Compared to neutral globular proteins, neutral polysaccharides, such as dextran, pullulan and Ficoll, appear hyperpermeable across the glomerular filtration barrier. This has been attributed to an ...increased flexibility and/or asymmetry of polysaccharides. The present study investigates whether polysaccharides are hyperpermeable also across the continuous capillaries in the rat peritoneum. In anaesthetized Wistar rats, FITC-Ficoll or FITC-pullulan together with ¹²⁵I-human serum albumin (RISA) or neutralized ¹²⁵I-bovine serum albumin (nBSA) were given intravenously, after which peritoneal dialysis (PD) using conventional PD fluid (Gambrosol 1.5%) was performed for 120 min. Concentrations of FITC-polysaccharides and radioactive albumin species in plasma and dialysis fluid were analysed with high-performance size exclusion chromatography and a gamma counter respectively. Transperitoneal clearance values were calculated for polysaccharides in the molecular radius range 36-150 Å, and for RISA and nBSA. Ficoll and pullulan showed more or less identical permeabilities, compared to RISA and nBSA, across the peritoneal membrane. Although RISA-clearance, 5.50 ± 0.28 (μL min⁻¹; ±SEM), tended to be lower than the clearances of Ficoll₃₆Å (6.55 ± 0.25), pullulan₃₆Å (6.08 ± 0.22) and nBSA (6.56 ± 0.23), the difference was not statistically significant. This is in contrast to the hyperpermeability exhibited by polysaccharides across the glomerular filtration barrier and also contrasts with the charge selectivity of the latter. The phenomenon of molecular flexibility is more important for a macromolecule's permeability through the glomerular filter than across the continuous peritoneal capillary endothelium. Furthermore, it seems that charge plays a subordinate role in the steady-state transport across the combined peritoneal capillary-interstitial barrier.
Postoperative Ileus: It Costs More Than You Expect Asgeirsson, Theodor, MD; El-Badawi, Khaled I., MD; Mahmood, Ali, MD ...
Journal of the American College of Surgeons,
02/2010, Letnik:
210, Številka:
2
Journal Article
Recenzirano
Background The clinical impact of postoperative ileus (POI) after colectomy is difficult to quantify financially because of administrative coding limitations. Accurate data are important to allow ...pharmaco-economic analysis of methods aimed at reducing POI. The aim of this study was to assess the financial impact of POI for the 30-day episode of care for colectomy. Study Design We reviewed all colectomy patients at our institution from July 2007 to June 2008. Primary POI was defined as more than three episodes of emesis with return to NPO diet status and/or reinsertion of nasogastric tube; secondary POI was associated with intraabdominal complications. Readmission for gastrointestinal failure was defined as delayed POI (no radiologic or surgical identification of small bowel obstruction). All other complications requiring readmission were grouped together for analysis. Data reviewed included primary admission and readmission costs, reason for readmission, intervention, index and total length of stay, narcotic use, time to ambulation, and time to enteral feeds. Results One hundred eighty-six colectomies were eligible for analysis, with 45 cases (38 primary and 7 secondary) of POI during the index admission. The total cost was significantly higher for patients with POI ($16,612 versus $8,316; p < 0.05). However, readmission costs were not statistically different for delayed POI and other complications ($3,546 versus $6,705). Conclusions POI occurred in 24% (84% primary) of colectomy patients and disproportionately affected cost at the index admission. Interestingly, delayed POI was similar in cost to readmission for other serious adverse surgical complications.
Using a data sample corresponding to an integrated luminosity of 342 $fb^{-1}$ collected with the BABAR detector at the SLAC PEP-II electron-positron storage ring operating at a center-of-mass energy ...near 10.58 GeV, we measure ${\cal{B}} (\tau^- \to \pi^- \pi^- \pi^+ \nu_\tau) = (8.83 \pm 0.01 \pm 0.13) %$, ${\cal{B}} (\tau^- \to K^- \pi^- \pi^+ \nu_\tau) = (0.273\pm 0.002\pm 0.009)%$, ${\cal{B}} (\tau^- \to K^- \pi^- K^+ \nu_\tau) = (0.1346\pm 0.0010 \pm 0.0036)%$ and ${\cal{B}} (\tau^- \to K^- K^- K^+ \nu_\tau) = (1.58\pm 0.13 \pm 0.12)\times 10^{-5}$, where the uncertainties are statistical and systematic, respectively. Events where the $\pi^+\pi^-$ pair is consistent with coming from a $K^0_S$ are excluded. These are significant improvements over previous measurements, with the ${\cal{B}} (\tau^- \to K^- K^- K^+ \nu_\tau)$ result being the first resonant plus non-resonant measurement of this mode. We also report a first measurement of ${\cal{B}} (\tau^- \to \phi\pi^- \nu_\tau) = (3.42\pm 0.55 \pm 0.25)\times 10^{-5}$ and a new measurement of ${\cal{B}} (\tau^- \to \phi K^- \nu_\tau) = (3.39\pm 0.20 \pm 0.28)\times 10^{-5}$.
We present branching fraction measurements of the decays B^{+} -> a1(1260)^{+} K^{0} and B^{0} to a1(1260)^{-} K^{+} with a1(1260)^{+} -> pi^{-} pi^{+} pi^{+}. The data sample corresponds to 383 ...million B B-bar pairs produced in e^{+}e^{-} annihilation through the Y(4S) resonance. We measure the products of the branching fractions: B(B^{+}-> a1(1260)^{+} K^{0})B(a1(1260)^{+} -> pi^{-} pi^{+} pi^{+}) = (17.4 +/- 2.5 +/- 2.2) 10^{-6} B(B^{0}-> a1(1260)^{-} K^{+})B(a1(1260)^{-} -> pi^{+} pi^{-} pi^{-}) = (8.2 +/- 1.5 +/- 1.2) 10^{-6}. We also measure the charge asymmetries A_{ch}(B^{+} -> a1(1260)^{+} K^{0})= 0.12 +/- 0.11 +/- 0.02 and A_{ch}(B^{0} -> a1(1260)^{-} K^{+})= -0.16 +/- 0.12 +/- 0.01. The first uncertainty quoted is statistical and the second is systematic.
We report the results of a study of the decays B^+ -> J/psi omega K^+ and B^0 -> J/psi omega K_S^0 using 383 million B Bbar events from Y4S decays with the BABAR detector at the PEP-II ...asymmetric-energy e^+ e^- storage rings. We observe evidence for Y(3940) -> J/psi omega with product branching fractions B(B^+ -> Y K^+, Y -> J/psi omega) = (4.9 +- 1.0 (stat) +- 0.5 (syst)) * 10^{-5} and B(B^0 -> Y K^0, Y -> J/psi omega) = (1.5 ^{+1.4}_{-1.2} (stat) ^{+0.2}_{-0.2} (syst))* 10^{-5}. The measured mass and width are M(Y)= (3914.6 ^{+3.8}_{-3.4} (stat) ^{+1.9}_{-1.9} (syst)) MeV/c^2 and \Gamma (Y)= (33^{+12}_{-8}(stat)^{+5}_{-5}(syst)) MeV, respectively.
We report results of a search for CPT and Lorentz violation in B0-B0bar oscillations using inclusive dilepton events from 232 million Y(4S) --> BBbar decays recorded by the BABAR detector at the ...PEP-II B Factory at SLAC. We find 2.8sigma significance, compatible with no signal, for variations in the complex CPT violation parameter z at the Earth's sidereal frequency and extract values for the quantities \Delta(a_\mu) in the general Lorentz-violating standard-model extension. The spectral powers for variations in z over the frequency range 0.26/year to 2.1/day are also compatible with no signal.
We report the observation of the b -> d penguin-dominated decay B0 -> K*0 K*0bar with a sample of 383.2 +/- 4.2 million BBbar pairs collected with the BaBar detector at the PEP-II asymmetric-energy ...e^+e^- collider at the Stanford Linear Accelerator Center. The measured branching fraction is Br(B0 -> K*0 K*0bar) = 0.49^{+0.16}_{-0.13} +/- 0.05 x 10^{-6} and the fraction of longitudinal polarization f_L (B0 -> K*0 K*0bar) = 0.81^{+0.10}_{-0.12} +/- 0.06. The first error quoted is statistical and the second systematic. We also obtain an upper limit at the 90% confidence level on the branching fraction for Br(B0 ->K*0 K*0) < 0.18 x 10^{-6}.
We present partial branching fractions for inclusive charmless semileptonic B decays Bbar --> X_u ell nubar, and the determination of the CKM matrix element |V_{ub}|. The analysis is based on a ...sample of 383 million Y(4S) decays into B Bbar pairs collected with the BaBar detector at the PEP-II e+ e- storage rings. We select events using either the invariant mass M_X of the hadronic system, the invariant mass squared, q^2, of the lepton and neutrino pair, the kinematic variable P_+ or one of their combinations. We then determine partial branching fractions in limited regions of phase space: Delta B = (1.18 +- 0.09_{stat.} +- 0.07_{sys.} +- 0.01_{theo.}) x 10^{-3} (M_X < 1.55 GeV/c^2), Delta B = (0.95 +- 0.10_{stat.} +- 0.08_{sys.} +- 0.01_{theo.}) x 10^{-3} (P_+ < 0.66 GeV/c), and Delta B = (0.76 +- 0.08_{stat.} +- 0.07_{sys.} +- 0.02_{theo.}) x 10^{-3} (M_X < 1.7 GeV/c^2, q^2 > 8 GeV^2/c^4). Corresponding values of |V_{ub}| are extracted using several theoretical calculations.
We present measurements of the semileptonic decays B- --> D0 tau- nubar, B- --> D*0 tau- nubar, B0bar --> D+ tau- nubar, and B0bar --> D*+ tau- nubar, which are potentially sensitive to non--Standard ...Model amplitudes. The data sample comprises 232x10^6 Upsilon(4S) --> BBbar decays collected with the BaBar detector. From a combined fit to B- and B0bar channels, we obtain the branching fractions B(B --> D tau- nubar) = (0.86 +/- 0.24 +/- 0.11 +/- 0.06)% and B(B --> D* tau- nubar) = (1.62 +/- 0.31 +/- 0.10 +/- 0.05)% (normalized for the B0bar), where the uncertainties are statistical, systematic, and normalization-mode-related.
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