Measurements by the hyperspectral spectrometers GOME, SCIAMACHY and GOME-2 are used to determine the rate of linear change (and trends) in cloud top height (CTH) in the period between June 1996 and ...May 2012. The retrievals are obtained from Top-Of-Atmosphere (TOA) backscattered solar light in the oxygen A-band using the Semi-Analytical CloUd Retrieval Algorithm SACURA. The physical framework relies on the asymptotic equations of radiative transfer, valid for optically thick clouds. Using linear least-squares techniques, a global trend of −1.78 ± 2.14 m yr−1 in deseasonalized CTH has been found, in the latitude belt within ±60°, with diverging tendencies over land (+0.27 ± 3.2 m yr−1) and ocean (−2.51 ± 2.8 m yr−1). The El Niño–Southern Oscillation (ENSO), strongly coupled to CTH, forces clouds to lower altitudes. The global ENSO-corrected trend in CTH amounts to −0.49 ± 2.22 m yr−1. At a global scale, no explicit regional pattern of statistically significant trends (at 95% confidence level, estimated with bootstrap technique) have been found, which would be representative of typical natural synoptical features. One exception is North Africa, which exhibits the strongest upward trend in CTH sustained by an increasing trend in water vapour.
Abstract Background Our study aims at disclosing epidemiology and most relevant clinical features of esophageal atresia (EA) pointing to a model of multicentre collaboration. Methods A detailed ...questionnaire was sent to all Italian Units of pediatric surgery in order to collect data of patients born with EA between January and December 2012. The results were crosschecked by matching date and place of birth of the patients with those of diagnosis-related group provided by the Italian Ministry of Health (MOH). Results A total of 146 questionnaires were returned plus a further 32 patients reported in the MOH database. Basing on a total of 178 patients with EA born in Italy in 2012, the incidence of EA was calculated in 3.33 per 10,000 live births. Antenatal diagnosis was suspected in 29.5% patients. 55.5% showed associated anomalies. The most common type of EA was Gross type C (89%). Postoperative complications occurred in 37% of type C EA and 100% of type A EA. A 9.5% mortality rate was reported. Conclusions This is the first Italian cross-sectional nationwide survey on EA. We can now develop shared guidelines and provide more reliable prognostic expectations for our patients.
Children with short bowel syndrome requiring parenteral nutrition are at high risk of recurrent central line–associated bloodstream infections requiring inpatient admission. Predicting responses to ...treatment at admission could help revise our current treatment algorithm and reduce the length of stay.
We conducted a retrospective study of all intestinal rehabilitation clinic patients admitted for central line–associated bloodstream infections at our academic hospital between January 2018 and June 2021. Demographic, blood culture, and treatment response data were analyzed.
There were 180 separate admissions for central line–associated bloodstream infections, involving 24 patients who met the inclusion and exclusion criteria. The average length of stay was 9.4 days, and 77.1% of the admissions exceeded the predicted length of stay. All patients were treated according to the standard protocols. In the initial blood cultures, 64.4%, 10.6%, and 25% grew a single bacterium, a single fungus, and multiple organisms, respectively. After treatment initiation, 73.3% of single bacterial infections did not show additional positive cultures. However, 78.9% and 48.9% of fungal and multiple organism infections, respectively, had multiple positive cultures, even after initiating treatment. All positive repeat cultures were treated with an ethanol lock for 24 hours in addition to continued treatment. The treatment preserved 90.5% of the catheters.
Patients experiencing short bowel syndrome admitted for central line–associated bloodstream infections with initial cultures growing fungi or multiple organisms frequently had multiple positive cultures, whereas those with a single bacterial organism did not. Discharging patients who grew a single bacterial organism and placing an initial ethanol lock on those with multiple or fungal organisms could reduce the average length of stay, even if some of these patients would require readmission for line removal.
Minimally invasive surgery (MIS) for the repair of congenital diaphragmatic hernias (CDH) had been described. This report reviews the authors’ experience with MIS repairs of CDH and discusses the ...technical development of this approach.
From 1999 until now, the authors collected data on children who underwent an MIS approach for CDH repair.
Seventeen children (11 Morgagni and 7 Bochdalek) had undergone an attempt at MIS repair. All Morgagni defects were treated successfully using laparoscopy (mean age, 28 ± 31 months). Mean follow-up was 22 ± 9 months. There was 1 recurrence. Four children with Bochdalek CDH were treated as newborns (range, 3 to 21 days), and 3 had operations later (4, 11, and 32 months). The first repair was attempted initially transabdominally and was converted to a thoracoscopic approach. The rest of the Bochdalek repairs were performed thoracoscopically. Bochdalek repairs via MIS were successful in 3 children (2 older children and 1 neonate). No child had pulmonary hypertension. Two of the 3 Bochdalek patients did well postoperatively (follow-up, 18 +/− 7 months); the last patient experienced recurrence 11 months after repair.
MIS for CDH is ideal for Morgagni defects. It should be considered for nonnewborns with a Bochdalek CDH. The MIS approach for a newborn with a CDH cannot be recommended because of the high failure rate and frequent rise in P
co
2 levels.
We present a global and regional multi-annual (June 1996–May 2003) analysis of cloud properties (spherical cloud albedo – CA, cloud optical thickness – COT and cloud top height – CTH) of optically ...thick (COT > 5) clouds, derived using measurements from the GOME instrument on board the ESA ERS-2 space platform. We focus on cloud top height, which is obtained from top-of-atmosphere backscattered solar light measurements in the O2 A-band using the Semi-Analytical CloUd Retrieval Algorithm SACURA. The physical framework relies on the asymptotic equations of radiative transfer. The dataset has been validated against independent ground- and satellite-based retrievals and is aimed to support trace-gases retrievals as well as to create a robust long-term climatology together with SCIAMACHY and GOME-2 ensuing retrievals. We observed the El Niño-Southern Oscillation anomaly in the 1997–1998 record through CTH values over the Pacific Ocean. The global average CTH as derived from GOME is 5.6 ± 3.2 km, for a corresponding average COT of 19.1 ± 13.9.
Cell death due to necrosis results in acute inflammation, while death by apoptosis generally does not. The effect of adenosine triphosphate (ATP) on the pattern of cell death induced by oxidants was ...examined in bovine endothelial cells. ATP levels were altered by hydrogen peroxide (H
2O
2), glutamine (Gln), and metabolic inhibition (MI), to determine if necrosis can be shifted to apoptosis during oxidant injury. The form of cell death was determined by fluorescence microscopic techniques and the pattern of DNA degradation on agarose gels. ATP levels were measured using the luciferase–luciferin assay. Apoptosis occurred with 100 μM H
2O
2 without an alteration in ATP levels. ATP was significantly lowered with 5 mM H
2O
2, and necrosis occurred. MI, in combination with 100 μM H
2O
2, decreased ATP and resulted in necrosis. MI alone, however, did not cause cell death. Gln partially restored ATP levels in cells injured with 5 mM H
2O
2 and resulted in a significant increase in apoptosis. DNA laddering on agarose gels confirmed the apoptotic changes seen by fluorescence microscopy. In summary, a threshold level of ATP 25% of basal levels is required for apoptosis to proceed after oxidant stress, otherwise necrosis occurs. Agents like glutamine that enhance ATP levels in oxidant-stressed cells may be potent means of shifting cell death during inflammation to the noninflammatory form of death—apoptosis.
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