Cardiac Tamponade Secondary to Methicillin-Resistant Staphylococcus Aureus Pericarditis

As pericardites bacterianas, apesar da sua baixa incidência e das terapêuticas actuais, apresentam um prognóstico desfavorável, sobretudo quando causadas por Staphylococcus aureus meticilino resistente (MRSA). O Tamponamento cardíaco é uma complicação potencialmente letal nos doentes com pericardites por este agente. Numa Unidade de Cuidados Intensivos, para além da imunossupressão, constituem factores predisponentes para este tipo de infecção, a elevada taxa de colonização nasal e cutânea, assim como a utilização de técnicas invasivas (1) entre as quais a simples colocação de catéteres intravenosos. Relatam-se dois casos clínicos de tamponamento cardíaco em doentes jovens, no contexto de imunossupressão de diferentes etiologias (infecção HIV e pós transplante hepático). Os internamentos foram complicados de quadros sépticos importantes com isolamento de MRSA nos líquidos biológicos e desenvolvimento de pericardite bacteriana e subsequente tamponamento cardíaco. Os autores salientam a importância dos quadros clínicos infecciosos em doentes imunodeprimidos, que constituem uma população cada vez mais numerosa, e a importância da monitorização ecocardiográfica na evolução prognóstica das pericardites bacterianas no contexto de sépsis

Lymphopenia in Patients Submitted to Assisted Ventilation Due to Aggravated Chronic Respiratory Failure: a Prospective Study

Objectivo: avaliar e caracterizar a linfopenia em doentes admitidos numa unidade de cuidados intensivos para suporte ventilatório por exacerbação de insuficiência respiratória crónica e eventual relação com a gravidade da doença. Material e métodos: estudo prospectivo com 6 meses de duração e mais 6 meses de seguimento após alta da unidade. Incluídos 24 doentes, 22 homens, com APACHE II médio de 19,7, 3 dos quais com possibilidade de seguimento após a alta. Foram colhidas análises para determinação das subpopulações linfocitárias na admissão e a cada 7 dias de ventilação mecânica. Excluídos doentes com sinais de infecção ou imunossupressão prévia, à excepção dos corticóides. Resultados: a linfopenia foi encontrada em 79,2 % dos doentes com depleção de todas as subpopulações linfocitárias sendo mais expressiva a depleção de linfócitos B CD19+. Esta linfopenia não se relacionou com os níveis séricos de cortisol, e apesar de se relacionar com uma maior gravidade clínica não esteve associada a uma maior mortalidade. O registo evolutivo no internamento mostrou tendencialmente uma recuperação da linfopenia. Conclusões: a linfopenia é frequente em doentes ventilados por exacerbação de doença respiratória crónica. Trata-se de uma linfopenia não selectiva, que recupera ao longo do internamento, mais acentuada ao nível dos linfócitos B CD19+. Estes doentes apresentam índices de gravidade maior mas sem diferenças na mortalidade. O seguimento ambulatório destes doentes mostrou-se difícil e foi inconclusivo

A Comparative Study of Cardiovascular Tolerability with Slow Extended Dialysis Versus Continuous Haemodiafiltration in the Critical Patient

Background: In the haemodynamically unstable patient the method of treatment of acute renal failure is still largely controversial. The purpose of our study was to compare slow extended dialysis with continuous haemodiafiltration in the critical patient with indication for renal replacement therapy and haemodynamic instability. Patients and Methods: This is a cohort study comparing in 63 ventilated critical patients a 12 month period when only continuous haemodiafiltration was used (n=25) with an equal period of slow extended dialysis (n=38). Our primary objective was to evaluate the impact of the dialytic procedure on cardiovascular stability in those patients. As secondary aims we considered system coagulation/thrombosis and predictors of mortality. In the two groups we analysed the first session performed, the second session performed and the average of all the sessions performed in each patient. Results: In these patients, mortality in the intensive care unit was high (68% in the continuous haemodiafiltration group and 63% in the slow extended dialysis group). We did not find any association between the dialytic technique used and death; only the APACHE score was a predictor of death. Slow extended dialysis was a predictor of haemodynamic stability, a negative predictor of sessions that had to be interrupted for haemodynamic instability, and a predictor of achieving the volume removal initially sought. Slow extended dialysis was also associated with less coagulation of the system. Conclusions: Our data suggested that slow extended dialysis use was not inferior to continuous haemodiafiltration use in terms of cardiovascular tolerability

Body weight gain in clozapine-treated patients:Is norclozapine the culprit?

The antipsychotic drug clozapine is associated with weight gain. The proposed mechanisms include blocking of serotonin (5-HT2a/2c ), dopamine (D2 ) and histamine (H1 ) receptors. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2) to norclozapine, a metabolite with more 5-HT2c -receptor and less H1 blocking capacity. We hypothesized that norclozapine serum levels correlate with body mass index (BMI), waist circumference and other parameters of the metabolic syndrome. We performed a retrospective cross-sectional study in 39 patients (female n = 8 (20.5%), smokers n = 18 (46.2%), average age 45.8 ± 9.9 years) of a clozapine outpatient clinic in the Netherlands between 1 January 2017 and 1 July 2020. Norclozapine concentrations correlated with waist circumference (r = 0.354, P = .03) and hemoglobin A1c (HbA1c) (r = 0.34, P = .03). In smokers (smoking induces CYP1A2), norclozapine concentrations correlated with waist circumference (r = 0.723, P = .001), HbA1c (r = 0.49, P = .04) and BMI (r = 0.63, P = .004). Elucidating the relationship between norclozapine and adverse effects of clozapine use offers perspectives for interventions and treatment options

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

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

Report of a Working Group on Forages: Sixth meeting, 6-8 March 1997, Beitostølen, Norway

This report on forage genetic resources work in Europe begins with a review of current activities, including the core collection of Lolium, and an outline of recent international developments in issues related to plant genetic resources. Presented papers are then arranged under the following headings: European Central Forages Databases (13 papers); status of national collections (7); duplications in forages collections (2); standards for regeneration (1); collecting activities (13) and research activities (6). Appendices provide information on: forage passport descriptors; a protocol for designating primary holders of accessions; guidelines for the regeneration of accessions in seed collections of the main perennial forage grasses and legumes of temperate grasslands; germplasm holdings; and safety-duplication capacities. (Abstract © CAB ABSTRACTS, CAB International

An unusual case of hypothermia associated with therapeutic doses of olanzapine: a case report

<p>Abstract</p> <p>Introduction</p> <p>We report a case of a 42-year-old man who had symptomatic hypothermia as a result of taking olanzapine for paranoid schizophrenia. According to published data, only a few cases of hypothermia associated with olanzapine have been reported since its introduction into clinical use.</p> <p>Case presentation</p> <p>A 42-year-old Sri Lankan man with schizophrenia who was being treated with a therapeutic dose of olanzapine presented with reduced level of consciousness. He had a core temperature of 32°C and was bradycardic. At the time of admission, the electrocardiogram showed sinus bradycardia with J waves. He did not have any risk factors for developing hypothermia except the use of olanzapine. There was improvement in his clinical condition with reversal of electrocardiogram changes following gradual rewarming and the omission of olanzapine.</p> <p>Conclusion</p> <p>Hypothermia induced by antipsychotic medications is not uncommon, but olanzapine-induced hypothermia is rare and occurrence has been reported during initiation or increasing the dose. But here the patient developed hypothermia without dose adjustment.</p

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