To test the German Aortic Valve (GAV) score at our university hospital in patients undergoing isolated aortic valve replacement (AVR).
A total of 224 patients who underwent isolated conventional AVR ...between January 2015 and December 2018 were included. Patients with concomitant procedures and transcatheter aortic valve implantation were excluded. Patients' data were collected and analyzed retrospectively. Patients' risk scores were calculated according to criteria described by GAV score. Sensitivity, specificity, and accuracy (area under the ROC curve AUC) were also calculated. The calibration of the model was tested by the Hosmer-Lemeshow method.
The mortality rate was 8.04% (18 patients). The patients' mean age was 58.2±19.3 years and 25% of them were female (56 patients). Mean GAV score was 1.73±5.86 (min: 0.0; max: 3.53). The GAV score showed excellent discriminative capacity (AUC 0.925, 95% confidence interval 0.882-0.956; P<0.001). The cutoff "1.8" turned out to be the best discriminatory point with the best combination of sensitivity (88.9%) and specificity (75.7%) to predict operative death. Hosmer-Lemeshow method revealed a P-value of 0.687, confirming a good calibration of the model.
The GAV score applies to our population with high predictive accuracy.
Aim
We previously reported that atrial natriuretic peptide (ANP) reduces serum amylase and intrapancreatic trypsinogen activation in the onset of acute pancreatitis whereas secretin increases them. ...In the present work, we sought to establish the effect of ANP and secretin on the inflammatory response and cell death in experimental acute pancreatitis.
Methods
The expression and activity of key inflammatory mediators and apoptosis were evaluated in the presence or absence of the atrial peptide, secretin or both in cerulein‐induced acute pancreatitis in rats. Also, ultrastructural changes in pancreatic acinar cells were assessed by transmission electron microscopy.
Results
ANP significantly reduced NF‐κB activation and TNF‐α intrapancreatic levels. Furthermore, it decreased inducible nitric oxide synthase and cyclooxygenase 2 expression and activity while it diminished myeloperoxidase activity. ANP also stimulated apoptosis as shown by caspase‐3 expression and activation as well as TUNEL assay. These findings correlated well with the ultrastructural changes observed in the exocrine pancreas. Although secretin reduced various inflammatory markers, it also diminished caspase‐3 activation and the overall response was the aggravation of the disease as reflected by the ultrastructural alterations of pancreatic acinar cells. In the presence of ANP, various effects evoked by secretin were antagonized.
Conclusion
Present findings show that ANP significantly attenuated the severity of acute pancreatitis in the rat by inducing apoptosis and reducing the inflammatory response and further suggest that ANP may have eventual therapeutic implications in the disease and/or in medical interventions at risk of its developing like endoscopic retrograde cholangiopancreatography.
It has been shown experimentally that when a drop is deposited at the center of a substrate with an axial temperature gradient (hotter in the center), thermocapillarity effects makes an outward flow ...to appear so that the drop evolves towards a ring whose radius increases with time. Upon reaching a critical radius, the contact line becomes unstable, showing gentle undulations whose amplitudes grow with time. Using the lubrication approximation and adopting appropriate dimensionless variables, a parameter-free differential equation is obtained that governs this type of thermocapillary flow. Numerical solutions of this equation are presented to study the unstable stage. Experimental results are compared with those obtained from the numerical solutions.
The purpose of the present study was to evaluate the effect of the addition of microbial inoculant and cottonseed cake on the fermentation profile, microbial population, aerobic stability, organic ...acids, chemical composition and losses of millet silages. The experimental design was completely randomised, in a 4 × 2 factorial arrangement, with the following treatments: (1) Control (millet); (2) Millet + 10% cottonseed cake (on a natural matter basis); (3) Millet + Weissella cibaria - heterofermentative lactic acid bacteria; (4) Millet + cottonseed cake and Weissella cibaria (blend); and two opening times (30 and 90 days after ensiling) with four replications, totalling 32 experimental units. Silages containing cottonseed cake had greater (P = .008) dry matter recovery. There was effect (P < .001) of the opening time on the counts of lactic acid bacteria, mould and yeast, and under aerobic stability, which were higher in silages opened at 90 days. The addition of cottonseed cake resulted in an increase in the nutritional quality of the silage, compared to control silages and silages inoculated with Weissella cibaria. The addition of cottonseed cake in millet silage proved to be efficient in reducing silage losses, improving the fermentation profile and nutritional value.
Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could ...reduce mortality and major complications.
HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896).
Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p<0·0001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0·91 (95% CI 0·72 to 1·14) and absolute risk reduction (ARR) of 1% (−1 to 3; p=0·40). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0·97 (0·83 to 1·13) and an ARR of 1% (−2 to 4; p=0·71).
Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care.
Canadian Institutes of Health Research.
The aim of this study was to determine the ideal level of neutral detergent fibre (NDF) that maximises productive performance and to evaluate the ingestive behaviour of feedlot Santa Inês lambs. ...Diets consisted of Tifton 85 grass hay (Cynodon sp.), with particle size from 1 to 2 cm, and concentrate, and the treatments were represented by different NDF levels (20, 32, 44, 56 and 68% NDF dry matter). There was a quadratic effect (P < 0.05) for the intake of dry matter, organic matter and crude protein, with maximum intake estimated at 27, 26 and 27% NDF. There was a quadratic effect (P < 0.05) for digestibility of crude protein and NDF, with the lowest digestibility estimated at 40 and 37% NDF. There was a quadratic effect (P < 0.05) for weight gain, average daily gain and feed efficiency, with maximum gains estimated at 27, 29 and 30% NDF. There was an effect (P < 0.05) of NDF levels on variables of ingestive behaviour periods/day of feeding, rumination and idle. For the feedlot Santa Inês lambs fed diets based on Tifton 85 grass hay, we recommend 27 - 30% neutral detergent fibre.
In summary, the risk of perioperative AKI was not significantly different in patients allocated to accelerated surgery versus standard care for hip fracture. AKI occurred nearly twice as often in ...patients with versus without CKD (21% vs 11%); however, regardless of CKD status, the risk of AKI was not significantly lower with accelerated surgery versus standard care.
We study the migration of droplets on a solid surface which is under a uniform temperature gradient. The present article focus on partial wetting fluids which surface tension depends on the squared ...temperature. These type of liquids, called self-rewetting, show a complex dynamics and here we will compare with those liquids of linear dependence in the temperature. Unlike to the latter ones, the droplet width increases with the time.
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