The epidemiology of venous thromboembolism (VTE) after cancer surgery is based on clinical trials on VTE prophylaxis that used venography to screen deep vein thrombosis (DVT). However, the clinical ...relevance of asymptomatic venography-detected DVT is unclear, and the population of these clinical trials is not necessarily representative of the overall cancer surgery population.
The aim of this study was to evaluate the incidence of clinically overt VTE in a wide spectrum of consecutive patients undergoing surgery for cancer and to identify risk factors for VTE.
@RISTOS was a prospective observational study in patients undergoing general, urologic, or gynecologic surgery. Patients were assessed for clinically overt VTE occurring up to 30 +/- 5 days after surgery or more if the hospital stay was longer than 35 days. All outcome events were evaluated by an independent Adjudication Committee.
A total of 2373 patients were included in the study: 1238 (52%) undergoing general, 685 (29%) urologic, and 450 (19%) gynecologic surgery. In-hospital prophylaxis was given in 81.6% and postdischarge prophylaxis in 30.7% of the patients. Fifty patients (2.1%) were adjudicated as affected by clinically overt VTE (DVT, 0.42%; nonfatal pulmonary embolism, 0.88%; death 0.80%). The incidence of VTE was 2.83% in general surgery, 2.0% in gynecologic surgery, and 0.87% in urologic surgery. Forty percent of the events occurred later than 21 days from surgery. The overall death rate was 1.72%; in 46.3% of the cases, death was caused by VTE. In a multivariable analysis, 5 risk factors were identified: age above 60 years (2.63, 95% confidence interval, 1.21-5.71), previous VTE (5.98, 2.13-16.80), advanced cancer (2.68, 1.37-5.24), anesthesia lasting more than 2 hours (4.50, 1.06-19.04), and bed rest longer than 3 days (4.37, 2.45-7.78).
VTE remains a common complication of cancer surgery, with a remarkable proportion of events occurring late after surgery. In patients undergoing cancer surgery, VTE is the most common cause of death at 30 days after surgery.
Estuarine ecosystems are increasingly being affected by pollution caused by anthropogenic activities. In this study, Crassostrea gasar oysters were transplanted and maintained for seven days at three ...sites (S1, S2, and S3) in the Laguna Estuarine System (LES)—situated in southern Brazil—that has been exposed to multiple anthropic stresses. On the basis of the concentrations of metal and organic pollutants in oysters, we identified marked spatial variations in pollutant levels, with S3 showing the highest concentration of Ag, Fe, Ni, Zn, and total polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and linear alkylbenzenes (LABs), followed by S2 and S1. Along with the concentrations of pollutants, a set of biomarkers was analyzed. Oysters maintained at S3 showed enhanced protective defenses in gills, as observed by the increased levels of superoxide dismutase (SOD-like) and heat shock protein 90 (HSP90-like) transcripts and catalase (CAT) activity, concomitant with reduced lipid peroxidation (MDA) levels. Decreased antioxidant activities together with increased MDA levels are indicative of the digestive gland being more susceptible to pollutant-induced oxidative damage. Oysters transplanted into LES showed lower levels of cytochrome P450 transcripts (CYP356A1-like and CYP2AU1), and decreased glutathione S-transferase (GST) enzyme activity, suggesting lower biotransformation capacity. By integrating information regarding the concentration of metal and organic pollutants with that of molecular as well as biochemical biomarkers, our study provides novel insights into pollutant exposure and the potential biological impacts of such exposure on estuarine organisms in southern Brazil.
Display omitted
•Oysters were transplanted to an estuary impacted by multiple human activities.•Lower biotransformation responses resulted in contaminants bioaccumulation in LES oysters.•S3 oysters' gills increased antioxidant defenses avoiding lipid peroxidation.•Digestive glands were susceptible to contaminant-induced oxidative damages.
We investigated the transepithelial potential (TEP) and its responses to changes in the external medium in
Alcolapia grahami
, a small cichlid fish living in Lake Magadi, Kenya. Magadi water is ...extremely alkaline (pH = 9.92) and otherwise unusual: titratable alkalinity (290 mequiv L
−1
, i.e. HCO
3
−
and CO
3
2−
) rather than Cl
−
(112 mmol L
−1
) represents the major anion matching Na
+
= 356 mmol L
−1
, with very low concentrations of Ca
2+
and Mg
2+
(<1 mmol L
−1
). Immediately after fish capture, TEP was +4 mV (inside positive), but stabilized at +7 mV at 10–30 h post-capture when experiments were performed in Magadi water. Transfer to 250% Magadi water increased the TEP to +9.5 mV, and transfer to fresh water and deionized water decreased the TEP to −13 and −28 mV, respectively, effects which were not due to changes in pH or osmolality. The very negative TEP in deionized water was attenuated in a linear fashion by log elevations in Ca
2+
. Extreme cold (1 vs. 28°C) reduced the positive TEP in Magadi water by 60%, suggesting blockade of an electrogenic component, but did not alter the negative TEP in dilute solution. When fish were transferred to 350 mmol L
−1
solutions of NaHCO
3
, NaCl, NaNO
3
, or choline Cl, only the 350 mmol L
−1
NaHCO
3
solution sustained the TEP unchanged at +7 mV; in all others, the TEP fell. Furthermore, after transfer to 50, 10, and 2% dilutions of 350 mmol L
−1
NaHCO
3
, the TEPs remained identical to those in comparable dilutions of Magadi water, whereas this did not occur with comparable dilutions of 350 mmol L
−1
NaCl—i.e. the fish behaves electrically as if living in an NaHCO
3
solution equimolar to Magadi water. We conclude that the TEP is largely a Na
+
diffusion potential attenuated by some permeability to anions. In Magadi water, the net electrochemical forces driving Na
+
inwards (+9.9 mV) and Cl
−
outwards (+3.4 mV) are small relative to the strong gradient driving HCO
3
−
inwards (−82.7 mV). Estimated permeability ratios are
P
Cl
/
P
Na
= 0.51–0.68 and
= 0.10–0.33. The low permeability to HCO
3
−
is unusual, and reflects a unique adaptation to life in extreme alkalinity. Cl
−
is distributed close to Nernst equilibrium in Magadi water, so there is no need for lower
P
Cl
. The higher
P
Na
likely facilitates Na
+
efflux through the paracellular pathway. The positive electrogenic component is probably due to active HCO
3
−
excretion.
The Department of Defense utilizes complex technologies in numerous fields; each technology must comply with specific parameters and system capabilities. In this selection of a complex technology ...best meeting prescribed capabilities, the parameter set includes nine areas, which have sub-areas. To handle the complexity of the process, the team identified the Analytical Hierarchy Process (AHP), a methodology providing a reliable solution. The AHP produced an importance coefficient for each area and sub-area, which were combined in the final phase of the ranking process. Users and technical support personnel agreed that the selected system met the requirements, field operational needs, and maintenance requisites. The AHP approach represents a viable tool to handle group decisions in support of technology management and related selection processes.
The energy density of layered oxide cathode materials increases with their Ni content, while the stability decreases and degradation becomes more severe. A common strategy to mitigate or prevent ...degradation is the application of protective coatings on the particle surfaces. In this article, a room‐temperature, liquid‐phase reaction of trimethylaluminum (TMA) and tetraethyl orthosilicate (TEOS) with adsorbed moisture on either LiNi0.85Co0.10Mn0.05O2 or LiNiO2, yielding a hybrid coating that shows synergetic benefits compared to coatings from TMA and TEOS individually, is reported. The surface layer is investigated in long‐term pouch full‐cell studies as well as by electron microscopy, X‐ray photoelectron spectroscopy, and differential electrochemical mass spectrometry, demonstrating that it prevents degradation primarily by a fluorine‐scavenging effect, and by reducing the extent of rock salt‐type phase formation.
In a liquid‐phase reaction between atomic layer deposition reagents and surface moisture, layered Ni‐rich oxide cathode active materials, LiNi0.85Co0.10Mn0.05O2 (NCM851005) and LiNiO2 (LNO), are coated with a hybrid Al/Si‐based layer. The optimal reagent mixture determined from a design of experiments approach and battery testing (>1000 cycles), including post‐mortem analysis and in situ gas analysis, is reported for both materials.
The study aims to investigate the ability of maxillofacial surgery to reduce strabismus and improve ocular clinical symptomatology in patients with fracture of the medial or lateral floor of the ...orbit, or both, and to evaluate such abilities relative to the temporal distance between trauma and surgery.
25 patients with traumatic diplopia were evaluated by CT, Goldman manual field of view, Hess-Lancaster test, eye examination and orthoptic examination, before and after surgery.
We observed: a statistically significant reduction of the deviation angle, both from close and long distance (P = 0.0054 and P = 0.0051 respectively) with a 38% reduction of the deviation from short distance and 54% from afar; a regression of diplopia in 20% of the surgically treated cases (CL from 0 to 39%), significant at the Mc Nemar test; a negative correlation with the time elapsed between the onset of the fracture and maxillofacial surgery (R = -0.26), even if the analysis did not show a statistical significance of the data (P = 0.2). However, it is evident that the maximum improvement is observed only in cases operated within 5 months of the trauma, while the failures (worsening or persistence of diplopia) were observed only in the cases operated later.
We can state that the intervention reduces strabismus and improves ocular symptomatology, as it statistically significantly reduces cases of diplopia; furthermore, it would seem preferable to intervene early, especially when damage to a muscular structure is suspected, even if the data do not allow definitive conclusions in this regard.
The dynamics of aquatic macrophytes in intermittent rivers is generally related to the characteristics of the resistance and resilience of plants to hydrologic disturbances of flood and drought. In ...the semi-arid region of Brazil, intermittent rivers and streams are affected by disturbances with variable intensity, frequency, and duration throughout their hydrologic cycles. The aim of the present study is to determine the occurrence and variation of biomass of aquatic macrophyte species in two intermittent rivers of distinct hydrologic regimes. Their dynamics were determined with respect to resistance and resilience responses of macrophytes to flood and drought events by estimating the variation of biomass and productivity throughout two hydrologic cycles. Twenty-one visits were undertaken in the rewetting, drying, and drought phases in a permanent puddle in the Avelós stream and two temporary puddles in the Taperoá river, state of Paraíba, Northeast Brazil. The sampling was carried out by using the square method. Floods of different magnitudes occurred during the present study in the river and in the stream. The results showed that floods and droughts are determining factors in the occurrence of macrophytes and in the structure of their aquatic communities. The species richness of the aquatic macrophyte communities was lower in the puddles of the river and stream subject to flood events, when compared to areas where the run-off water is retained. At the beginning of the recolonization process, the intensity of the floods was decisive in the productivity and biomass of the aquatic macrophytes in the Taperoá river and the Avelós stream. In intermediate levels of disturbance, the largest values of productivity and biomass and the shortest time for starting the recolonization process occurred.
PDF
