Concequences of sepsis and septic schock

Sepsis is a life threatening, acute organ dysfunction due to a dysregulated host response to infection. There is increase in number of patients who survive sepsis but develop chronic critical illness afterwards.After sepsis patients with preexisting chronic diseases can completely recover and returb in pre-sepsis health condition. On the other side there are patients who survived sepsis and frequently experience long term disability ,physical and cognitive impairments.The recovery trajectories are influenced by presepsis health status,severity of organ dysfunction and host immune response during the sepsis episode itself.After sepsis and dismissing of ICU patients confront so called post intensive care syndrome(PICS).This syndrome is collection of physical mental and emotional symptoms that continue to persist after patient leaves intensive care unit( ICU).The symptoms van last for a few months to many years post recovery.The common symptoms include generalized weakness,fatigue,decreased mobility,anxious or depressed mood,sexual dysfunction,sleep disturbances,and cognitive issues ( memory disturbance /loss,slow mental processing,poor concentration and so on).Also patientsafter sepsis are struggling with impairment of pulmonary function,increasing of cardiovascular diseases,acute kidney injury,gastrointestinal problems,coagulopathy,hair loss etc.There are four main sequels after sepsis:multy system injury,prolonged critical illness,traumatized care givers and health system who needs to confront extended health care needs

Preparation for difficult airway managemen

Abstract: A difficult airway is a clinical situation where in a healthcare provider who is skilled at airway management experiences difficulty with one or more recognized techniques. The difficulty of airway management depends on patient characteristics, medical and surgical history, patient’s current status and vital signs. Prediction of difficulty in airway management is not completely reliable. Preoperative airway assessment should be performed routinely in order to identify factors that might lead to difficulty, and various algorithms have been outlined for managing difficult airways. Case Study: Our patient was 79 year old female admitted for planned orthopedic surgery In “sitting position”. She was obese, BMI was 37.8kg/m , with limited head and neck mobility. She suffered from HTA and Asthma bronchiale. Mallampati evaluation scored with 4, present with big tongue and limited mouth opening, thyromental distance less than 5cm. Results: the patient was positioned with head slightly extended in the “sniffing position”, preoxygenated with face-mask and 100% oxygen for 3 minutes. Standard instruments and additional equipment for intubating a difficult airway, including a fiberoptic bronchoscope, bougie, intubating stylets and laryngeal mask were available. Standard monitoring of vital signs, end-tidal capnography, and cerebral oximetry were performed. Induction was with propofol and suxamethonium. Face-mask ventilation was adequate. At first attempt of intubation we used conventional laryngoscope. I saw the epiglottis and small posterior part of rima glottidis. Using a bougie endotracheal intubation was done successfully. Conclusions: Good preparation for difficult airway management, with skilled persons and adequate equipment leads to successful endotracheal intubatio

Present Status and Future Outlook

Sustainable, modern societies require significant progress toward sustainable technologies, industries, and products. Solvent-free methods, which are of great interest in a vast range of catalyst synthesis, have added value to material manufacturing, and many essential industrial organic synthesis and transformations can offer economically viable alternatives for classical procedures. Moreover, they can modernize classical technologies and organic reactions toward environmental sustainability, making them cleaner, safer, and more efficient. Simultaneously, with proper tailor-made catalyst employment, further noticeable increases in reactivity and selectivity can be expected under mild/short reaction conditions minimizing the number of reaction steps, waste formation and providing a high atom economy. The proposed contribution aims to provide a summary of the present status and future outlook for solvent-free methods considering both (i) solvent-free synthesis of advanced materials, i.e. catalysts, and (ii) solvent-free reactions

Catalytic performance of CoAlZn and NiAlZn mixed oxides in hydrogen production by bio-ethanol partial oxidation

CoAlZn and NiAlZn mixed oxides were prepared by sol-gel method and tested in partial oxidation of bio-ethanol (POE). At lower temperatures, CoAlZn showed higher ethanol conversion and higher selectivity to H2 and CO than NiAlZn. At higher temperatures, ethanol conversion on both catalysts reached 100%, while selectivity (S) to H2 and CO became higher on NiAlZn. At 750 C, NiAlZn showed S(H2) of 95%, S(CO) of 90%, while for CoAlZn these values were 90% and 83% respectively. Both catalysts were resistant to coking, but the amount of carbon deposits was still lower on NiAlZn. During 50 h on-stream, ethanol conversion and selectivity to H2 and CO on NiAlZn remained unchanged demonstrating stable performance of the catalyst. The difference in catalytic behavior was ascribed to different reducibility and lattice oxygen mobility in the mixed oxides. TPR and DRIFT-monitored pyridine desorption tests revealed that in the respective materials, NiO particles were reduced easier than Co3O4 and NiAlZn had more mobile lattice oxygen with higher capacity to form vacancies than CoAlZn. Higher concentration of metallic Ni species coupled with more abundant mobile oxygen afforded correspondingly higher rates of C-H bond cleavage and carbon removal as CO on NiAlZn than on CoAlZn. Copyright © 2013, Hydrogen Energy Publications, LLC. Published by Elsevier Ltd. All rights reserved

AlZn based Co and Ni catalysts for the partial oxidation of bioethanol — influence of different synthesis procedures

The catalytic performance of Co and Ni catalysts on AlZn mixed oxide supports depends on the synthesis procedure used for their preparation. For this study CoAlZn and NiAlZn catalysts were prepared by conventional sol-gel synthesis of the mixed oxide and subsequent impregnation of the support with the transition metal (SG = sol gel method) as well as by a single-step method were a gel is formed based on salts of all components using citric acid as chelating agent (CM = citrate method). The structure and morphology of the catalysts were characterized by nitrogen sorption, XRD and TPR measurements. They showed high activity in the partial oxidation of ethanol at 600-750 °C, but their properties depend on the preparation method. The higher performance of the catalysts prepared by the citrate method, where the transition metal is incorporated into the crystal structure of the support during preparation, is based on a change in morphology and structure, resulting in more active sites exposed on the surface. Compared to the Co catalysts, Ni catalysts showed a higher performance. This might be due to the higher reducibility and the smaller Ni particles size, which allows a better interaction with the support in NiAlZn catalysts

Phase formation in mixed TiO2-ZrO2 oxides prepared by sol-gel method

Pure titania, zirconia, and mixed oxides (3\u201437 mol.% of ZrO2) are prepared using the sol-gel method and calcined at different temperatures. The calcined samples are characterized by Raman spectroscopy, X-ray powder diffraction, scanning electron microscopy, transmission electron microscopy, and nitrogen adsorption porosimetry. Measurements reveal a thermal stability of the titania anatase phase that slightly increases in the presence of 3\u201413 mol.% of zirconia. Practically, the titania anatase-rutile phase transformation is hindered during the temperature increase above 700 C. The mixed oxide with 37 mol.% of ZrO2 treated at 550 C shows a new single amorphous phase with a surface area of the nanoparticles double with respect to the other crystalline samples and the formed srilankite structure (at 700 C). The anatase phase is not observed in the sample containing 37 mol.% of ZrO2. The treatment at 700 C causes the formation of the srilankite (Ti0.63Zr0.37Ox) phase

Synthesis, Characterization and Catalytic Activity of mesoporous Mn-MCM-41 materials

MCM-41 has been synthesized at two different pH using cetyl-trimethylammonium bromide (CTAB) surfactant as template and adding the silica precursor to aqueous solutions containing CTAB. The obtained solids were calcined at 600 ◦C for 4 h. Mn-MCM-41 powders with different Mn/Si molar ratios were prepared using the incipient wetness method, followed by calcination at 550 ◦C for 5 h. At the end of the impregnation process the powders colour changed from white to brown whose intensity depends on manganese quantity. The materials characterization was performed by X-ray diffraction, N2 adsorption, 29Si Cross Polarization–Magic Angle Spinning NMR, and X-ray Photoelectron Spectroscopy. The effects of the manganese quantity and of the structural characteristic of the MCM-41 support were studied. The catalytic activity of the prepared systems was evaluated in a complete n-hexane oxidation

Bio-DEE Synthesis and Dehydrogenation Coupling of Bio-Ethanol to Bio-Butanol over Multicomponent Mixed Metal Oxide Catalysts

Within the Waste2Fuel project, innovative, high-performance, and cost-effective fuel production methods from municipal solid wastes (MSWs) are sought for application as energy carriers or direct drop-in fuels/chemicals in the near-future low-carbon power generation systems and internal combustion engines. Among the studied energy vectors, C1-C2 alcohols and ethers are mainly addressed. This study presents a potential bio-derived ethanol oxidative coupling in the gas phase in multicomponent systems derived from hydrotalcite-containing precursors. The reaction of alcohol coupling to ethers has great importance due to their uses in different fields. The samples have been synthesized by the co-precipitation method via layered double hydroxide (LDH) material synthesis, with a controlled pH, where the M(II)/M(III) ≈ 0.35. The chemical composition and topology of the sample surface play essential roles in catalyst activity and product distribution. The multiple redox couples Ni2+/Ni3+, Cr2+/Cr3+, Mn2+/Mn3+, and the oxygen-vacant sites were considered as the main active sites. The introduction of Cr (Cr3+/Cr4+) and Mn (Mn3+/Mn4+) into the crystal lattice could enhance the number of oxygen vacancies and affect the acid/base properties of derived mixed oxides, which are considered as crucial parameters for process selectivity towards bio-DEE and bio-butanol, preventing long CH chain formation and coke deposition at the same time