Gastric intramucosal pH is stable during titration of positive end-expiratory pressure to improve oxygenation in acute respiratory distress syndrome

BACKGROUND: Optimal positive end-expiratory pressure (PEEP) is an important component of adequate mechanical ventilation in acute lung injury and acute respiratory distress syndrome (ARDS). In the present study we tested the effect on gastric intramucosal pH of incremental increases in PEEP level (i.e. PEEP titration) to improve oxygenation in ARDS. Seventeen consecutive patients with ARDS, as defined by consensus criteria, were included in this clinical, prospective study. All patients were haemodynamically stable, and were not receiving vasopressors. From an initial level of 5 cmH(2)O, PEEP was titrated at 2 cmH(2)O increments until the partial arterial oxygen tension was 300 mmHg or greater, peak airway pressure was 45 cmH(2)O or greater, or mean arterial blood pressure decreased by 20% or more of the baseline value. Optimal PEEP was defined as the level of PEEP that achieved the best oxygenation. The maximum PEEP was the highest PEEP level reached during titration in each patient. RESULTS: Gastric mucosal pH was measured using gastric tonometry at all levels of PEEP. The thermodilution technique was used for measurement of cardiac index. Gastric mucosal pH was similar at baseline and at optimal PEEP levels, but it was slightly reduced at maximum PEEP. Cardiac index and oxygen delivery remained stable at all PEEP levels. CONCLUSION: Incremental titration of PEEP based on improvement in oxygenation does not decrease gastric intramucosal perfusion when cardiac output is preserved in patients with ARDS

What Do Productivity Shocks Tell Us About The Saving-Investment Relationship?

This study is a contribution to the empirical literature on the significance of productivity shocks in explaining a high saving-investment correlation, using data from a panel of 21 OECD countries over the period 1970-2003. The study looks at the distributional properties of the productivity shocks in order to test if productivity shocks can relate saving to investment. To this end, we divide the countries into three groups with respect to the distributional characteristics of productivity shocks in each country with an application of the Fuzzy-c-means (FCM) clustering technique. The results provide some support for the productivity shock argument, indicating that the saving retention coefficients are greater for the countries subject to large productivity shocks in magnitude.WoSScopu

What Do Productivity Shocks Tell Us About the Saving-Investment Relationship?

This study is a contribution to the empirical literature on the significance of productivity shocks in explaining a high saving-investment correlation, using data from a panel of 21 OECD countries over the period 1970-2003. The study looks at the distributional properties of the productivity shocks in order to test if productivity shocks can relate saving to investment. To this end, we divide the countries into three groups with respect to the distributional characteristics of productivity shocks in each country with an application of the Fuzzy-c-means (FCM) clustering technique. The results provide some support for the productivity shock argument, indicating that the saving retention coefficients are greater for the countries subject to large productivity shocks in magnitude.Productivity Shocks, Kolmogorov-Smirnov Statistics, International Capital Mobility, Fuzzy Clustering, Feldstein-Horioka Puzzle

An empirical investigation on the determinants of the saving-investment interaction

This study aims to shed light on the Feldstein-Horioka (F-H) puzzle, making use of the potential explanations put forward in the related literature. To this end, the study takes a distinct empirical route, combining a cointegration technique and regression analysis. In the first step, we obtain three definitions for the dependent variable that represent the degree of the interaction between domestic saving and investment (S-I), employing a cointegration analysis for 86 countries in the sample. In the second step, each definition of the dependent variable is regressed on potential explanations for the co-movement of the S-I such as openness, country size, productivity shocks, and real interest rate differentials. After examining a number of potential variables for their explanatory power on this puzzle, however, none of the posited variables are found to be statistically significant determinants of the S-I interaction. The results indicate that the size of the economy, productivity shocks or interest rate differentials have almost no role in explaining the S-I behavior. Further, the findings show that openness has no influence on the S-I interaction, suggesting that it is not plausible to view the S-I correlation as an indicator of international capital mobility as F-H did

Forensic epidemiology of childhood deaths-Gaziantep (2005-2012)

In the present study, judicial death cases during childhood were assessed retrospectively for description and discussion of the data obtained in company with the literature were aimed. For the purposes of this study, the postmortem examination and post-mortem records of the cases between the ages of 0-18, who had died between January 2005 and December 2012. The sociodemographic characteristics and origin of the 1113 cases, the type of the incident, the distribution of the causes of death post-mortems were evaluated. The mean age of the 1113 cases was 6.77±0.17 (mean ± SE), and 66.8% cases were male, while 33.1% were female, (Male/Female: 2/1). The greatest part of all the deaths comprised fatal accidents with cases 61.4%, followed by (26.1%) suspicious deaths, 4.3% homicides, and 4.1% suicides the most common cause for death was detected as traffic accident by 33.5% cases among the 48 cases who were homicided, 58.3% were in the 15-18 age group. Consequently, it was observed that child death cases occurred in our territory were frequently accidental and traffic accidents were more commonIn the present study, judicial death cases during childhood were assessed retrospectively for description and discussion of the data obtained in company with the literature were aimed. For the purposes of this study, the postmortem examination and post-mortem records of the cases between the ages of 0-18, who had died between January 2005 and December 2012. The sociodemographic characteristics and origin of the 1113 cases, the type of the incident, the distribution of the causes of death post-mortems were evaluated. The mean age of the 1113 cases was 6.77±0.17 (mean ± SE), and 66.8% cases were male, while 33.1% were female, (Male/Female: 2/1). The greatest part of all the deaths comprised fatal accidents with cases 61.4%, followed by (26.1%) suspicious deaths, 4.3% homicides, and 4.1% suicides the most common cause for death was detected as traffic accident by 33.5% cases among the 48 cases who were homicided, 58.3% were in the 15-18 age group. Consequently, it was observed that child death cases occurred in our territory were frequently accidental and traffic accidents were more commo

Efficacy of blood parameters in predicting the severity of gestational hypertension and preeclampsia

The aim of this retrospective study was to demonstrate the effectiveness of APRI, DNI, NLR, PLR, and PDW in predicting the severity of gestational hypertension (GHT) and PE and to determine whether these factors can be used as screening tools. Normotensive pregnant women (n = 792) served as the control group. 1,213 single pregnant women who met the following criteria for a GHT diagnosis were included in the study group. We found a significantly higher mean PLR and NLR value. The mean PDW value was significantly lower in the control group than in the other groups. The SPE group had a significantly higher mean APRI score. The groups did not differ by their DNI. We determined PDW and APRI as independent parameters that predicted SPE by multiple logistic regression analysis. In retrospective analysis of blood samples taken from these participants below week 20, we found that the APRI value differed significantly between the control and SPE groups. NLR, PLR, DNI, and PDW had no clinical significance. We further suggested that APRI may provide a clinical indication of progression from hypertensive pregnancy disorders to SPE, which seems to be a promising implication that should be verified by further studies.IMPACT STATEMENT What is already known on this subject? Hypertensive disorders in pregnancy are a major cause of maternal and perinatal morbidity and mortality. Screening pregnant women for risk factors for developing hypertensive disorders and identifying women at high risk in early pregnancy and initiating prophylactic treatment are important for pregnancy monitoring and planning in experienced centres. Because only 30% of women who will develop preeclampsia can be predicted by risk factors, the combined use of laboratory tests and imaging with risk factors to calculate a woman’s risk of developing preeclampsia is currently being investigated. However, no proven marker has yet been found. What do the results of this study add? In our study, we found that NLR, PLR, DNI, and PDW have no clinical significance in assessing the risk of developing gestational hypertension and preeclampsia and in predicting the severity of preeclampsia. However, in our study, we found that APRI can provide a clinical indication of the progression of hypertensive pregnancy to SPE. What are the implications of these findings for clinical practice and/or further research? This study represents an important contribution to the literature because it is the first study to examine the association between APRI and HT in pregnancy

yuşturucu Madde Kullanan Olguların Sosyodemografik ve Kriminolojik Yönden İncelenmesi

Uyuşturucu Madde Kullanan OlgularınSosyodemografik ve Kriminolojik Yönden İncelenmesi.&nbsp;&nbsp;</div

Effects of Prone and Jackknife Positioning on Lumbar Disc Herniation Surgery

Background: Intra-abdominal hypertension due to surgical position increases bleeding at the surgical site. In this study, we evaluated the impact of prone and jackknife position on intra-abdominal pressure (IAP), lung mechanics, blood loss at the surgical site, and duration of the surgical procedure on lumbar disc operations

Bioactivity–guided isolation of flavonoids from <i>Cynanchum acutum</i> L. subsp. <i>sibiricum</i> (willd.) Rech. f. and investigation of their antiproliferative activity

<p><i>Cynanchum acutum</i> L. subsp. <i>sibiricum</i> (Willd.) Rech. f. was extracted with hexane, acetone, methanol and water individually. A sample was heated in water then extracted with ethyl acetate. Among the extracts, the ethyl acetate extract exhibited the most antiproliferative activity, so isolation of bioactive compounds was carried out from this extract. A new compound, kaempferol-3-<i>O</i>-<i>β</i>-xylopyranosyl-(1-2)-<i>β</i>-rhamnopyranoside (<b>1</b>) along with five known compounds, quercetin-3-<i>O</i>-<i>β</i>-xyloside (<b>2</b>), kaempferol-3-<i>O</i>-<i>β</i>-glucoside (<b>3</b>), quercetin-3-<i>O</i>-<i>β</i>-glucoside (<b>4</b>), kaempferol-3-<i>O</i>-<i>β</i>-rhamnopyranoside (<b>5</b>), and kaempferol-3-<i>O</i>-<i>β</i>-d-neohesperidoside (<b>6</b>) were isolated from ethyl acetate extract. The structures were elucidated by spectroscopic techniques, basically 1D NMR, 2D NMR and LC-TOF/MS. Antiproliferative effects of isolated compounds were determined by xCELLigence using the HeLa (human uterus carcinoma) cell lines. Compound <b>2</b> and compound <b>5</b> revealed the good antiproliferative activity against HeLa cell lines.</p