Luminal concentrations of L- and D-lactate in the rectum may relate to severity of disease and outcome in septic patients

INTRODUCTION: Little is known about the condition of the large bowel in patients with sepsis. We have previously demonstrated increased concentrations of L-lactate in the rectal lumen in patients with abdominal septic shock. The present study was undertaken to assess the concentrations of L- and D-lactate in rectal lumen and plasma in septic patients including the possible relation to site of infection, severity of disease, and outcome. METHODS: An intensive care unit observational study was conducted at two university hospitals, and 23 septic patients and 11 healthy subjects were enrolled. Participants were subjected to rectal equilibrium dialysis, and concentrations of L- and D-lactate in dialysates and plasma were analysed by spectrophotometry. RESULTS: Luminal concentrations of L-lactate in rectum were related to the sequential organ failure assessment scores (R(2 )= 0.27, P = 0.01) and were higher in non-survivors compared to survivors and healthy subjects (mean [range] 5.0 [0.9 to 11.8] versus 2.2 [0.4 to 4.9] and 0.5 [0 to 1.6] mmol/l, respectively, P < 0.0001), with a positive linear trend (R(2 )= 0.53, P < 0.0001). Also, luminal concentrations of D-lactate were increased in non-survivors compared to survivors and healthy subjects (1.1 [0.3 to 2.5] versus 0.3 [0 to 1.2] and 0.1 [0 to 0.8] mmol/l, respectively, P = 0.01), with a positive linear trend (R(2 )= 0.14, P = 0.04). Luminal concentrations of L- and D-lactate were unaffected by the site of infection. Plasma concentrations of L-lactate were also increased in non-survivors compared to survivors (3.8 [1.7 to 7.0] versus 1.5 [0 to 3.6] mmol/l, P < 0.01). In contrast, plasma concentrations of D-lactate were equally raised in non-survivors (0.4 [0.1 to 0.7] mmol/l) and survivors (0.3 [0.1 to 0.6] mmol/l) compared with healthy subjects (0.03 [0 to 0.13] mmol/l). CONCLUSION: In patients with severe sepsis and septic shock, luminal concentrations of L- and D-lactate in the rectum were related to severity of disease and outcome

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Indvandring og integration af udlændinge har i årtier været et vigtigt tema i dansk politik. Adskillige valgkampe har været domineret af udlændingepolitikken, og udlændingepolitikken har ført kiler ned mellem partierne i de to blokke – og endda ned i de enkelte partier. Sommerens og efterårets politiske udspil og debatten om det øgede antal fl ygtninge viser, at temaet fortsat er sprængfarligt med potentiale for at skabe splittelse og nye fronter i dansk politik. Netop derfor er det vigtigt med et ordentligt videngrundlag, så diskussioner og beslutninger ikke bliver baseret på myter og antagelser. Dette temanummer af Samfundsøkonomen trækker trådene op og præsenterer forskning og fakta inden for en række problemstillinger, som også kan forventes at blive aktuelle i de politiske debatter om indvandring og integration frem mod det kommende folketingsvalg

Effects of daytime or night-time grazing on animal performance, diurnal behaviour and enteric methane emissions from dairy cows at high latitudes

This study compared animal performance and enteric methane (CH4) emissions from dairy cows in a part-time grazing (PTG) system in northern Sweden. Twenty-four Nordic Red dairy cows were allocated to one of two treatments: DAY (10 h daytime pasture access) or NIGHT (12 h night-time pasture access). The cows in each treatment received the same ad libitum partial mixed ration (PMR) indoors and ad libitum herbage allowance. Methane was recorded using two linked GreenFeedTM emissions monitoring (GEM) units, on pasture and indoors. Day or night grazing showed no statistical differences in estimated grass or PMR intake, milk production or daily enteric CH4 emissions. There was a rapid decrease in diurnal CH4 emissions (28%) when the cows were moved from indoors to pasture in both grazing treatments. Using two GEM units (indoor, outdoor) in combination improved the diurnal assessment of enteric CH4 emissions during PTG conditions in the mixed feeding system

Effects of daytime or night-time grazing on animal performance, diurnal behaviour and enteric methane emissions from dairy cows at high latitudes

This study compared animal performance and enteric methane (CH4) emissions from dairy cows in a part-time grazing (PTG) system in northern Sweden. Twenty-four Nordic Red dairy cows were allocated to one of two treatments: DAY (10 h daytime pasture access) or NIGHT (12 h night-time pasture access). The cows in each treatment received the same ad libitum partial mixed ration (PMR) indoors and ad libitum herbage allowance. Methane was recorded using two linked GreenFeedTM emissions monitoring (GEM) units, on pasture and indoors. Day or night grazing showed no statistical differences in estimated grass or PMR intake, milk production or daily enteric CH4 emissions. There was a rapid decrease in diurnal CH4 emissions (28%) when the cows were moved from indoors to pasture in both grazing treatments. Using two GEM units (indoor, outdoor) in combination improved the diurnal assessment of enteric CH4 emissions during PTG conditions in the mixed feeding system.publishedVersio