Intestinal failure in adults: recommendations from the ESPEN Expert Groups

Background and aims: Intestinal failure (IF) is defined as “the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth”. Functionally, it may be classified as type I acute intestinal failure (AIF), type II prolonged AIF and type III chronic intestinal failure (CIF) The ESPEN Workshop on IF was held in Bologna, Italy, on 15-16 October 2017 and the aims of this document were to highlight the current state of the art and future directions for research in IF. Methods: This paper represents the opinion of experts in the field, based on current evidence. It is not a formal review, but encompasses the current evidence, with emphasis on epidemiology, classification, diagnosis and management. Results: IF is the rarest form of organ failure and can result from a variety of conditions that affect gastrointestinal anatomy and function adversely. Assessment, diagnosis, and short and long-term management involves a multidisciplinary team with diverse expertise in the field that aims to reduce complications, increase life expectancy and improve quality of life in patients. Conclusions: Both AIF and CIF are relatively rare conditions and most of the published work presents evidence from small, single-centre studies. Much remains to be investigated to improve the diagnosis and management of IF and future studies should rely on multidisciplinary, multicentre and multinational collaborations that gather data from large cohorts of patients. Emphasis should also be placed on partnership with patients, carers and government agencies in order to improve the quality of research that focuses on patient-centred outcomes that will help to improve both outcomes and quality of life in patients with this devastating condition

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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Effect of Cirsium arvense L. on soil physical properties and crop growth

The re-cultivation of abandoned areas creates weed control problems. The main problems in these areas are perennial weeds, such as Cirsium arvense L. but this perennial deep-rooted plant may have a beneficial effect on the physical properties of compacted soil. In order to study the effect of C. arvenses root system on soil properties, the field experiment and a survey of arable fields were conducted in Estonia. The soil bulk density and penetration resistance were measured from soils covered by C. arvense or spring barley (Hordeum vulgare L.) on compacted and un-compacted soil. The results showed significantly lower penetration resistance and bulk density underneath C. arvense than under barley in both the field experiment and a field survey on arable soils. The shoot mass of C. arvense was less affected than the shoot mass of barley by soil compaction and was caused by C. arvenses better ability to develop its root system in compacted soil. Wheat yield, on soils affected by C. arvense, was increased by 28% on loose soil and 37% on compacted soil. It may be concluded that in areas affected by deep-rooted weed species, such C. arvense, the soils physical properties will improve at least in the first two years.

Ekologiczne konsekwencje degradacji gleby w warunkach estońskich

The extreme soil compaction and standard indices for Estonian soils sted to sustainable crop production are worked out which could be a basis for chracterizing the agro-ecological conditions for some particular soils. Comparison of measurements showed, that increase of subsoil hardness by compaction is mostly visible in soils with relatively weak agro-technical capability (90 and 120 kPa). The penetration resistance of arable soils is quite different depending on Estonian area. We are briefly introducing our results concerning the influence of soil compaction on penetration resistance of different soils in Estonia, on uptake of nutrients and new viewpoints concerning the changes in cellualar fluid pH of barley as depended on the soil compaction. Concerning degree of intracellular fluid pH we could conclude that this method is rather sensitive and allows us to find out plausible relations between the CpH compaction of soil and the level of the nitrogen fertilizer. Our contribution to this work justified itself and allowed us to analyse from a new point of view the positive as well as negative aspects of the effect of soil compaction and level of nitrogen fertilizer. Without nitrogen fertilizer the influence of soil compaction is rather negative. The effect of soil bulk density on cellular fluid pH of barley leaves generally depends on the number of passes. The experiment showed also that stronger decrease of nutrient content started at the same soil bulk densityvalue, at which the cellular fluid pH quickly increased. If the soil bulk density- increased up to level of 1.52-1.54 Mg·m⁻³, the cellular fluid pH increased very quickly.Opracowano wskaźniki i standardy odnoszące się do maksymalnego, z punktu widzenia zrównoważonej produkcji rolniczej, ugniecenia gleb estońskich. Mogą one stanowić podstawę charakteryzowania warunków agro-ekologicznych dla niektórych gleb. Porównanie wyników badań wykonanych w różnych miejscach wskazuje, że wzrost zwięzłości podglebia w wyniku ugniecenia jest najbardziej widoczny na glebach o stosunkowo słabej nośności agro-technicznej (90 i 120 kPa). Opory penetracji gleb uprawnych różnią się znacznie w zależności od rejonu Estonii. Przedstawiliśmy w skrócie nasze wyniki, dotyczące wpływu ugniecenia gleb na opory penetracji dla rolniczych gleb Estonii i na pobieranie składników nawozowych, a także przedstawiliśmy nasz pogląd dotyczący zmian odczynu pH płynu komórkowego jęczmienia w zależności od ugniecenia gleby. Co się tyczy poziomu odczynu pH płynu komórkowego stwierdziliśmy, że ta metoda jest dostatecznie czuła i pozwala ustalić wiarygodne relacje między CpH, ugnieceniem gleby i poziomem nawożenia azotowego. Nasz wkład w tę pracę był uzasadniony i pozwolił analizować z nowego punktu widzenia zarówno pozytywne jak i negatywne aspekty ugniecenia gleby i nawożenia azotowego. Bez nawożenia azotowego skutki ugniecenia są raczej negatywne. Wpływ gęstości gleby na pH płynu komórkowego liści jęczmienia zależy głównie od liczby przejazdów. Eksperyment wykazał również, że spadek ilości pobranego nawozu rozpoczyna się przy tej samej wartości gęstości gleby, przy której występuje gwałtowny wzrost pH płynu komórkowego. Przy wzroście gęstości gleby do poziomu 1,52-1,54 Mg·m⁻³, pH płynu komórkowego bardzo szybko wzrasta