, a difference in overall sensorial perception compared with non-substituted products. The results confirm the viability of substituting vegetal fat for animal fat

    Auctions as a Dynamic Pricing Mechanism for E-Services

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    Chylothorax after high translumbar aortography

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    Chlothorax is a rare complication of high translumbar aortography and a case is described here
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