248 research outputs found

    Failure to reduce C-reactive protein levels more than 25% in the last 24 hours before intensive care unit discharge predicts higher in-hospital mortality: A cohort study

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    Purpose: To discharge a patient from the intensive care unit (ICU) is a complex decision-making process because in-hospital mortality after critical illness may be as high as up to 27%. Static C-reactive protein (CRP) values have been previously evaluated as a predictor of post-ICU mortality with conflicting results. Therefore, we evaluated the CRP ratio in the last 24 hours before ICU discharge as a predictor of in-hospital outcomes. Methods: A retrospective cohort study was performed in 409 patients from a 6-bed ICU of a university hospital. Data were prospectively collected during a 4-year period. Only patients discharged alive from the ICU with at least 72 hours of ICU length of stay were evaluated. Results: In-hospital mortality was 18.3% (75/409). Patients with reduction less than 25% in CRP concentrations at 24 hours as compared with 48 hours before ICU discharge had a worse prognosis, with increased mortality (23% vs 11%, P = .002) and post-ICU length of stay (26 [7-43] vs 11 [5-27] days, P = .036). Moreover, among hospital survivors (n = 334), patients with CRP reduction less than 25% were discharged later (hazard ratio, 0.750; 95% confidence interval, 0.602-0.935; P = .011). Conclusions: In this large cohort of critically ill patients, failure to reduce CRP values more than 25% in the last 24 hours of ICU stay is a strong predictor of worse in-hospital outcomes. (C) 2012 Elsevier Inc. All rights reserved

    Degradation studies of hydrophilic, partially degradable and bioactive cements (HDBCs) incorporating chemically modified starch

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    The degradation rate in Hydrophilic, Degradable and Bioactive Cements (HDBCs) containing starch/cellulose acetate blends (SCA) is still low. In order to increase degradation, higher amounts of starch are required to exceed the percolation threshold. In this work, gelatinization, acetylation and methacrylation of corn starch were performed and assessed as candidates to replace SCA in HDBCs. Formulations containing methacrylated starch were prepared with different molar ratios of 2-hydroxyethyl methacrylate and methyl methacrylate in the liquid component and the amount of residual monomer released into water was evaluated. The concentration of reducing sugars, percentage of weight loss and morphologic analyses after degradation all confirmed increased degradation of HDBC with alpha-amylase, with the appearance of pores and voids from enzymatic action. Methacrylated starch therefore is a better alternative to be used as the solid component of HDBC then SCA, since it leads to the formation of cements with a lower release of toxic monomers and more prone to hydrolytic degradation while keeping the other advantages of HDBCs.The authors acknowledge to Foundation for Science and Technology (FCT), who supported this study through funds from project Concept2Cement (POCTI/CTM/60735/2004)

    Ferritic stainless steel welding with the A-TIG process

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    O processo de soldagem TIG com fluxo (processo A-TIG) apresenta como principal vantagem a possibilidade de se obter uma maior penetração do cordão de solda empregando os mesmos parâmetros de soldagem do processo TIG convencional. Diversos estudos mostram a influência dos fluxos ativos sobre as características geométricas das soldas em aços inoxidáveis austeníticos, porém pouco se sabe sobre a influência deste processo nas características geométricas e metalúrgicas de cordões de solda em aços inoxidáveis ferríticos. Neste trabalho são aplicados diferentes tipos de fluxo na soldagem de aço inoxidável ferrítico com o objetivo de verificar possíveis influências no perfil do cordão de solda, no seu aspecto visual, na microestrutura, na dureza da zona fundida e na resistência ao impacto (ensaio Charpy). As soldagens "bead-on-plate" foram realizadas sem metal de adição. Foram utilizados seis tipos de fluxo, sendo um óxido elaborado em laboratório (TiO2) e cinco fluxos comerciais. Os resultados mostraram que a utilização do fluxo permite um aumento na penetração com mudanças significativas no aspecto do cordão de solda. Verificou-se ainda que a microestrutura e a dureza do cordão de solda do aço estudado não foram afetadas pelo tipo de fluxo utilizado, com a microestrutura analisada em microscópio óptico. O aço em estudo mostrou um alto grau de fragilidade à temperatura ambiente._________________________________________________________________________________________ RESUMO: The A-TIG welding process presents as main advantage the possibility of increase in the penetration depth using the same parameters as conventional TIG welding. Many researchers show the influence of the active flux on the weld geometry in austenitic stainless steel, however little it is known of the influence of this process in the weld fillet shape and metallurgic characteristics of the weld fillet in ferritic stainless steel. In this work different types of flux are applied with the objective to verify possible influences on the weld fillet in ferritic stainless steel welding, such its visual aspect, the microstructure, the hardness and resistance to the impact of the fusion zone. Bead on plate welds were made without metal filler. Six types of flux had been used, and one flux was prepared in laboratory (TiO2) and the others five were commercial flux. The results indicate that the use of the flux allows increase in the penetration with significant changes in the aspect of the weld fillet. It was verified that the microstructure and the hardness of the weld fillet of this ferritic stainless steel was not been affected by the flux type. The result of the Charpy test in the metal base it was batter in the fusion zone

    Avian influenza virus (H11N9) in migratory shorebirds wintering in the Amazon region, Brazil

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    Aquatic birds are the natural reservoir for avian influenza viruses (AIV). Habitats in Brazil provide stopover and wintering sites for water birds that migrate between North and South America. The current study was conducted to elucidate the possibility of the transport of influenza A viruses by birds that migrate annually between the Northern and Southern Hemispheres. In total, 556 orotracheal/cloacal swab samples were collected for influenza A virus screening using real-time RT-PCR (rRT-PCR). The influenza A virus-positive samples were subjected to viral isolation. Four samples were positive for the influenza A matrix gene by rRT-PCR. From these samples, three viruses were isolated, sequenced and characterized. All positive samples originated from a single bird species, the ruddy turnstone (Arenaria interpres), that was caught in the Amazon region at Caeté Bay, Northeast Pará, at Ilha de Canelas. To our knowledge, this is the first isolation of H11N9 in the ruddy turnstone in South America. (Résumé d'auteur

    Exercise training in the aerobic/anaerobic metabolic transition prevents glucose intolerance in alloxan-treated rats

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    <p>Abstract</p> <p>Background</p> <p>Ninety percent of cases of diabetes are of the slowly evolving non-insulin-dependent type, or Type 2 diabetes. Lack of exercise is regarded as one of the main causes of this disorder. In this study we analyzed the effects of physical exercise on glucose homeostasis in adult rats with type 2 diabetes induced by a neonatal injection of alloxan.</p> <p>Methods</p> <p>Female Wistar rats aged 6 days were injected with either 250 mg/kg of body weight of alloxan or citrate buffer 0.01 M (controls). After weaning, half of the animals in each group were subjected to physical training adjusted to meet the aerobic-anaerobic metabolic transition by swimming 1 h/day for 5 days a week with weight overloads. The necessary overload used was set and periodically readjusted for each rat through effort tests based on the maximal lactate steady state procedure. When aged 28, 60, 90, and 120 days, the rats underwent glucose tolerance tests (GTT) and their peripheral insulin sensitivity was evaluated using the HOMA index.</p> <p>Results</p> <p>The area under the serum glucose curve obtained through GTT was always higher in alloxan-treated animals than in controls. A decrease in this area was observed in trained alloxan-treated rats at 90 and 120 days old compared with non-trained animals. At 90 days old the trained controls showed lower HOMA indices than the non-trained controls.</p> <p>Conclusion</p> <p>Neonatal administration of alloxan induced a persistent glucose intolerance in all injected rats, which was successfully counteracted by physical training in the aerobic/anaerobic metabolic transition.</p
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