711 research outputs found

    Correlation between capillary oxygen saturation and small intestinal wall thickness in the equine colic patient

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    The surgical evaluation of haemorrhagic infarcted intestine and the decision for or against bowel resection require a lot of experience and are subjective. The aim of this prospective, clinical study was to examine the correlation between oxygen saturation and small intestinal wall (IW) thickness, using two objective methods. In 22 colicky horses, the blood flow, oxygen saturation and relative amount of haemoglobin were measured intraoperatively via laser Doppler and white light spectroscopy (O2C, oxygen to see, LEA Medizintechnik) at six measuring points (MPs) in small and large intestines. Furthermore, the IW thickness was measured ultrasonographically. Nine of 22 horses had an increased small IW thickness greater than 4?mm (Freeman 2002, Scharner and others 2002, le Jeune and Whitcomb 2014) at measuring point 1 (MP1) (strangulated segment), four horses had a thickened bowel wall at measuring point 3 (MP3) (poststenotic) and one at measuring point 2 (MP2). The oxygen saturation was 0 at MP1 in six horses, at MP3 in two horses and at MP2 (prestenotic) in one. Oxygen saturation and small IW thickness were independent of each other at MP1 and MP2. At MP3, the two parameters were negatively correlated. In summary, it is not possible to draw conclusions about oxygen saturation based on IW thickness

    Metabolic responses and resilience to environmental challenges in the sedentary Batrachoid Halobatrachus didactylus (Bloch & Schneider, 1801)

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    In the context of climate change, warming of the seas and expansion of hypoxic zones are challenges that most species of fish are, or will be subjected to. Understanding how different species cope with these changes in their environment at the individual level can shed light on how populations and ecosystems will be affected. We provide first-time estimates on the metabolic rates, thermal, and oxygen-related limits for Halobatrachus didactylus, a coastal sedentary fish that lives in intertidal environments of the Northeast Atlantic. Using respirometry in different experimental designs, we found that this species is highly resistant to acute thermal stress (CTmax: 34.82 ± 0.66 °C) and acute hypoxia (Pcrit: 0.59–1.97 mg O2 L−1). We found size-specific differences in this stress response, with smaller individuals being more sensitive. We also quantified its aerobic scope and daily activity patterns, finding this fish to be extremely sedentary, with one of the lowest standard metabolic rates found in temperate fish (SMR: 14.96 mg O2 kg−1h−1). H. didactylus activity increases at night, when its metabolic rate increases drastically (RMR: 36.01 mg O2 kg−1h−1). The maximum metabolic rate of H. didactylus was estimated to be 67.31 mg O2 kg−1h−1, producing an aerobic scope of 52.35 mg O2 kg−1h−1 (77.8% increase). The metrics obtained in this study prove that H. didactylus is remarkably resilient to acute environmental variations in temperature and oxygen content, which might enable it to adapt to the extreme abiotic conditions forecasted for the world’s oceans in the near future.info:eu-repo/semantics/publishedVersio

    Антибіотикопрофілактика в хірургії

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    Наук. кер.: М.Г. КононенкоГнійно-запальні післяопераційні ускладнення за останні десятиріччя набувають все більшої актуальності. Це вже стає проблемою. Такі ускладнення необхідно попереджувати. Для забезпечення тканин операційного поля антибіотиком у ефективній (бактерицидній) концентрації на весь період хірургічного втручання проводять антибіотикопрофілактику (АБП). Вона є складовою частиною комплексної профілактики гнійно-запальних ускладнень. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/2734

    A review of Bayesian perspectives on sample size derivation for confirmatory trials

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    Sample size derivation is a crucial element of the planning phase of any confirmatory trial. A sample size is typically derived based on constraints on the maximal acceptable type I error rate and a minimal desired power. Here, power depends on the unknown true effect size. In practice, power is typically calculated either for the smallest relevant effect size or a likely point alternative. The former might be problematic if the minimal relevant effect is close to the null, thus requiring an excessively large sample size. The latter is dubious since it does not account for the a priori uncertainty about the likely alternative effect size. A Bayesian perspective on the sample size derivation for a frequentist trial naturally emerges as a way of reconciling arguments about the relative a priori plausibility of alternative effect sizes with ideas based on the relevance of effect sizes. Many suggestions as to how such `hybrid' approaches could be implemented in practice have been put forward in the literature. However, key quantities such as assurance, probability of success, or expected power are often defined in subtly different ways in the literature. Starting from the traditional and entirely frequentist approach to sample size derivation, we derive consistent definitions for the most commonly used `hybrid' quantities and highlight connections, before discussing and demonstrating their use in the context of sample size derivation for clinical trials

    Concordance of KRAS/BRAF Mutation Status in Metastatic Colorectal Cancer before and after Anti-EGFR Therapy

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    Anti-EGFR targeted therapy is a potent strategy in the treatment of metastatic colorectal cancer (mCRC) but activating mutations in the KRAS gene are associated with poor response to this treatment. Therefore, KRAS mutation analysis is employed in the selection of patients for EGFR-targeted therapy and various studies have shown a high concordance between the mutation status in primary CRC and corresponding metastases. However, although development of therapy related resistance occurs also in the context of novel drugs such as tyrosine kinase-inhibitors the effect of the anti-EGFR treatment on the KRAS/BRAF mutation status itself in recurrent mCRC has not yet been clarified. Therefore, we analyzed 21 mCRCs before/after anti-EGFR therapy and found a pre-/posttherapeutic concordance of the KRAS/BRAF mutation status in 20 of the 21 cases examined. In the one discordant case, further analyses revealed that a tumor mosaicism or multiple primary tumors were present, indicating that anti-EGFR therapy has no influence on KRAS/BRAF mutation status in mCRC. Moreover, as the preselection of patients with a KRASwt genotype for anti-EGFR therapy has become a standard procedure, sample sets such ours might be the basis for future studies addressing the identification of potential anti-EGFR therapy induced genetic alterations apart from KRAS/BRAF mutations

    Risk factors associated with severe hospital burden of COVID-19 disease in Regione Lombardia: a cohort study.

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    BACKGROUND: Understanding the risk factors associated with hospital burden of COVID-19 is crucial for healthcare planning for any future waves of infection. METHODS: An observational cohort study is performed, using data on all PCR-confirmed cases of COVID-19 in Regione Lombardia, Italy, during the first wave of infection from February-June 2020. A multi-state modelling approach is used to simultaneously estimate risks of progression through hospital to final outcomes of either death or discharge, by pathway (via critical care or not) and the times to final events (lengths of stay). Logistic and time-to-event regressions are used to quantify the association of patient and population characteristics with the risks of hospital outcomes and lengths of stay respectively. RESULTS: Risks of severe outcomes such as ICU admission and mortality have decreased with month of admission (for example, the odds ratio of ICU admission in June vs March is 0.247 [0.120-0.508]) and increased with age (odds ratio of ICU admission in 45-65 vs 65 + age group is 0.286 [0.201-0.406]). Care home residents aged 65 + are associated with increased risk of hospital mortality and decreased risk of ICU admission. Being a healthcare worker appears to have a protective association with mortality risk (odds ratio of ICU mortality is 0.254 [0.143-0.453] relative to non-healthcare workers) and length of stay. Lengths of stay decrease with month of admission for survivors, but do not appear to vary with month for non-survivors. CONCLUSIONS: Improvements in clinical knowledge, treatment, patient and hospital management and public health surveillance, together with the waning of the first wave after the first lockdown, are hypothesised to have contributed to the reduced risks and lengths of stay over time
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