KRVNI OPTOK SREDNJE MOŽDANE ARTERIJE U PRETKAZIVANJU NEPOVOLJNA ISHODA U FETUSA S USPORENIM RASTOM

The development of a Doppler ultrasound technique offers new opportunities in the follow-up of the mater-nal and fetal circulation in the normal and in the high-risk pregnancies. Analysis of sonograms (Doppler velocity wave-form) on the a.cerebri media (ACM) gives important information about the status and the condition of the fetus. The resistance index (RI) has a significant application in the clinical practice for the detection and follow-up of the fetal growth and the perinatal outcome at the IUGR fetus. Material and methods. The Doppler ultrasound (US) follow-up was perfor-med in 86 normal pregnancies and 78 pregnancies with an IUGR of the fetus within the third trimester, divided in seven groups of gestational weeks (g.w.) With the Doppler machine TOSHIBA SONOLAYER SSA 120A and the application of an 3.75 MHz transabdominal probe, RI was determined at the a.cerebri media ( RIACM). Results. The analysis of the RIACM in normal pregnancies showed that the distribution was regular in the followed-up gestational weeks which manifested as a permanent decrease of the values for RIACM (of 0.83 in the 28–29 g.w.; 0.77 in the 34 –35 g.w., up to 0.725 at the term). In the pregnancies with an IUGR of the fetus, the RIACM was measured, which for any group of a g.w. statistically was significantly different from the findings in the normal pregnancies (p48 h (p48h; perinatalnim mortalitetom (p<0.001). U predviđanju lošeg peri-natalnog ishoda, u kojemu su uključeni svi prije analizirani parametri, RI a. cerebri medije je predviđao loš perinatalni ishod sa senzitivnošću od 68,9%, specifičnošću od 77%, PPV od 79% i NPV od 69,4%. Zaključak. RI a.cerebri medije je važan parametar za predviđanje perinatalnog ishoda u kliničkoj praksi. Usprkos brojnim rezultatima koji promiču dopler ultrazvuk za najranije predviđanje fetalne patnje od CTG-a, najbolji rezultati se dobivaju zajedničkom primjenom ove dvije kao i nekoliko drugih antepartalnih metoda i analiza. Dopler ultrazvučna analiza pokazuje kronične promjene koje same po sebi ne ukazuju na potrebu momentalnog prekida trudnoće, sve dok se CTG-om ne utvrde akutne promjene. Ove dvije metode ne isključuju jedna drugu već se dopunjuju

A quick, simplified approach to the evaluation of combustion rate from an internal combustion engine indicator diagram

In this paper a simplified procedure of an internal combustion engine in-cylinder pressure record analysis has been presented The method is very easy for programming and provides quick evaluation of the gas temperature and the rate of combustion. It is based on the consideration proposed by Hohenberg and Killman, but enhances the approach by involving the rate of heat transferred to the walls that was omitted in the original approach. It enables the evaluation of the complete rate Of heat released by combustion (often designated as gross heat release rate or fuel chemical energy release rate), not only the rate of heat transferred to the gas (which is often designated as net heat release rate). The accuracy of the method has been also analyzed and it is shown that the errors caused by the simplifications in the model are very small, particularly if the crank angle step is also small A several practical applications on recorded pressure diagrams taken from both spark ignition and compression ignition engine are presented as well

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

KRVNI OPTOK SREDNJE MOŽDANE ARTERIJE U PRETKAZIVANJU NEPOVOLJNA ISHODA U FETUSA S USPORENIM RASTOM

The development of a Doppler ultrasound technique offers new opportunities in the follow-up of the mater-nal and fetal circulation in the normal and in the high-risk pregnancies. Analysis of sonograms (Doppler velocity wave-form) on the a.cerebri media (ACM) gives important information about the status and the condition of the fetus. The resistance index (RI) has a significant application in the clinical practice for the detection and follow-up of the fetal growth and the perinatal outcome at the IUGR fetus. Material and methods. The Doppler ultrasound (US) follow-up was perfor-med in 86 normal pregnancies and 78 pregnancies with an IUGR of the fetus within the third trimester, divided in seven groups of gestational weeks (g.w.) With the Doppler machine TOSHIBA SONOLAYER SSA 120A and the application of an 3.75 MHz transabdominal probe, RI was determined at the a.cerebri media ( RIACM). Results. The analysis of the RIACM in normal pregnancies showed that the distribution was regular in the followed-up gestational weeks which manifested as a permanent decrease of the values for RIACM (of 0.83 in the 28–29 g.w.; 0.77 in the 34 –35 g.w., up to 0.725 at the term). In the pregnancies with an IUGR of the fetus, the RIACM was measured, which for any group of a g.w. statistically was significantly different from the findings in the normal pregnancies (p48 h (p48h; perinatalnim mortalitetom (p<0.001). U predviđanju lošeg peri-natalnog ishoda, u kojemu su uključeni svi prije analizirani parametri, RI a. cerebri medije je predviđao loš perinatalni ishod sa senzitivnošću od 68,9%, specifičnošću od 77%, PPV od 79% i NPV od 69,4%. Zaključak. RI a.cerebri medije je važan parametar za predviđanje perinatalnog ishoda u kliničkoj praksi. Usprkos brojnim rezultatima koji promiču dopler ultrazvuk za najranije predviđanje fetalne patnje od CTG-a, najbolji rezultati se dobivaju zajedničkom primjenom ove dvije kao i nekoliko drugih antepartalnih metoda i analiza. Dopler ultrazvučna analiza pokazuje kronične promjene koje same po sebi ne ukazuju na potrebu momentalnog prekida trudnoće, sve dok se CTG-om ne utvrde akutne promjene. Ove dvije metode ne isključuju jedna drugu već se dopunjuju

Adsorption of itaconic acid from aqueous solutions onto alumina

Itaconic acid, IA (C5H6O4), was investigated as a potential flocculant for the aqueous processing of alumina powders. The adsorption of IA, as a function of its concentration and pH value of the solution, onto the alumina surface was studied by the solution depletion method. The stability of the suspensions in the presence of itaconic acid was evaluated in light of the surface charge of the alumina powder used, the degree of dissociation of IA, as well as the sedimentation behavior and rheology of the suspensions. It was found that the adsorption process is extremely pH dependent; the maximum adsorption of IA onto alumina surface occurring at a pH close to the value of the first IA dissociation constant, pKa1. Also, IA does not influence the value of the point of zero charge of alumina. It was shown that IA represents an efficient flocculant for concentrated acidic alumina suspensions

Synthesis of silicon-based nanoparticles by 10.6 mu m nanosecond CO2 laser ablation in liquid

Silicon-based nanoparticles were produced by irradiating a single-crystal silicon target with 10.6 mu m nanosecond transverse excited atmospheric (TEA) pulsed CO2 laser in de-ionized water. The effects of the laser pulse energies and repetition rate were studied. To reveal the role of thermal effects, a low laser repetition rate has been applied, excluding the interaction of the laser beam with the previously generated cavitation bubble. The analysis of the influence of the laser pulse energies and the laser repetition rate showed that the increase of the laser pulse energies leads to an increase of the nanoparticle size. An explanation of such results was proposed and the importance of the role of the target surface temperature in the ablation process is discussed

A multicenter study on the effects of lanthanum carbonate (Fosrenol™) and calcium carbonate on renal bone disease in dialysis patients

A multicenter study on the affects of lanthanum carbonate (Fosrenol™) and calcium carbonate on renal bone disease in dialysis patients.BackgroundLanthanum carbonate (LC) (Fosrenol™) is a novel new treatment for hyperphosphatemia. In this phase III, open-label study, we compared the effects of LC and calcium carbonate (CC) on the evolution of renal osteodystrophy (ROD) in dialysis patients.MethodsNinety-eight patients were randomized to LC (N = 49) or CC (N = 49). Bone biopsies were taken at baseline and after one year of treatment. Acceptable paired biopsies were available for static and dynamic histomorphometry studies in 33 LC and 30CC patients. Blood samples were taken at regular intervals for biochemical analysis and adverse events were monitored.ResultsLC was well tolerated and serum phosphate levels were well controlled in both treatment groups. The incidence of hypercalcemia was lower in the LC group (6% vs. 49% for CC). At baseline, subtypes of ROD were similarly distributed in both groups, with mixed ROD being most common. At one-year follow-up in the LC group, 5 of 7 patients with baseline low bone turnover (either adynamic bone or osteomalacia), and 4 of 5 patients with baseline hyperparathyroidism, had evolved toward a normalization of their bone turnover. Only one lanthanum-treated patient evolved toward adynamic bone compared with 6 patients in the CC group. In the LC group, the number of patients having either adynamic bone, osteomalacia, or hyperpara decreased overall from 12 (36%) at baseline to 6 (18%), while in the calcium group, the number of patients with these types of ROD increased from 13 (43%) to 16 (53%).ConclusionLC is a poorly absorbed, well-tolerated, and efficient phosphate binder. LC-treated dialysis patients show almost no evolution toward low bone turnover over one year (unlike CC-treated patients), nor do they experience any aluminum-like effects on bone