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1.
Environ Monit Assess ; 192(11): 706, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33064217

RESUMEN

Recently, cyanobacteria blooms have become a concern for agricultural irrigation water quality. Numerous studies have shown that cyanotoxins from these harmful algal blooms (HABs) can be transported to and assimilated into crops when present in irrigation waters. Phycocyanin is a pigment known only to occur in cyanobacteria and is often used to indicate cyanobacteria presence in waters. The objective of this work was to identify the most influential environmental covariates affecting the phycocyanin concentrations in agricultural irrigation ponds that experience cyanobacteria blooms of the potentially toxigenic species Microcystis and Aphanizomenon using machine learning methodology. The study was performed at two agricultural irrigation ponds over a 5-month period in the summer of 2018. Phycocyanin concentrations, along with sensor-based and fluorometer-based water quality parameters including turbidity (NTU), pH, dissolved oxygen (DO), fluorescent dissolved organic matter (fDOM), conductivity, chlorophyll, color dissolved organic matter (CDOM), and extracted chlorophyll were measured. Regression tree analyses were used to determine the most influential water quality parameters on phycocyanin concentrations. Nearshore sampling locations had higher phycocyanin concentrations than interior sampling locations and "zones" of consistently higher concentrations of phycocyanin were found in both ponds. The regression tree analyses indicated extracted chlorophyll, CDOM, and NTU were the three most influential parameters on phycocyanin concentrations. This study indicates that sensor-based and fluorometer-based water quality parameters could be useful to identify spatial patterns of phycocyanin concentrations and therefore, cyanobacteria blooms, in agricultural irrigation ponds and potentially other water bodies.


Asunto(s)
Ficocianina , Estanques , Riego Agrícola , Monitoreo del Ambiente , Maryland
2.
Anaesthesia ; 74(6): 778-792, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30963557

RESUMEN

Guidelines are presented for the organisational and clinical management of anaesthesia for day-case surgery in adults and children. The advice presented is based on previously published recommendations, clinical studies and expert opinion.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Anestesia , Adulto , Niño , Humanos , Procedimientos Quirúrgicos Ambulatorios/métodos , Anestesia/métodos , Anestesiología/métodos , Sociedades Médicas , Reino Unido
4.
Appl Environ Microbiol ; 81(14): 4801-8, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25956764

RESUMEN

Once released, manure-borne bacteria can enter runoff via interaction with the thin mixing layer near the soil surface. The objectives of this work were to document temporal changes in profile distributions of manure-borne Escherichia coli and enterococci in the near-surface soil layers after simulated rainfalls and to examine differences in survival of the two fecal indicator bacteria. Rainfall simulations were performed in triplicate on soil-filled boxes with grass cover and solid manure application for 1 h with rainfall depths of 30, 60, and 90 mm. Soil samples were collected weekly from depth ranges of 0 to 1, 1 to 2, 2 to 5, and 5 to 10 cm for 1 month. Rainfall intensity was found to have a significant impact on the initial concentrations of fecal indicator bacteria in the soil. While total numbers of enterococci rapidly declined over time, E. coli populations experienced initial growth with concentration increases of 4, 10, and 25 times the initial levels at rainfall treatment depths of 30, 60, and 90 mm, respectively. E. coli populations grew to the approximately the same level in all treatments. The 0- to 1-cm layer contained more indicator bacteria than the layers beneath it, and survival of indicator bacteria was better in this layer, with decimation times between 12 and 18 days after the first week of growth. The proportion of bacteria in the 0- to 1-cm layer grew with time as the total number of bacteria in the 0- to 10-cm layer declined. The results of this work indicate the need to revisit the bacterial survival patterns that are assumed in water quality models.


Asunto(s)
Enterococcus/crecimiento & desarrollo , Escherichia coli/crecimiento & desarrollo , Estiércol/microbiología , Viabilidad Microbiana , Microbiología del Suelo , Lluvia/química , Suelo/química
5.
Anaesthesist ; 64(12): 968-974, 2015 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-26537762

RESUMEN

BACKGROUND: To record and analyze critical incidents is of paramount importance for any organization dedicated to improving patient safety. Therefore, many hospitals have implemented a critical incident reporting system (CIRS). However, the impact, benefits and use of such CIRS systems on patient safety have often been reported to be unsatisfactory. AIM: What have we learned over the past decade about the effective and optimal use of a CIRS? MATERIAL AND METHODS: Following the Yorkshire contributory factors framework, the potential benefits of a CIRS are illustrated with selected examples from the neonatal and pediatric intensive care unit. Based on a literature search in PubMed from January 2000 to December 2014 this article also describes critical factors and concepts for the successful use of a CIRS. RESULTS: A positive mind-set towards errors, high psychological safety and the conviction that a CIRS can be beneficial are important factors to encourage individual healthcare personnel to report critical incidents and learn from errors. On the part of the organization, adequate resources of personnel, systematic analysis of the reported incidents as well as dissemination of the results and implementation of safety improvement strategies are critical factors for the effective use of a CIRS. All incidents with potential relevance for patient safety should be reported. The categorization of the reported incidents facilitates the analysis and identification of relevant conclusions. As an organization dedicated to improve patient safety we have to learn from errors as well as from successes. CONCLUSION: The successful use of a CIRS depends on the motivation of individual healthcare providers as well as on organizational features that encourage critical incident reporting.

6.
J Environ Qual ; 43(5): 1559-65, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25603241

RESUMEN

Modeling inactivation of indicator microorganisms is a necessary component of microbial water quality forecast and management recommendations. The linear semi-logarithmic (LSL) model is commonly used to simulate the dependencies of bacterial concentrations in waters on time. There were indications that assumption of the semi-logarithmic linearity may not be accurate enough in waters. The objective of this work was to compare performance of the LSL and the two-parametric Weibull inactivation models with data on survival of indicator organism in various types of water from a representative database of 167 laboratory experiments. The Weibull model was preferred in >99% of all cases when the root mean squared errors and Nash-Sutcliffe statistics were compared. Comparison of corrected Akaike statistic values gave the preference to the Weibull model in only 35% of cases. This was caused by (i) a small number of experimental points on some inactivation curves, (ii) closeness of the shape parameter of the Weibull equation to one, and (iii) piecewise log-linear inactivation dynamic that could be well described by neither of the two models compared. Based on the Akaike test, the Weibull model was favored in agricultural, lake, and pristine waters, whereas the LSL model was preferred for groundwater, wastewater, rivers, and marine waters. The decimal reduction time parameter of both the LSL and Weibull models exhibited an Arrhenius-type dependence on temperature. Overall, the existing inactivation data indicate that the application of the Weibull model can improve the predictive capabilities of microbial water quality modeling.

7.
Sci Total Environ ; 915: 170143, 2024 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-38242477

RESUMEN

Microbial communities in surface waters are affected by environmental conditions and can influence changes in water quality. To explore the hypothesis that the microbiome in agricultural waters associates with spatiotemporal variations in overall water quality and, in turn, has implications for resource monitoring and management, we characterized the relationships between the microbiota and physicochemical properties in a model irrigation pond as a factor of sampling time (i.e., 9:00, 12:00, 15:00) and location within the pond (i.e., bank vs. interior sites and cross-sectional depths at 0, 1, and 2 m). The microbial communities, which were defined by 16S rRNA gene sequencing analysis, significantly varied based on all sampling factors (PERMANOVA P < 0.05 for each). While the relative abundances of dominant phyla (e.g., Proteobacteria and Bacteroidetes) were relatively stable throughout the pond, subtle yet significant increases in α-diversity were observed as the day progressed (ANOVA P < 0.001). Key water quality properties that also increased between the morning and afternoon (i.e., pH, dissolved oxygen, and temperature) positively associated with relative abundances of Cyanobacteria, though were inversely proportional to Verrucomicrobia. These properties, among additional parameters such as bioavailable nutrients (e.g., NH3, NO3, PO4), chlorophyll, phycocyanin, conductivity, and colored dissolved organic matter, exhibited significant relationships with relative abundances of various bacterial genera as well. Further investigation of the microbiota in underlying sediments revealed significant differences between the bank and interior sites of the pond (P < 0.05 for α- and ß-diversity). Overall, our findings emphasize the importance of accounting for time of day and water sampling location and depth when surveying the microbiomes of irrigation ponds and other small freshwater sources.


Asunto(s)
Cianobacterias , Estanques , Estanques/microbiología , ARN Ribosómico 16S/genética , Estudios Transversales , Proteobacteria/genética , Cianobacterias/genética
8.
Mymensingh Med J ; 31(2): 449-457, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35383766

RESUMEN

In many low and middle-income countries, iodine-deficient hypothyroidism leads to complex public health consequences. However, increasing evidence from population-based studies has linked thyroid autoimmunity with excess iodine intake. The iodine supplementation program in Bangladesh was a success story. This cross-sectional study aims to assess the pattern and predictors of autoimmunity among Bangladeshi hypothyroid patients. In this study, 154 consecutive, newly detected, biochemically-confirmed patients with primary hypothyroidism were recruited from the Endocrinology outpatient department of Bangabandhu Sheikh Mujib Medical University and tested for anti-thyroid peroxidase and anti-thyroglobulin antibody levels from October 2015 and November 2016. Patterns of thyroid autoimmunity were assessed via descriptive statistics. Predictors of autoimmunity were assessed with multivariable mixed-effect logistic regression. The mean age of participants was 36.1±11.0 years, and 70.1% were female. The frequency of thyroid autoimmunity in the study subjects was very high, 89.0% were positive for either anti-TPO or anti-Tg antibodies and 48.7% were positive for both. More participants were positive for anti-TPO antibodies (82.5%) than anti-Tg antibodies (55.2%). The risk of autoimmunity was associated with the thyroid's structural abnormalities but not with functional status. Weight gain and hypertension were associated with autoimmunity, whereas diabetes was protective against autoimmunity.


Asunto(s)
Autoinmunidad , Hipotiroidismo , Adulto , Autoanticuerpos , Bangladesh/epidemiología , Estudios Transversales , Femenino , Humanos , Hipotiroidismo/epidemiología , Persona de Mediana Edad , Tirotropina
9.
Anaesthesia ; 66(12): 1088-92, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21883127

RESUMEN

Patients are frequently told new information in the early postoperative period and may retain little of it. Two hundred patients undergoing general anaesthesia for day surgery procedures were randomly allocated into two equal groups, 'Early' and 'Late'. Both groups were asked to undertake a simple memory test either in the early or late postoperative phase of their recovery. A list of five objects was verbally presented and recall of these five objects was tested after 30 min. A control group of 100 patients performed the same test. Patients in the control group received no sedative medications. Statistically significant differences (p < 0.001) in recall ability were demonstrable between each of the three groups. Twenty-three percent of patients in the 'Early' group had total amnesia of any test information given. Only 1% of the 'Late' group were unable to remember any information; a mean interval of 40 min separated the two groups. We recommend that verbal information given postoperatively be delayed until a recovery interval of at least 40 in, and should be supported with written material.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Periodo de Recuperación de la Anestesia , Recuerdo Mental , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
10.
Artículo en Alemán | MEDLINE | ID: mdl-22015795

RESUMEN

Cancer represents the second most common cause of death in Germany. The country's federal states operate regional population-based cancer registries that collect and analyze data on cancer patients. This provides an essential basis for describing the cancer burden in the German population. In order to obtain valid and reliable information on cancer incidence at the national level, the Robert Koch Institute (RKI) set up the Federal Cancer Surveillance Unit in 1983 as a central institution for evaluating this cancer registry data. In August 2009, when the Federal Cancer Registry Data Act (BKRG) came into force, the Center for Cancer Registry Data (ZfKD) at the RKI took over the work of the Cancer Surveillance Unit with a broader remit. In the future, it will also regularly publish findings on survival, prevalence, and tumor stage distribution. A newly established record linkage process will help identify multiple submissions from the federal states. Further innovations and new tasks of the ZfKD include expanding an interactive Internet platform and encouraging a more intensive use of cancer registry data for epidemiological research by providing datasets to external scientists. The range of information available to the interested public is also to be expanded.


Asunto(s)
Academias e Institutos/estadística & datos numéricos , Neoplasias/epidemiología , Sistema de Registros/estadística & datos numéricos , Berlin , Estudios Transversales , Diseño de Investigaciones Epidemiológicas , Humanos , Incidencia , Internet , Registro Médico Coordinado , Estadificación de Neoplasias , Neoplasias/mortalidad , Neoplasias/patología , Vigilancia de la Población , Programas Informáticos , Tasa de Supervivencia
11.
Integr Org Biol ; 3(1): obab007, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34841194

RESUMEN

Synopsis Dietary requirements and acquisition strategies change throughout ontogeny across various clades of tetrapods, including birds. For example, birds hatch with combinations of various behavioral, physiological, and morphological factors that place them on an altricial-precocial spectrum. Passeriformes (=songbirds) in particular, a family constituting approximately more than half of known bird species, displays the most drastic difference between hatchling and adults in each of these aspects of their feeding biology. How the shift in dietary resource acquisition is managed during ontogeny alongside its relationship to the morphology of the feeding apparatus has been largely understudied within birds. Such efforts have been hampered partly due to the small size of many birds and the diminutive jaw musculature they employ. In this study, we used standard and diffusible iodine-based contrast-enhanced computed tomography in conjunction with digital dissection to quantify and describe the cranial musculature of the Black-throated Finch (Poephila cincta) at fledgling and adult stages. Our results reveal that in both the fledgling and the adult, cranial musculature shows clear and complex partitioning in the Musculus adductor mandibulae externus that is consistent with other families within Passeriformes. We quantified jaw-muscle sizes and found that the adult showed a decrease in muscle mass in comparison to the fledgling individual. We propose that this could be the result of low sample size or a physiological effect of parental care in Passeriformes. Our study shows that high-resolution visualization techniques are informative at revealing morphological discrepancies for studies that involve small specimens such as Passeriformes especially with careful specimen selection criteria.

12.
Gene Ther ; 17(2): 181-9, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19741732

RESUMEN

Transplantation of pigment epithelial cells in patients with age-related macular degeneration and Parkinson's disease has the potential to improve functional rehabilitation. Genetic modification of cells before transplantation may allow the delivery of neuroprotective factors to achieve functional improvement. As transplantation of cells modified using viral vectors is complicated by the possible dissemination of viral particles and severe immune reactions, we have explored non-viral methods to insert genetic material in pigment epithelial cells. Using lipofection or nucleofection ARPE-19 cells, freshly isolated and primary retinal and iris pigment epithelial (IPE) cells were transfected with plasmids encoding green fluorescent protein (GFP) and with three plasmids encoding recombinant pigment epithelium-derived factor (PEDF) and GFP. Transfection efficiency was evaluated by fluorescence microscopy and stability of protein expression by immunoblotting. Pigment epithelial cells were successfully transfected with plasmid encoding GFP. Expression of GFP in ARPE-19 was transient, but was observed for up to 1 year in IPE cells. Analysis of pigment epithelial cells transfected with PEDF plasmids revealed that PEDF fusion proteins were successfully expressed and functionally active. In conclusion, efficient transfer of genetic information in pigment epithelial cells can be achieved using non-viral transfection protocols.


Asunto(s)
Proteínas del Ojo/genética , Proteínas Fluorescentes Verdes/genética , Iris/metabolismo , Factores de Crecimiento Nervioso/genética , Epitelio Pigmentado Ocular/metabolismo , Plásmidos , Serpinas/genética , Transfección/métodos , Animales , Células Cultivadas , Electroporación , Humanos , Ratas , Porcinos
14.
Br J Dermatol ; 162(2): 410-4, 2010 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-19804593

RESUMEN

BACKGROUND: Photodynamic therapy with a self-adhesive 5-aminolaevulinic acid (5-ALA) patch shows high efficacy rates in the treatment of mild to moderate actinic keratosis (AK) in short term trials. OBJECTIVES: The purpose of the trial was to follow up patients after successful 5-ALA patch-PDT at 3 month intervals over a total period of 12 months. Patients who had received placebo-PDT or cryosurgery served for comparison. PATIENTS/METHODS: Three months after therapy, 360 patients from two separate randomized parallel group phase III studies (one superiority trial vs. placebo-PDT, one noninferiority trial vs. cryosurgery) were suitable for the follow-up study. Patients had to show at least one successfully treated AK lesion after initial therapy. A total of 316 patients completed the follow-up. RESULTS: Twelve months after a single treatment, 5-ALA patch-PDT still proved superior to placebo-PDT and cryosurgery (P < 0.001 for all tests). On a lesion basis, efficacy rates were 63% and 79% for PDT, 63% for cryosurgery and 9% and 25% for placebo-PDT. Recurrence rates of patch-PDT proved superior to those of cryosurgery (per protocol set: P = 0.011, full analysis set: P = 0.049). While 31% of cryosurgery lesions were still hypopigmented after 1 year, the 5-ALA patch-PDT groups showed hypopigmentation in 0% (superiority trial) and 3% (noninferiority trial) of the treated lesions. CONCLUSION: Twelve months after a single 5-ALA patch-PDT the majority of lesions were still cleared with an excellent cosmetic outcome. 5-ALA patch-PDT proved to be superior to cryosurgery in the noninferiority study setting.


Asunto(s)
Ácido Aminolevulínico/administración & dosificación , Queratosis Actínica/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/administración & dosificación , Administración Cutánea , Relación Dosis-Respuesta a Droga , Femenino , Estudios de Seguimiento , Humanos , Masculino , Factores de Tiempo , Resultado del Tratamiento
15.
J Environ Qual ; 49(6): 1633-1643, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33200447

RESUMEN

Several manure-borne microorganism removal models have been developed to provide accurate estimations of the number of microorganisms removed from manure or manured soils undergoing rainfall. It has been commonly assumed that these models perform equally well when used to simulate microbe removal in runoff from manures of different consistency and levels of weathering. The objectives of this work were (a) to observe kinetics of the removal of Escherichia coli and enterococci with runoff for two different manure consistencies and three manure weathering durations, and (b) to compare performance of the log-linear, Vadas-Kleinman-Sharpley, and Bradford-Shijven models in simulation of the observed kinetics. Liquid and solid dairy manure were applied to grassed soil boxes that received simulated rainfall immediately after application and subsequently at 1 and 2 wk. Runoff samples were collected for 1 h at increasing time intervals during each event. Only the effective rainfall depth at the start of runoff was significantly affected by manure consistency (p = .033), whereas other parameters were not (p > .05). Substantial differences in microorganism removal kinetics during the initial, 1-, and 2-wk rainfall events were manifested by the significant (p < .05) effect of the degree of manure weathering in about 70% of cases. The log-linear model produced the largest fitting error especially during the initial rainfall event. The Vadas-Kleinman-Sharpley model and the Bradford-Schijven model were comparable in accuracy for all events. The latter model was slightly more accurate, and the former model had better expressed dependencies of parameter values on manure weathering. Ignoring manure weathering may lead to incorrect parameterization of manure removal models.


Asunto(s)
Estiércol , Lluvia , Heces , Indicadores y Reactivos , Cinética , Fósforo , Suelo , Movimientos del Agua
16.
Sci Total Environ ; 716: 135757, 2020 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-31837850

RESUMEN

Microbial water quality datasets are essential in irrigated agricultural practices to detect and inform measures to prevent the contamination of produce. Escherichia coli (E. coli) concentrations are commonly used to evaluate microbial water quality. Remote sensing imagery has been successfully used to retrieve several water quality parameters that can be determinants of E. coli habitats in waterbodies. This pilot study was conducted to test the possibility of using imagery from a small unmanned aerial vehicle (sUAV or drone) to improve the estimation of microbial water quality in small irrigation ponds. In situ measurements of pH, turbidity, specific conductance, and concentrations of dissolved oxygen, chlorophyll-a, phycocyanin, and fluorescent dissolved organic matter were taken at depths of 0-15 cm in 23 locations across a pond in Central Maryland, USA. The pond surface was concurrently imaged using a drone with three modified GoPro cameras, and a multispectral MicaSense RedEdge camera with five spectral bands. The GoPro imagery was decomposed into red, blue, and green components. Mean digital numbers for 1-m radius areas in the images were combined with the water quality data to provide input for a regression tree-based analysis. The accuracy of the regression-tree data description with "only imagery" inputs was the same or better than that of trees constructed with "only water-quality parameters" as inputs. From multiple cross-validation runs with "only imagery" inputs for the regression trees, the average (±SD) determination coefficient and root-mean-squared error of the decimal logarithm of E. coli concentrations were 0.793 ±â€¯0.035 and 0.131 ±â€¯0.011, respectively. The results of this study demonstrate the opportunities for using sUAV imagery for obtaining a more accurate delineation of the spatial variation of E. coli concentrations in irrigation ponds.


Asunto(s)
Estanques , Calidad del Agua , Riego Agrícola , Escherichia coli , Maryland , Proyectos Piloto
17.
Br J Dermatol ; 160(5): 1066-74, 2009 May.
Artículo en Inglés | MEDLINE | ID: mdl-19222455

RESUMEN

BACKGROUND: Photodynamic therapy (PDT) is increasingly used for treatment of actinic keratoses (AKs) but is a cumbersome procedure. A thin self-adhesive patch (PD P 506 A) containing 5-aminolaevulinic acid (5-ALA) was developed to facilitate PDT. OBJECTIVES: To investigate efficacy and safety of the patch in comparison with placebo-PDT (superiority design, observer-blinded; study AK 03) and standard therapy, cryosurgery (noninferiority design, open; study AK 04). METHODS: Two separate confirmatory randomized parallel-group phase III studies were set up. In total, 449 patients with up to eight mild to moderate AK study lesions located on the head were treated in 29 German study centres (study AK 03: 103 patients; study AK 04: 346 patients). RESULTS: Twelve weeks after treatment, 5-ALA patch-PDT proved to be superior to placebo-PDT (P < 0.001) and cryosurgery (P = 0.007). Efficacy rates on a lesion basis were 82% (AK 03) and 89% (AK 04) for PDT, 77% for cryosurgery and 19% (AK 03) and 29% (AK 04) for placebo-PDT. Local reactions at the treatment site occurred in almost all patients treated with 5-ALA patch-PDT or cryosurgery. Headache was the only side-effect not related to the treatment site which occurred in more than one patient. CONCLUSIONS: PD P 506 A is an innovative, easy-to-handle 5-ALA patch for PDT of mild to moderate AK lesions. Compared with current PDT procedures, pretreatment (e.g. curettage) is not needed and handling is considerably facilitated. A single PDT treatment results in efficacy rates being statistically significantly superior to placebo and cryosurgery.


Asunto(s)
Ácido Aminolevulínico/administración & dosificación , Queratosis Actínica/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/administración & dosificación , Administración Cutánea , Adulto , Anciano , Anciano de 80 o más Años , Ácido Aminolevulínico/efectos adversos , Criocirugía/efectos adversos , Formas de Dosificación , Método Doble Ciego , Esquema de Medicación , Femenino , Humanos , Queratosis Actínica/cirugía , Masculino , Persona de Mediana Edad , Fotoquimioterapia/efectos adversos , Fármacos Fotosensibilizantes/efectos adversos , Resultado del Tratamiento
18.
Infection ; 37(2): 109-16, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19412586

RESUMEN

OBJECTIVES: Respiratory syncytial virus (RSV) infections are a leading cause of hospital admissions in small children. A substantial proportion of these patients require medical and nursing care, which can only be provided in intermediate (IMC) or intensive care units (ICU). This article reports on all children aged < 3 years who required admission to IMC and/or ICU between October 1, 2001 and September 30, 2005 in Switzerland. PATIENTS AND METHODS: We prospectively collected data on all children aged < 3 years who were admitted to an IMC or ICU for an RSV-related illness. Using a detailed questionnaire, we collected information on risk factors, therapy requirements, length of stay in the IMC/ICU and hospital, and outcome. RESULTS: Of the 577 cases reported during the study period, 90 were excluded because the patients did not fulfill the inclusion criteria; data were incomplete in another 25 cases (5%). Therefore, a total of 462 verified cases were eligible for analysis. At the time of hospital admission, only 31 patients (11%) were older than 12 months. Since RSV infection was not the main reason for IMC/ICU admission in 52% of these patients, we chose to exclude this subgroup from further analyses. Among the 431 infants aged < 12 months, the majority (77%) were former near term or full term (NT/FT) infants with a gestational age > or = 35 weeks without additional risk factors who were hospitalized at a median age of 1.5 months. Gestational age (GA) < 32 weeks, moderate to severe bronchopulmonary dysplasia (BPD), and congenital heart disease (CHD) were all associated with a significant risk increase for IMC/ICU admission (relative risk 14, 56, and 10, for GA < or = 32 weeks, BPD, and CHD, respectively). Compared with NT/FT infants, high-risk infants were hospitalized at an older age (except for infants with CHD), required more invasive and longer respiratory support, and had longer stays in the IMC/ICU and hospital. CONCLUSIONS: In Switzerland, RSV infections lead to the IMC/ICU admission of approximately 1%-2% of each annual birth cohort. Although prematurity, BPD, and CHD are significant risk factors, non-pharmacological preventive strategies should not be restricted to these high-risk patients but also target young NT/FT infants since they constitute 77% of infants requiring IMC/ICU admission.


Asunto(s)
Unidades Hospitalarias , Hospitalización/estadística & datos numéricos , Unidades de Cuidados Intensivos , Infecciones por Virus Sincitial Respiratorio/epidemiología , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Displasia Broncopulmonar/complicaciones , Preescolar , Cardiopatías/complicaciones , Cardiopatías/congénito , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Palivizumab , Estudios Prospectivos , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico , Virus Sincitiales Respiratorios , Factores de Riesgo , Estadísticas no Paramétricas , Suiza/epidemiología
19.
Anaesthesia ; 64(2): 152-5, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19143692

RESUMEN

We conducted a retrospective survey to investigate if the grade of anaesthetist was a significant factor in determining outcome after day surgery in a district general hospital. All day surgery procedures performed between 1996 and 2006 were included except those under surgically administered local anaesthetic. The outcome measures assessed were unplanned admissions and symptoms reported after discharge. The overall admission rate was 2.6%, the admission rate for anaesthetic-related reasons was 1.5%, and 49% of patients reported some symptoms after discharge. Over the period studied the admission rate fell from 4.2% to 2.0%, admissions for anaesthetic-related reasons fell from 3.0% to 0.7% and reported symptoms fell from 67% to 37%. Consultants anaesthetists were associated with the lowest unplanned admission rate (consultants 2.3%, staff grade and associate specialists 3.1%, and trainees 3.3%), the lowest admission rate for anaesthetic reasons (consultants 1.2%, staff and associate specialists 2.0%, and trainees 1.8%), lower than expected specialty-weighted admissions and the lowest number of reported symptoms (consultants 47.3%, staff grade and associate specialists 52.6%, trainees 49.0%) (p < 0.001). We conclude that there was an improvement in outcome over the period of study and that the grade of anaesthetist is associated with outcome after day surgery.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios/normas , Anestesia/normas , Anestesiología/normas , Competencia Clínica , Adulto , Procedimientos Quirúrgicos Ambulatorios/efectos adversos , Anestesia/efectos adversos , Consultores , Inglaterra , Hospitalización/estadística & datos numéricos , Hospitales de Distrito , Hospitales Generales , Humanos , Cuerpo Médico de Hospitales/normas , Medicina/estadística & datos numéricos , Persona de Mediana Edad , Estudios Retrospectivos , Especialización , Resultado del Tratamiento
20.
Sci Total Environ ; 670: 732-740, 2019 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-30909049

RESUMEN

The microbial quality of irrigation water is typically assessed by measuring the concentrations of E. coli in irrigation water reservoirs that are variable in space and time. E. coli concentrations are affected by water quality parameters that co-vary with E. coli concentrations and may be easily measured with currently available sensors. The objective of this work was to identify the most influential environmental covariates affecting E. coli concentrations during a three-month biweekly monitoring period within two irrigation ponds in Maryland during the summer of 2017. E. coli levels as well as sensor-based water quality parameters including turbidity, pH, dissolved oxygen, dissolved fluorescent organic matter, conductivity, and chlorophyll were measured at 23 and 34 locations in ponds 1 and 2, respectively. Regression tree analyses were used to determine the most influential water quality parameters for the prediction of E. coli levels. Correlations between E. coli and water quality covariates were not strong and were inconsistently significant. Shoreline sample locations had higher E. coli concentrations than interior pond samples and significant differences were observed when comparing these two groups. Regression trees provided fairly accurate predictions of E. coli levels based on water quality parameters with R2 values ranging from 0.70 to 0.93. Factors identified via the regression trees varied by sampling date but common leading covariates included cyanobacteria, organic matter, and turbidity. Results indicated environmental covariates, sensed either remotely or in situ, could be useful to delineate areas with different E. coli survival conditions across irrigation ponds and potentially other water bodies such as lakes, rivers, or bays.


Asunto(s)
Riego Agrícola , Monitoreo del Ambiente , Escherichia coli/crecimiento & desarrollo , Estanques/microbiología , Microbiología del Agua , Maryland , Estaciones del Año
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