The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Terminally differentiated memory T cells are increased in patients with common variable immunodeficiency and selective IgA deficiency

Introduction : Previous studies showed that several lymphocyte abnormalities seen in the most frequent symptomatic immunoglobulin deficiency, common variable immunodeficiency (CVID), were also observed in a genetically related asymptomatic disorder – selective IgA deficiency (IgAD). In this study we searched for abnormalities in the differentiation stages of T cells as well as for similarities of these abnormalities in CVID and IgAD patients. Material and methods : Using flow cytometry in 80 patients with IgAD, 48 patients with CVID, and 80 control persons we determined T-lymphocyte subsets: both CD4 and CD8 were divided into the naïve CD45RO–CD27 + , early differentiated CD45RO + CD27 + , late differentiated CD45RO + CD27– and fully differentiated effector CD45RO–CD27– memory T cells, as well as Treg cells, defined as CD4 + CD25highCD127low T cells. Results : An increase of CD4 + and CD8 + late differentiated memory cells was observed comparing CVID patients to controls, as well as comparing IgAD patients to controls. In CVID patients an increase of CD4 + early differentiated memory cells, a decrease of CD8 + intermediate memory cells, and CD4 + and CD8 + naïve cells were found as well. The abnormalities in IgAD patients might be explained by higher CMV seropositivity observed in our IgAD. We confirmed the repeatedly published decrease of Treg cells in CVID patients, while Treg cells in IgAD patients were increased compared to controls. Conclusions : Our results show T-cell activation not only in CVID, but also in IgAD patients. The increase in IgAD patients may be influenced by a more frequent CMV infection in our group of IgAD patients

Assessment process of concept for mining and its impact on the region

Raw materials policy of the Slovak republic is currently in stage of the stagnation due to complex conception and outdated data (not updated from 2003). Nowadays there is an effort of the state to develop a completely new concept of the raw material policy using best available techniques in the given field. Paper is based on the study case of assessment of regional impacts of mining and processing the gold ore to public finance derived from real contitions of the Slovak republic region. Results achieved originates from the models for the assessment of the project of mining as well as from the model of environmental and social impact assessment. The main aim of the contribution is to increase the effectiveness in raw materials using with regard to environmental and social impact of the assessed region which could be implemented to the raw materials policy on the national level

Import Substitution as a Condition for Sustainable Development of Mining Regions

One of the promising directions for studying the indicators of sustainable development of the extracting region is the analysis of economic trends, the definition and expert evaluation of their values and their practical approval. The assessment of the whole complex of environmental, economic and social indicators of sustainable development is of obvious importance in monitoring, evaluating and adjusting regional targeted programs, developing concepts and programs for long-term socialand-economic development, analyzing their effectiveness. It will allow, if necessary, to correct specific directions of social-and-economic and ecological development of the region. In extracting clusters, the need for the development of an import-substituting machine building cluster is urgent. For its establishing it is necessary to organize an investment consortium of engineering products’ consumers, an international network of industry innovation, research-and-production and design firms, a regional agency for attracting and protecting investments in import substitution of industrial products, and a set of tax incentives for residents of the import-substituting cluster

Assessment process of concept for mining and its impact on the region

Raw materials policy of the Slovak republic is currently in stage of the stagnation due to complex conception and outdated data (not updated from 2003). Nowadays there is an effort of the state to develop a completely new concept of the raw material policy using best available techniques in the given field. Paper is based on the study case of assessment of regional impacts of mining and processing the gold ore to public finance derived from real contitions of the Slovak republic region. Results achieved originates from the models for the assessment of the project of mining as well as from the model of environmental and social impact assessment. The main aim of the contribution is to increase the effectiveness in raw materials using with regard to environmental and social impact of the assessed region which could be implemented to the raw materials policy on the national level

Mine Sited after Mine Activity: The Brownfields Methodology and Kuzbass Coal Mining Case

Operating life of a mine lasts from a few years to several decades. Mine closure occurs once the mineral resource is exhausted, or operations are no longer profitable. Mine closure plans are required by most regulatory agencies worldwide before a mining closure permission is granted, and must demonstrate that the site will not pose a threat to the environment and health of the society in future. The article describes a new tool, the brownfields methodology, which can help to promote the revitalization of old mining areas as a part of their technological modernization and subsoil full extraction with environmental damage reduction

Metabolické cesty benzimidazolových anthelmintik ve zvonku okrouhlistém (Campanula rotundifolia)

Benzimidazoles anthelmintics, which enter into environment primarily through excretion in the feces or urine of treated animals, can affect various organisms and disrupt ecosystem balance. The present study was signed to test the phytotoxicity and biotransformation of the three benzimidazole anthelmintics albendazole (ABZ), fenbendazole (FBZ) and flubendazole (FLU) in the harebell (Campanula rotundifolia). This meadow plant commonly grows in pastures and comes into contact with anthelmintics through the excrements of treated animals. Suspensions of harebell cells in culture medium were used as an in vitro model system. ABZ, FLU and FBZ were not found to be toxic for harebell cells, which were able to metabolize ABZ, FLU and FBZ via the formation of a wide scale of metabolites. Ultrahigh-performance liquid chromatography coupled with high mass accuracy tandem mass spectrometry (UHPLC-MS/MS) led to the identification of 24, 18 and 29 metabolites of ABZ, FLU and FBZ, respectively. Several novel metabolites were identified for the first time. Based on the obtained results, the schemes of the metabolic pathways of these anthelmintics were proposed. Most of these metabolites can be considered deactivation products, but a substantial portion of them may readily be decomposed to biologically active substances which could negatively affect ecosystems.Benzimidazolová anthelmintika vstupujují do životního prostředí primárně prostřednictvím léčených zvířat, která je vylučují. Tyto látky mohou nepříznivě ovlivnit různé organismy a narušit rovnováhu ekosystému. Tato práce se zabává testováním fytotoxicity a biotransformace třech benzimidazolových anthelmintik albendazlu (ABZ), fenbendazolu (FBZ) a flubendazolu (FLU) ve zvonku (Campanula rotundifolia). tato luční rostlina běžně roste na pastvinách a přichází s exkrementy zvířat léčených anthelmintiky do styku. Jako in vitro model byly využity suspenze buněk zvonku v kultivačním médiu. Buňky zvonku byly schopny ABZ, FLU a FBZ metabolizovat. S využitím UHPLC/MS/MS bylo identifikováno 24, 18 a 29 ruzných metabolitů pro ABZ, FLU a FBZ. Práce popisuje i několik doposud nepopsaných metabolitů. Na základě naměřených a interpretovaných dat byly navrženy metabolické cesty léčiv