scholarly journals The Capnograph: Applications and Limitations —An Analysis of 2000 Incident Reports

1993 ◽  
Vol 21 (5) ◽  
pp. 551-557 ◽  
Author(s):  
J. A. Williamson ◽  
R. K. Webb ◽  
J. Cookings ◽  
C. Morgan
Keyword(s):  
General Anaesthesia ◽  
Breathing Circuit ◽  
Organ Damage ◽  
Power Failure ◽  
Anaesthetic Circuit ◽  
Detection Mode ◽  
The Moment ◽  
Patient Circuit ◽  
Sampling Problems

The first 2000 incidents reported to the Australian Incident Monitoring Study were analysed with respect to the role of the capnograph. One hundred and fifty-seven (8%) were first detected by a capnograph and there were a further 18 (1%) in which capnography was contributory. Of the 1256 incidents which occurred in association with general anaesthesia 48% were “human detected” and 52% “monitor detected”. The capnograph was ranked second and detected 24% of these monitor detected incidents; this figure would have been nearly 30% if a correctly checked, calibrated capnograph had always been used. The capnograph is a “front-line” monitor for oesophageal intubation, failure of ventilation, anaesthetic circuit faults, gas embolism, sudden circulatory collapse and malignant hyperthermia. It is a valuable “back-up” monitor when other monitors (e.g. low pressure alarm, pulse oximeter) are not in use, are being used incorrectly or fail. Such situations, in order of frequency of detection were: circuit-leak, overpressure of the breathing circuit, bronchospasm, leak of ventilator-driving-gas into the patient circuit, aspiration and/or regurgitation and hypoventilation. There were 20 reports of “failure”, over two-thirds of which would not have occurred with appropriate checking and calibration. Seven were due to gas sampling problems and 6 to apnoea alarm failure. Two circuit leaks and 2 faulty unidirectional valves were not detected; on 3 occasions problems occurred due to power failure, calibration problems, or misinterpretation of an alarm. In a theoretical analysis of the 1256 general anaesthesia incidents it was considered that the capnograph, used on its own, would have detected 55% of these incidents, had they been allowed to evolve (43% before any potential for organ damage). It is highly recommended that a suitable, correctly checked, calibrated capnograph be used on all intubated and/or ventilated patients from the moment of intubation until extubation; capnography is also useful in the “apnoea” detection mode for patients breathing spontaneously on a mask.

PINGVINAS IR PROTĖJAS. Įsivaizdavimas kaip kitybė manyje

2007 ◽  
Vol 4 ◽  
pp. 21-37
Author(s):  
Kristupas Sabolius
Keyword(s):  
Fight Club ◽  
The World ◽  
The Moment ◽  
Hollywood Movie

Kitybės klausimas dažniausiai kyla iš ego santykio su kitais arba su pasauliu. Šiame straipsnyje daroma prielaida, kad įsivaizdavimo funkcija ištirpdo subjektą ir jame pačiame atveria intersubjektyvią perspektyvą. Šiuo tikslu sugretinami Sartre’o, Husserlio bei Merleau-Ponty įsivaizdavimo funkcijos tyrimai, kuriuose išryškėja vaizdo kaip iš ego centro išslystančios ribos statusas, ir Holivudo filmo „Kovos klubas“ siužetas. Viename iš šios juostos epizodų pasirodantis pingvinas žymi egologinės schizmos akimirką ir tampa fantazijos apsireiškimu ir įsikūnijimu.Išgryninus žaidybinį, savarankišką ir multiformišką charakterį, galime konstantuoti, kad įsivaizdavimas, jei kalbėtume Kanto terminais, yra ne papildanti tarpinė funkcija, bet transcendentalinio subjekto genezėje atlieka paradoksalų „svetimos vidujybės“ arba „vidinės svetimybės“ vaidmenį. Vaizduotė yra katalizatoriaus, kuris, likdamas šalia, įgalina transcendentalinių formų išsikristalizavimą.Pagrindiniai žodžiai: vaizduotė, įsivaizdavimas, fantazija, ego, kitybė, sąmonė.PENGUIN AND PROTEUSImagination as Otherness in meKristupas Sabolius SummaryThe question of Otherness is usually taken into account while discussing the Ego’s relation with Others as well as with the World. This article is based on the premises that the function of phantasy melts the subjectivity, revealing the perspective of intersubjectivity within it. On this purpose Sartre’s, Husserl’s and Merleau-Ponty’s researches on the function of imagination, which elucidate the image as the boundary slipping from the centre of Ego, are compared to the story of Hollywood’ movie „Fight Club“. The penguin, which appears in one of the episodes, registers the moment of egological schism, thus becoming the revelation and incarnation of phantasy. While the playful, autonomous and multiform character of imaginary is cleared out, we can ascertain, speaking in Kantian terms, that it has not a complementary or intermediary function, but, in the genesis of transcendental subject, plays the paradoxical role of „allien innerness“ or „inner alienity“. Thought remaining always beside, imagination is a catalyzer which enables crystallization of transcendental forms.Keywords: imagination, imaginary, phantasy, ego, otherness, consciousness.

OBOLESCENCE AND THE DIFFUSION OF INNOVATIONS

2020 ◽  
pp. 113-130
Author(s):  
A.V. GOLUBEV ◽  
Keyword(s):  
Diffusion Of Innovations ◽  
Time Lag ◽  
Practical Implementation ◽  
Primary Role ◽  
Innovation Development ◽  
Scientific Hypothesis ◽  
Scientific Papers ◽  
The Moment ◽  
Sociological Studies

The diffusion of innovations is described as a process in a number of scientific papers. At the same time, the causes of this process have not been sufficiently studied. The author’s goal is to consider the main regularities, under which the life cycle of innovations begins, and propose measures to enhance diffusion in modern conditions. As a scientific hypothesis, the author accepts the postulate about the primary role of the obolescence of attracted innovations in this process. The analysis revealed not only the economic proportions that initiate the start of innovation promotion, but also the influence on the diffusion rate of the obsolescence degree of innovations and the market share occupied by the new product. Methodological approaches have been developed to determine economic efficiency depending on the moment of technological change-over, as well as to determine the absolute and relative speed of innovation diffusion. Sociological studies were conducted to determine the state of innovation development and the time lag between obtaining information about an innovation and its practical implementation. The author presents his “Agroopyt” information system developed to disseminate knowledge in the agricultural sphere and ensure technology transfer in agriculture. Digital methods provide for significant accelerateion of the diffusion of innovations and expand its scope.

scholarly journals Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001628
Author(s):  
Kamal Matli ◽  
Raymond Farah ◽  
Mario Maalouf ◽  
Nibal Chamoun ◽  
Christy Costanian ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Anticoagulation Therapy ◽  
Antiplatelet Agents ◽  
Organ Damage ◽  
Multiple Organ ◽  
Rapid Review ◽  
Thromboembolic Events ◽  
Antithrombotic Agent ◽  
Heparin Resistance

Although primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic and thromboembolic events. Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important. The aim of this rapid review was to highlight the role of thrombosis in COVID-19 and to provide new insights on the use of antithrombotic therapy in its management. A rapid systematic review was performed using preferred reporting items for systematic reviews. Papers published in English on antithrombotic agent use and COVID-19 complications were eligible. Results showed that the use of anticoagulants increased survival and reduced thromboembolic events in patients. However, despite the use of anticoagulants, patients still suffered thrombotic events likely due to heparin resistance. Data on antiplatelet use in combination with anticoagulants in the setting of COVID-19 are quite scarce. Current side effects of anticoagulation therapy emphasise the need to update treatment guidelines. In this rapid review, we address a possible modulatory role of antiplatelet and anticoagulant combination against COVID-19 pathogenesis. This combination may be an effective form of adjuvant therapy against COVID-19 infection. However, further studies are needed to elucidate potential risks and benefits associated with this combination.

scholarly journals TCA Cycle and Fatty Acids Oxidation Reflect Early Cardiorenal Damage in Normoalbuminuric Subjects with Controlled Hypertension

Antioxidants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1100
Author(s):  
Aranzazu Santiago-Hernandez ◽  
Marta Martin-Lorenzo ◽  
Ariadna Martin-Blazquez ◽  
Gema Ruiz-Hurtado ◽  
Maria G Barderas ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Tricarboxylic Acid Cycle ◽  
Renin Angiotensin System ◽  
Roc Curves ◽  
Tca Cycle ◽  
Urinary Metabolites ◽  
Organ Damage ◽  
Fatty Acid Binding ◽  
Angiotensin System

Moderately increased albuminuria, defined by an albumin to creatinine ratio (ACR) > 30 mg/g, is an indicator of subclinical organ damage associated with a higher risk of cardiovascular and renal disease. Normoalbuminuric subjects are considered at no cardiorenal risk in clinical practice, and molecular changes underlying early development are unclear. To decipher subjacent mechanisms, we stratified the normoalbuminuria condition. A total of 37 hypertensive patients under chronic renin–angiotensin system (RAS) suppression with ACR values in the normoalbuminuria range were included and classified as control (C) (ACR < 10 mg/g) and high-normal (HN) (ACR = 10–30 mg/g). Target metabolomic analysis was carried out by liquid chromatography and mass spectrometry to investigate the role of the cardiorenal risk urinary metabolites previously identified. Besides this, urinary free fatty acids (FFAs), fatty acid binding protein 1 (FABP1) and nephrin were analyzed by colorimetric and ELISA assays. A Mann–Whitney test was applied, ROC curves were calculated and Spearman correlation analysis was carried out. Nine metabolites showed significantly altered abundance in HN versus C, and urinary FFAs and FABP1 increased in HN group, pointing to dysregulation in the tricarboxylic acid cycle (TCA) cycle and fatty acids β-oxidation. We showed here how cardiorenal metabolites associate with albuminuria, already in the normoalbuminuric range, evidencing early renal damage at a tubular level and suggesting increased β-oxidation to potentially counteract fatty acids overload in the HN range.

scholarly journals Sickle Cell Disease: Role of Oxidative Stress and Antioxidant Therapy

Antioxidants ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 296
Author(s):  
Rosa Vona ◽  
Nadia Maria Sposi ◽  
Lorenza Mattia ◽  
Lucrezia Gambardella ◽  
Elisabetta Straface ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Globin Gene ◽  
Organ Damage ◽  
Cell Disease ◽  
Vessel Occlusion ◽  
Antioxidant Agents ◽  
Oxidant Status

Sickle cell disease (SCD) is the most common hereditary disorder of hemoglobin (Hb), which affects approximately a million people worldwide. It is characterized by a single nucleotide substitution in the β-globin gene, leading to the production of abnormal sickle hemoglobin (HbS) with multi-system consequences. HbS polymerization is the primary event in SCD. Repeated polymerization and depolymerization of Hb causes oxidative stress that plays a key role in the pathophysiology of hemolysis, vessel occlusion and the following organ damage in sickle cell patients. For this reason, reactive oxidizing species and the (end)-products of their oxidative reactions have been proposed as markers of both tissue pro-oxidant status and disease severity. Although more studies are needed to clarify their role, antioxidant agents have been shown to be effective in reducing pathological consequences of the disease by preventing oxidative damage in SCD, i.e., by decreasing the oxidant formation or repairing the induced damage. An improved understanding of oxidative stress will lead to targeted antioxidant therapies that should prevent or delay the development of organ complications in this patient population.

scholarly journals Role of non-Genetic Risk Factors in Exacerbating Alcohol-related organ damage

Alcohol ◽  
2020 ◽  
Vol 87 ◽  
pp. 63-72
Author(s):  
Natalia A. Osna ◽  
Rakesh Bhatia ◽  
Christopher Thompson ◽  
Surinder K. Batra ◽  
Sushil Kumar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genetic Risk ◽  
Genetic Risk Factors ◽  
Organ Damage

scholarly journals Role of HMGB1 in apoptosis-mediated sepsis lethality

2006 ◽  
Vol 203 (7) ◽  
pp. 1637-1642 ◽  
Author(s):  
Shixin Qin ◽  
Haichao Wang ◽  
Renqi Yuan ◽  
Hui Li ◽  
Mahendar Ochani ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
High Mobility ◽  
Organ Damage ◽  
The United States ◽  
Apoptotic Cells ◽  
Caspase Inhibitor ◽  
Common Pathway ◽  
The Third

Severe sepsis, a lethal syndrome after infection or injury, is the third leading cause of mortality in the United States. The pathogenesis of severe sepsis is characterized by organ damage and accumulation of apoptotic lymphocytes in the spleen, thymus, and other organs. To examine the potential causal relationships of apoptosis to organ damage, we administered Z-VAD-FMK, a broad-spectrum caspase inhibitor, to mice with sepsis. We found that Z-VAD-FMK–treated septic mice had decreased levels of high mobility group box 1 (HMGB1), a critical cytokine mediator of organ damage in severe sepsis, and suppressed apoptosis in the spleen and thymus. In vitro, apoptotic cells activate macrophages to release HMGB1. Monoclonal antibodies against HMGB1 conferred protection against organ damage but did not prevent the accumulation of apoptotic cells in the spleen. Thus, our data indicate that HMGB1 production is downstream of apoptosis on the final common pathway to organ damage in severe sepsis.

Social capital in the theory and research of LIS professionals in the light of the literature on the subject. Review of current knowledge

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maja Dorota Wojciechowska
Keyword(s):  
Social Capital ◽  
Current Knowledge ◽  
Future Research ◽  
Content Type ◽  
Individual Social Capital ◽  
Rural Libraries ◽  
The Subject ◽  
The Moment ◽  
The Impact

Purpose The purpose of the paper is to present the latest scholarly trends in the field of social capital in libraries, to review research concepts published by LIS professionals and to suggest further research possibilities in this area. Design/methodology/approach This paper presents a review and critical analysis of literature associated with research on social capital in libraries to highlight its importance for the development of LIS and its impact on the functioning of environments linked with various types of libraries. The goal of literature analysis was to determine the current condition of research on social capital in libraries. The main trends were identified and the need for further qualitative analyses, which are missing at the moment, was confirmed. Findings It was determined that, so far, LIS professionals have focussed mainly on the role of municipal libraries in developing social capital, the problem of building trust, especially in immigrant circles and the impact of libraries on promoting a civil society. Academic libraries, rural libraries, organisational capital in libraries and individual social capital of librarians were a much less frequent subject of research. The role of libraries in developing social capital in educational (primary and secondary education) and professional (non-university professionals) circles is practically non-existent in research, and it will require in-depth studies and analyses in the coming years. Originality/value This paper constitutes a synthetic review of the latest research concepts concerning social capital in libraries. It identifies the most important research trends and areas that so far have not been explored and suggests research methods to help LIS professionals design future research in this area more effectively.

Abstract 070: AntagomiR-762 Prevents Angiotensin II Induced Aortic Fibrosis and Stiffening

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Kim Ramil C Montaniel ◽  
Jing Wu ◽  
Matthew R Bersi ◽  
Liang Xiao ◽  
Hana A Itani ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Organ Damage ◽  
Matrix Proteins ◽  
Locked Nucleic Acid ◽  
Ang Ii ◽  
End Organ Damage ◽  
Acid Inhibitor ◽  
Vascular Stiffening ◽  
Aortic Stiffening

We and others have shown that hypertension (HTN) is associated with a striking deposition of collagen in the vascular adventitia. This causes vascular stiffening, which increases pulse wave velocity and contributes to end-organ damage. Through a screen of vascular microRNAs (miRNAs), we found that miR-762 is the most upregulated miRNA in mice with angiotensin II (Ang II)-induced HTN. qRT-PCR confirmed that miR-762 is upregulated 6.35±1.22 (p=0.03) fold in aortas of Ang II-infused mice compared with controls. This was a direct effect of Ang II, as miR-762 upregulation was not eliminated by lowering blood pressure with hydralazine and hydrochlorothiazide and was increased only 2-fold in DOCA salt HTN. To study the role of miR-762 in HTN, we administered a locked nucleic acid inhibitor of miR-762 (antagomiR-762). AntagomiR-762 administration did not alter the hypertensive response to Ang II, yet it normalized stress-strain relationships and aortic energy storage that occurs in systole (Table). Further studies showed that antagomiR-762 dramatically affected vascular matrix proteins, reducing mRNA for several collagens and fibronectin and dramatically upregulating collagenases MMP1a, 8 and 13 (Table). Thus, miR-762 has a major role in modulating vascular stiffening and its inhibition dramatically inhibits pathological fibrosis, enhances matrix degradation and normalizes aortic stiffness. AntagomiR-762 might represent a new approach to prevent aortic stiffening and its consequent end-organ damage.

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