scholarly journals A Novel Approach to Identify Polytraumatized Patients in Extremis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Lukas L. Negrin ◽  
Anna Antoni ◽  
Stefan Hajdu ◽  
Thomas Heinz
Keyword(s):  
Mortality Rate ◽  
Base Excess ◽  
Ph Value ◽  
Early Warning Score ◽  
Polytraumatized Patient ◽  
Predictors Of Mortality ◽  
Novel Approach ◽  
Time Period ◽  
Life Saving ◽  
Level I

Introduction. Due to the fact that early objective identification of polytraumatized patients in extremis is crucial for carrying out immediate life-saving measures, our objectives were to provide and scrutinize a definition that results in a particularly high mortality rate and to identify predictors of mortality in this group. Materials and Methods. A polytraumatized patient (ISS ≥ 16) was classified “in extremis” if five out of seven parameters (arterial paCO2 > 50 mmHg, hemoglobin < 9.5 g/dl, pH value < 7.2, lactate level > 4 mmol/l, base excess < −6 mmol/l, shock index > 1, and Horowitz index < 300) were met. By applying this definition, polytraumatized patients (age ≥ 18 years), admitted to our level I trauma center within a time period of three years, were retrospectively allocated to the “in extremis” group and to an age-, gender-, and ISS-matched “non-in extremis” group for comparison. Results. Out of 64 polytraumatized patients (mean ISS, 43.6), who formed the “in extremis” group, 36 patients (56.3%) died, thus revealing a threefold higher mortality rate than in the matched group (18.9%). Within the “in extremis” group, age and ISS were identified as predictors of mortality. Conclusion. Our definition might serve as a valuable early warning score or at least an impetus for defining polytraumatized patients in extremis in clinical practice.

scholarly journals A Novel Approach to Fabricate Foam Ceramics from Steel Slag

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yu Zheng ◽  
Xudong Luo ◽  
Jinlong Yang ◽  
Wenlong Huo ◽  
Chi Kang
Keyword(s):  
Compressive Strength ◽  
Ph Value ◽  
Steel Slag ◽  
Raw Material ◽  
Solid Loading ◽  
Insulation Material ◽  
Ceramic Foams ◽  
Novel Approach ◽  
The Stability ◽  
First Time

A novel approach is used for fabricating steel slag foam ceramics based on the particle-stabilized foaming method. In this work, steel slag was used as the raw material and propyl gallate (PG) was used as the surface modifier. For the first time, steel slag ceramic foams were successfully fabricated based on particle-stabilized foams. The results show that the stability of the ceramic foams was closely related to the pH value and PG concentration. The porosity and compressive strength could be controlled by changing the solid loading of steel slag and sintering temperature. The porosity of steel slag foam ceramics ranged from 85.6% to 62.53%, and the compressive strength was from 1.74 MPa to 10.42 MPa. The thermal conductivity of steel slag foam ceramics was only 0.067 W (m·K)−1, which shows that it could be used as a thermal insulation material.

scholarly journals A Comparative Study of Fe (II) Ion Adsorption onto Chemically Activated Banana Peel and Sawdust Bio-adsorbent

2018 ◽  
Vol 6 (2) ◽  
pp. 137-141
Author(s):  
Suman Lal Shrestha
Keyword(s):  
Ph Value ◽  
Banana Peel ◽  
Ion Adsorption ◽  
Ferrous Ions ◽  
Adsorption Models ◽  
Freundlich Isotherms ◽  
Adsorption Capacities ◽  
Time Period ◽  
Optimum Ph ◽  
Different Types

The adsorption capacity of ferrous ions onto bio-sorbents prepared from two different types of bio-waste of banana peel (CABP) and sawdust (CASD) treated with sulfuric acid was studied using Langmuir and Freundlich isotherms. Result shows that the optimum pH value for about 99 % Fe (II) adsorption onto the CABP and CASD was found to be 3 and 4, respectively, after 5 hours or more contact time period. Both the Langmuir and Freundlich adsorption models are fitted to remove the Fe (II) ions from aqueous solution by the bio-adsorbent of CABP and CASD. The maximum adsorption capacities for the CABP and CASD were found to be about 34 and 116 mg/g, respectively. These results showed that the CASD seems to be more effective bio-adsorbent than the CABP to remove the Fe (II) ions from drinking or/and wastewaters.Int. J. Appl. Sci. Biotechnol. Vol 6(2): 137-141 

scholarly journals Antibiotic-induced alterations and repopulation dynamics of yellowtail kingfish microbiota

2020 ◽  
Author(s):  
Thibault Philippe Raymond Albert Legrand ◽  
Sarah R. Catalano ◽  
Melissa L. Wos-Oxley ◽  
James W. Wynne ◽  
Laura S. Weyrich ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Bacterial Communities ◽  
Oral Antibiotic ◽  
Farmed Fish ◽  
Novel Approach ◽  
Time Period ◽  
Infection Treatment ◽  
Yellowtail Kingfish ◽  
Seriola Lalandi ◽  
Short Time

Abstract Background The use of antibiotics in aquaculture is a common infection treatment and is increasing in some sectors and jurisdictions. While antibiotic treatment can negatively shift gut bacterial communities, recovery and examination of these communities in fish of commercial importance is not well documented. Examining the impacts of antibiotics on farmed fish microbiota is fundamental for improving our understanding and management of healthy farmed fish. This work assessed yellowtail kingfish (Seriola lalandi) skin and gut bacterial communities after an oral antibiotic combination therapy in poor performing fish that displayed signs of enteritis over an 18-day period. In an attempt to promote improved bacterial re-establishment after antibiotic treatment, faecal microbiota transplantation (FMT) was also administered via gavage or in the surrounding seawater, and its affect was evaluated over 15 days post-delivery. Results Antibiotic treatment greatly perturbed the global gut bacterial communities of poor-performing fish – an effect that lasted for up to 18 days post treatment. This perturbation was marked by a significant decrease in species diversity and evenness, as well as a concomitant increase in particular taxa like an uncultured Mycoplasmataceae sp., which persisted and dominated antibiotic-treated fish for the entire 18-day period. The skin-associated bacterial communities were also perturbed by the antibiotic treatment, notably within the first 3 days; however, this was unlike the gut, as skin microbiota appeared to shift towards a more ‘normal’ (though disparate) state after 5 days post antibiotic treatment. FMT was only able to modulate the impacts of antibiotics in some individuals for a short time period, as the magnitude of change varied substantially between individuals. Some fish maintained certain transplanted gut taxa (i.e. present in the FMT inoculum; namely various Aliivibrio related ASVs) at Day 2 post FMT, although these were lost by Day 8 post FMT. Conclusion As we observed notable, prolonged perturbations induced by antibiotics on the gut bacterial assemblages, further work is required to better understand the processes/dynamics of their re-establishment following antibiotic exposure. In this regard, procedures like FMT represent a novel approach for promoting improved microbial recovery, although their efficacy and the factors that support their success requires further investigation.

scholarly journals P785 Predictors of mortality in IBD patients treated for pneumonia

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S620-S621
Author(s):  
O Ukashi ◽  
Y Barash ◽  
M J Segel ◽  
B Ungar ◽  
S Soffer ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Medical Center ◽  
Adverse Outcomes ◽  
Hospitalisation Rate ◽  
P Value ◽  
Free Text ◽  
Analysis Model ◽  
Opioid Use ◽  
Predictors Of Mortality

Abstract Background Community-acquired pneumonia is among the most common infections affecting ulcerative colitis (UC) and Crohn’s disease (CD) patients. Data regarding epidemiology and outcomes of pneumonia in inflammatory bowel disease (IBD) patients is lacking. We aimed to investigate the epidemiology, natural history and predictors of adverse outcomes in IBD patients treated for pneumonia. Methods This was a retrospective cohort study that included consecutive adult patients that were admitted to Sheba Medical Center for pneumonia from an electronic repository of all emergency department admissions between 2012 and 2018. Data included tabular demographic and clinical variables and free-text physician records. Pneumonia cases were extracted using ICD10 coding. We compared the characteristics and outcomes of IBD and non-IBD patients, and CD and UC patients. We also examined the association of clinical and laboratory variables with thirty-day mortality. Results Of 16,732 admissions with pneumonia, 97 were IBD patients (45-CD; 52-UC). IBD patients were younger than non-IBD patients (66.8 years vs. 70.2 years, p-value = 0.077). Comorbidities such as diabetes (16.5% vs. 22.8%, p = 0.142), hypertension (30.9% vs. 41.4%, p = 0.037) and congestive heart failure (15.5% vs. 19.2%, p = 0.35) were more prevalent among non-IBD patients. Use of immunosuppressant and biological medications was more common among IBD patients (corticosteroids [19.6% vs. 9.7%, p = 0.001], azathioprine [5.2% vs. 0.4%, p &lt; 0.001], vedolizumab [2.1% vs. 0%, p &lt; 0.001], tumour necrosis factor-α inhibitors [6.2% vs. 0%, p &lt; 0.001]). Thirty-day mortality rate was similar among IBD patients and non-IBD patients (12.1% vs. 11.3%, p = 0.824). We found increased hospitalisation rate among IBD patients (92.8% vs. 85.6%, p = 0.045), but similar length of stay in hospital (6.2 days vs. 6.2 days, p = 0.989). Thirty-day mortality rate (11.1% vs. 11.5%, p = 0.947) and hospitalisation rate (93.3% vs. 92.3%, p = 0.846) were similar in CD and UC patients. On the other hand, CD patients were younger (57.6 years vs. 74.8 years, p &lt; 0.01) and had a shorter length of stay in hospital (4.8 days vs. 7.5 days, p = 0.046) compared with UC patients. Using regression analysis model, bronchiectasis (Adjusted odds ratio [AOR] 109.6, p = 0.008, opioid use (AOR 13.0, p = 0.03) and PPIs use (AOR 5.9, p = 0.05) were independently associated with the risk of 30-day mortality in IBD patients. Conclusion This is the first study to identify predictors of mortality in IBD patients with pneumonia. The rate of mortality and duration of stay were similar between IBD and non-IBD patients. Use of PPIs, opioids and presence of bronchiectasis were associated with a higher risk of mortality in IBD patients with pneumonia.

Does Platelet Administration Affect Mortality in Elderly Head-Injured Patients Taking Antiplatelet Medications?

2009 ◽  
Vol 75 (11) ◽  
pp. 1100-1103 ◽  
Author(s):  
Douglas M. Downey ◽  
Benjamin Monson ◽  
Karyn L. Butler ◽  
Gerald R. Fortuna ◽  
Jonathan M. Saxe ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Platelet Transfusion ◽  
Injury Severity ◽  
Patient Characteristics ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Head Injured ◽  
Outcome Differences ◽  
Level I ◽  
Injured Patients

A significant portion of patients sustaining traumatic brain injury (TBI) take antiplatelet medications (aspirin or clopidogrel), which have been associated with increased morbidity and mortality. In an attempt to alleviate the risk of increased bleeding, platelet transfusion has become standard practice in some institutions. This study was designed to determine if platelet transfusion reduces mortality in patients with TBI on antiplatelet medications. Databases from two Level I trauma centers were reviewed. Patients with TBI 50 years of age or older with documented preinjury use of clopidogrel or aspirin were included in our cohort. Patients who received platelet transfusions were compared with those who did not to assess outcome differences between them. Demographics and other patient characteristics abstracted included Injury Severity Score, Glasgow Coma Scale, hospital length of stay, and warfarin use. Three hundred twenty-eight patients comprised the study group. Of these patients, 166 received platelet transfusion and 162 patients did not. Patients who received platelets had a mortality rate of 17.5 per cent (29 of 166), whereas those who did not receive platelets had a mortality rate of 16.7 per cent (27 of 162) ( P = 0.85). Transfusion of platelets in patients with TBI using antiplatelet therapy did not reduce mortality.

scholarly journals Rip current related drowning deaths and rescues in Australia 2004–2011

2013 ◽  
Vol 13 (4) ◽  
pp. 1069-1075 ◽  
Author(s):  
B. Brighton ◽  
S. Sherker ◽  
R. Brander ◽  
M. Thompson ◽  
A. Bradstreet
Keyword(s):  
Incident Report ◽  
Anecdotal Evidence ◽  
Rip Current ◽  
Rip Currents ◽  
Actual Number ◽  
Time Period ◽  
Life Saving ◽  
The Us ◽  
The World ◽  
The Uk

Abstract. Rip currents are a common hazard to beachgoers found on many beaches around the world, but it has proven difficult to accurately quantify the actual number of rip current related drowning deaths in many regions and countries. Consequently, reported estimates of rip current drowning can fluctuate considerably and are often based on anecdotal evidence. This study aims to quantify the incidence of rip current related drowning deaths and rescues in Australia from 2004 to 2011. A retrospective search was undertaken for fatal and non-fatal rip-related drowning incidents from Australia's National Coronial Information System (NCIS), Surf Life Saving Australia's (SLSA, 2005–2011) SurfGuard Incident Report Database (IRD), and Media Monitors for the period 1 July 2004 to 30 June 2011. In this time, rip currents were recorded as a factor in 142 fatalities of a total of 613 coastal drowning deaths (23.2%), an average of 21 per year. Rip currents were related to 44% of all beach-related drowning deaths and were involved in 57.4% of reported major rescues in Australian locations where rips occur. A comparison with international operational statistics over the same time period describes rip-related rescues as 53.7% of the total rescues in the US, 57.9% in the UK and 49.4% in New Zealand. The range 49–58% is much lower than 80–89% traditionally cited. The results reported are likely to underestimate the size of the rip current hazard, because we are limited by the completeness of data on rip-related events; however this is the most comprehensive estimate to date. Beach safety practitioners need improved data collection and standardized definitions across organisations. The collection of drowning data using consistent categories and the routine collection of rip current information will allow for more accurate global comparisons.

Trauma care before and after optimisation in a level I trauma Centre: Life-saving changes

Injury ◽  
2019 ◽  
Vol 50 (10) ◽  
pp. 1678-1683 ◽  
Author(s):  
Roos J.M. Havermans ◽  
Mariska A.C. de Jongh ◽  
Mike Bemelman ◽  
A. Pieter G. van Driel ◽  
Gerrit J. Noordergraaf ◽  
...  
Keyword(s):  
Trauma Care ◽  
Trauma Centre ◽  
Life Saving ◽  
Before And After ◽  
Level I

scholarly journals Predictors of mortality among HIV exposed infants at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Chalachew Adugna Wubneh ◽  
Aklilu Endalamaw ◽  
Nigusie Birhan Tebeje
Keyword(s):  
Birth Weight ◽  
Mortality Rate ◽  
Low Birth Weight ◽  
Hiv Infection ◽  
Exclusive Breastfeeding ◽  
Cox Regression ◽  
Growth Failure ◽  
Predictors Of Mortality ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

Abstract Background In the era of highly active antiretroviral therapy, vertical HIV transmission has been decreased. This may increase fertility desire of HIV infected women and an increasing number of HIV exposed infants as a result. A high probability of mortality among HIV exposed infants was reported across different countries. However, few studies are found on mortality of HIV exposed infants, in particular, no study was conducted before in the current study area. Methods Institution based retrospective cohort study from July 2013 to December 2017 was conducted. A total of 408 HIV exposed children were selected through simple random sampling technique. Data were extracted from registration book by using data extraction tool, which is adapted from the Ethiopian Federal Ministry of Health HIV exposed infant follow-up form. Kaplan–Meier survival curve was used to show the probability of mortality rate. Bivariable and multivariable cox regression models were used to identify predictors of mortality. Results Overall mortality rate was found to be 8.88 (95% CI: 6.36–12.36) per 100 child-year. Infant with death of at least one parent (AHR = 3.32; 95% CI: 1.503–7.32), non-exclusive breastfeeding (AHR = 0.10; 95% CI: 0.037–0.302), growth failure (AHR = 2.9; 95% CI: 1.09–8.09), presence of sign and symptom of HIV infection (AHR = 2.99; 95% CI: 1.33–6.74), and low birth weight (AHR = 2.6; 95% CI: 1.007–6.78) were found to be predictors of infant mortality. Conclusions Mortality of HIV exposed infants was high in Ethiopia. Prevention of the occurrence of HIV infection symptom, growth failure, and low birth weight is essential and further treat early whenever they occurred. Still, behavioral change interventions on mother who practice non-exclusive breastfeeding are indicated. Especial care for orphan infants is required due to their nature of vulnerability to varieties of health problem.

scholarly journals SYNTHESIS AND CHARACTERIZATION OF HYDROXYPROPYL CELLULOSE-CYSTEAMINE CONJUGATE AS A NOVEL CATIONIC THIOMER WITH LIPOPHILIC PROPERTIES

2019 ◽  
Vol 11 (1) ◽  
pp. 222 ◽  
Author(s):  
Deni Rahmat ◽  
Fikry A. R. Rahman ◽  
Liliek Nurhidayati ◽  
Dian Ratih Laksmitawati
Keyword(s):  
Reductive Amination ◽  
Ph Value ◽  
Thiol Group ◽  
Hydroxypropyl Cellulose ◽  
Scanning Calorimetry ◽  
Swelling Behaviour ◽  
Chemically Modified ◽  
Time Period ◽  
Free Thiol Group

Objective: Thiomers have been known as polymer with mucoadhesive properties. The aim of this study was to synthesize the mucoadhesive potential of hydroxypropyl cellulose-cysteamine conjugate (HPC-cysteamine).Methods: The parent polymer HPC was chemically modified by introducing sulphydryl bearing compound using reductive amination. HPC-cysteamine conjugates were prepared at reaction pH value of 5. The reaction was stabilized by the addition of cyanoborohydride. Afterwards, the conjugate was evaluated for optimum free thiol group, swelling behavior, viscosity and mucoadhesive properties.Results: The conjugates showed maximum thiol incorporation on HPC of 1063.03±64.27 µmol/g. The disulphide groups content was 278.71±32.14 μmol/g. Mucoadhesion studies revealed that mucoadhesion of HPC-cysteamine demonstrated 26 h. The swelling behaviour of HPC-cysteamine tablets increased within the time period of study. The viscosity of HPC-cysteamine was higher than that of unmodified HPC. The thermal profile of HPC-cysteamine and unmodified HPC analyzed by differential scanning calorimetry (DSC) displayed a different enthalpy (ΔH) value.Conclusion: HPC-cysteamine conjugate renders better properties which might be more beneficial for drug delivery system compared to unmodified HPC. 

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