7 research outputs found
Effects of vasopressin on anesthetic response time and circulatory dynamics of lidocaine
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Societal transformation in response to global environmental change: a review of emerging concepts
The study of societal transformation in response to environmental change has become established, yet little consensus exists regarding the conceptual basis of transformation. This paper aims to provide structure to the dialog on transformation, and to reflect on the challenges of social research in this area. Concepts of transformation are identified through a literature review, and examined using four analytical criteria. It is found that the term ‘transformation’ is frequently used merely as a metaphor. When transformation is not used as a metaphor, eight concepts are most frequently employed. They differ with respect to (i) system conceptualization, (ii) notions of social consciousness (deliberate/emergent), and (iii) outcome (prescriptive/descriptive). Problem-based research tends to adopt concepts of deliberate transformation with prescriptive outcome, while concepts of emergent transformation with no prescriptive outcome tend to inform descriptive-analytical research. Dialog around the complementarities of different concepts and their empirical testing are priorities for future research
Factors influencing heavy metal concentrations in the bottom sediments of the Al-Kharrar Lagoon and Salman Bay, eastern Red Sea coast, Saudi Arabia
Effect of methylprednisolone on acute kidney injury in patients undergoing cardiac surgery with a cardiopulmonary bypass pump : a randomized controlled trial
BACKGROUND: Perioperative corticosteroid use may reduce acute kidney injury. We sought to test whether methylprednisolone reduces the risk of acute kidney injury after cardiac surgery.
METHODS: We conducted a prespecified substudy of a randomized controlled trial involving patients undergoing cardiac surgery with cardiopulmonary bypass (2007-2014); patients were recruited from 79 centres in 18 countries. Eligibility criteria included a moderate-to-high risk of perioperative death based on a preoperative score of 6 or greater on the European System for Cardiac Operative Risk Evaluation I. Patients (n = 7286) were randomly assigned (1:1) to receive intravenous methylprednisolone (250 mg at anesthetic induction and 250 mg at initiation of cardiopulmonary bypass) or placebo. Patients, caregivers, data collectors and outcome adjudicators were unaware of the assigned intervention. The primary outcome was postoperative acute kidney injury, defined as an increase in the serum creatinine concentration (from the preoperative value) of 0.3 mg/dL or greater (>= 26.5 mu mol/L) or 50% or greater in the 14-day period after surgery, or use of dialysis within 30 days after surgery.
RESULTS: Acute kidney injury occurred in 1479/3647 patients (40.6%) in the methylprednisolone group and in 1426/3639 patients (39.2%) in the placebo group (adjusted relative risk 1.04, 95% confidence interval 0.96 to 1.11). Results were consistent across several definitions of acute kidney injury and in patients with preoperative chronic kidney disease.
INTERPRETATION: Intraoperative corticosteroid use did not reduce the risk of acute kidney injury in patients with a moderate-to-high risk of perioperative death who had cardiac surgery with cardiopulmonary bypass. Our results do not support the prophylactic use of steroids during cardiopulmonary bypass surgery