Filter size not the anticoagulation method is the decisive factor in continuous renal replacement therapy circuit survival

Background/Aim: As continuous renal replacement therapy (CRRT) has emerged as a standard therapy in pediatric intensive care units (PICU), many related issues that may have an impact on circuit survival have gained in importance. Objective of the study was an evaluation of factors associated with circuit survival, including anticoagulation (ACG). Methods: Retrospective study that included 40 patients, who in total received 7636 hours of CRRT during 150 sessions (84 filters, 4260 hours with heparin anticoagulation (Hep-ACG); 66 filters, 3376 hours with regional citrate anticoagulation (RCA)). Results: The Kaplan-Meier analysis of the total circuit survival time depending on the type of ACG did not demonstrate a significant difference between Hep-ACG and RCA. The percentage of clotted filters was significantly higher in case of smaller filters (HF20: 58.8%; ST60: 29.5%; ST100: 15.8%), and their lifetime was significantly lower regardless of ACG (the mean and median lifetime for HF20: 38.7/27.0 h; for ST60: 54.1/72.0 h., for ST100: 62.1/72.0 h, respectively). Conclusions: Irrespectively of filter size, filter clotting occurs within the first 24 hours after the initiation of CRRT. Most commonly, clotting affects small filters, and their lifetime is significantly shorter as compared to larger filters regardless of the type of the ACG

The role of ghrelin, leptin and insulin in foetal development

introduction and objective. The growing epidemic of childhood obesity has forced scientists to search for methods to prevent feeding disorders. Increasing interest in appetite regulating hormones has revealed their influence on energy homeostasis after birth or even in[i] utero[/i]. state of knowledge. The presence of ghrelin in the stomach of human foetuses and the distinctive production in the pancreas of neonates suggests the role of ghrelin in pre- and post-natal development. The neonatal period appears to be a critical time for the formation of adipose tissue-hypothalamus circuits, thus the amount of adipocytes in foetal life may be a major regulator of food intake. Insulin’s orexigenic effect in the arcuate nucleus of the hypothalamus can be a major modulator of foetal development. objective. This review, based on available literature, aims to analyses the role of appetite regulating hormones in foetal development. summary. Different concentrations of hormones, such as ghrelin, leptin and insulin during foetal life raises the question whether or not they can be modulated, thereby avoiding obesity before birth. Children with pancreas agenesis showed smaller body size at birth, which emphasises the probable role of insulin in foetal growth. Study of sheep foetuses with IUGR confirmed these finding. Appetite-regulating hormones show different roles in foetal development and seem to be essential in the perinatal period

Modelling hurricane track memory

It has been observed that hurricanes that are close in time often follow similar paths. If this can be shown to be statistically significant, it could have implications for how insurance premiums are calculated in areas of the US prone to hurricanes. We developed two independent path distance metrics and while one suggested that sequential storms within a given hurricane season are more likely to follow each other than any other pair of storms within that season, this conclusion was not supported by the other metric. Some considerations of how local and large scale air pressure gradients might affect hurricane paths were considered. A point vortex model in the presence of a steering flow field was developed and used to simulate the path of two time displaced vortices. In order for the vortices to follow each other they had to be relatively weak compared to the steering flow field. At realistic vortex strength, the trajectories became chaotic. In summary, our metrics provided conflicting evidence towards the no- tion of hurricane track memory. A large-scale steering flow field did not appear to provide sufficient explanation for hurricanes following each other, though this does not preclude hurricane track memory being due to localised physical changes following a large storm

Pro Libris: Lubuskie Pismo Literacko-Kulturalne, nr 4 (2010)

145 s. : il., portr.