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Fluid and electrolyte overload in critically ill patients: An overview

World Journal of Critical Care Medicine 2015年第2期4卷 116-129页

作者： Bruno Adler Maccagnan Pinheiro Besen André luiz Nunes Gobatto lívia maria garcia melro Alexandre Toledo Maciel Marcelo Park Intensive Care Unit Department of Medical Emergencies Hospital das Clínicas University of Sao Paulo Medical School Imed Research Group Intensive Care Unit Hospital Sao Camilo Pompéia

Fluids are considered the cornerstone of therapy for many shock states, particularly states that are associated with relative or absolute hypovolemia. Fluids are also commonly used for many other purposes, such as renalprotection from endogenous and exogenous substances, for the safe dilution of medications and as "maintenance" fluids. However, a large amount of evidence from the last decade has shown that fluids can have deleterious effects on several organ functions, both from excessive amounts of fluids and from their non-physiological electrolyte composition. Additionally, fluid prescription is more common in patients with systemic inflammatory response syndrome whose kidneys may have impaired mechanisms of electrolyte and free water excretion. These processes have been studied as separate entities(hypernatremia, hyperchloremic acidosis and progressive fluid accumulation) leading to worse outcomes in many clinical scenarios, including but not limited to acute kidney injury, worsening respiratory function, higher mortality and higher hospital and intensive care unit lengthof-stays. In this review, we synthesize this evidence and describe this phenomenon as fluid and electrolyte overload with potentially deleterious effects. Finally, we propose a strategy to safely use fluids and thereafter wean patients from fluids, along with other caveats to be considered when dealing with fluids in the intensive care unit.

关键词： Fluid therapy Critically Ill Oliguria Waterelectrolyte balance Central venous pressure Resuscitation Acute kidney injury Diuretics Multiple organ dysfunction syndrome Systemic inflammatory response syndrome

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Intense pulsed light‑based treatment for the improvement of symptoms in glaucoma patients treated with hypotensive eye drops

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Eye and Vision 2024年第2期10卷 12-21页

作者： Jose maria Martinez‑de‑la‑Casa Carlos Oribio‑Quinto Almudena Milans‑del‑Bosch Pilar Perez‑garcia laura Morales‑Fernandez Javier garcia‑Bella Jose Manuel Benitez‑del‑Castillo Julian garcia‑Feijoo David P.Pinero Ophthalmology Unit Department of Ophthalmology and ORLFaculty of MedicineHospital Clinico San-CarlosUniversidad Complutense de MadridInstituto de Investigacion Sanitaria del Hospital Clinico San-Carlos(IdISSC)28040 MadridSpain Department of Immunology Ophthalmology and ORLSchool of MedicineInstituto de Investigaciones Oftalmologicas Ramon CastroviejoUniversidad Complutense de MadridMadridSpain Department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicanteSpain

Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients *** current study was aimed at evaluating the potential clinical benefit of an intense pulsed light(IPl)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop *** our knowledge,this is the first series analyzing the therapeutic effect of this treatment option in this type of ***:This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye *** patients received four sessions of IPl treatment using the Optima IPl system(lumenis,Yokneam,Israel)adjusted to the official optimized lumenis *** in symptomatology,corneal staining,conjunctival hyperemia,non-invasive break-up time(NIBUT),tear osmolarity,tear meniscus height(TMH),meiboscore and meibomian gland expressibility was analyzed after ***:Statistically significant reductions were observed after IPl treatment in the symptomatology scores measured with different questionnaires[ocular surface disease index(OSDI),standard patient evaluation of eye dryness(SPEED)and symptom assessment questionnaire in dry eye(SANDE)]as well as with the visual analogue scale(Pl staining score(Plm meniscus height(P=0.012),as well as in tear film osmolarity(P=0.001).A significant reduction was also found in meibomian gland expressibility(P=0.003),changing the percentage of grade 3 eyes from 44.4%before IPl to 17.2%after ***:IPl therapy combined with meibomian gland expression(MGX)seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface diseas

关键词： Glaucoma Intense pulsed light Dry eye Meibomian glands

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Characteristics and trends of pediatric firepit burns: insights for prevention and safety

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World Journal of Pediatric Surgery 2024年第1期7卷 54-58页

作者： maria Fazal Charbel Chidiac Raheel Ahmad Oussama Issa Erica Hodgman Alejandro V garcia Johns Hopkins School of Medicine BaltimoreMarylandUSA Department of Surgery Division of Pediatric SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA Division of the Biological Sciences University of ChicagoChicagoIllinoisUSA School of Medicine American University of BeirutBeirutLebanon

Introduction As fire pits grow in popularity,so do the associated burn *** study examines pediatric fire pit burns characteristics to raise awareness and promote safety *** We conducted a retrospective review of pediatric patients(l from 2016 to *** Eighty-four patients were identified,of whom 70.2%were male,with a median age of 62 *** median percent total body surface area burned was 2%(interquartile range(IQR)=1-4).Thirty-five(41.7%)patients were admitted and 7(8.3%)underwent *** and trunk burns had the highest grafting rates(66%and 33%,respectively).The hands(41.7%)and the lower extremities(27.4%)were the most frequently burned body *** leading causes of burns were ashes/hot coals(34.5%),flames(31.0%),and direct contact(25.0%),often resulting from falling into the fire(59.5%)or running or playing in activities near it(26.2%).Thirty-five(41.7%)were admitted for inpatient management,while 49(58.3%)were treated as ***(13.2%)underwent at least one reconstructive surgery,7(8.4%)had at least one rehabilitation visit,and 65(77.4%)had follow-up clinic *** median length of stay was 2 days(IQR=1.0-3.5).The peak months for burns were from August through October(n=40,46.0%),with an increase observed from 10 cases in 2016to 20 cases in *** Given the significant proportion of firepit burns resulting from unsafe fire behaviors,it is crucial that caretakers are aware of proper firepit safety *** ofevidence Il.

关键词： burns admitted prevention

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Spectrum of delayed post-hypoxic leukoencephalopathy syndrome:A systematic review

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World Journal of Clinical Cases 2024年第29期12卷 6285-6301页

作者： Bahadar S Srichawla maria A garcia-Dominguez Department of Neurology University of Massachusetts Chan Medical SchoolWorcesterMA 01655United States

BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHlS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic *** by delayed onset of neurological and cognitive deficits,DPHlS presents substantial diagnostic and therapeutic *** To consolidate current knowledge on pathophysiology,clinical features,diagnostic approaches,and management strategies for DPHlS,providing a comprehensive overview and highlighting gaps for future *** Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines,we systematically searched PubMed,ScienceDirect and Hinari databases using terms related to delayed post-hypoxic *** criteria were original research articles,case reports,and case series involving human subjects with detailed clinical,neuroimaging,or pathological data on *** were extracted on study characteristics,participant demographics,clinical features,neuroimaging findings,pathological findings,treatment,and *** quality assessment was performed using the Joanna Briggs Institute critical appraisal *** A total of 73 cases were *** comorbidities included schizoaffective disorder,bipolar disorder,hypertension,and substance use *** primary causes of hypoxia were benzodiazepine overdose,opioid overdose,polysubstance overdose,and carbon monoxide(CO)*** frequently include decreased level of consciousness,psychomotor agitation,cognitive decline,parkinsonism,and *** commonly revealed diffuse T2 hyperintensities in cerebral white matter,sometimes involving the basal ganglia and the globus *** resonance spectroscopy often showed decreased N-acetylaspartate,elevated choline,choline-to-creatinine ratio,and normal or elevated *** is often supportive,including amantadine,an antioxidant cocktail,and

关键词： Delayed post hypoxic leukoencephalopathy syndrome Anoxic encephalopathy Delayed post hypoxic leukoencephalopathy Hypoxic-ischemic brain injury Grinker's myelinopathy Toxic leukoencephalopathy Toxic leukoencephalopathy Delayed postanoxic encephalopathy Carbon monoxide poisoning

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Potential of Applying Artificial Intelligence to Hot Metal logistics Management

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China's Refractories 2024年第3期33卷 37-41页

作者： maria Gabriela garcia CAMPOS Paul van BEURDEN Tata Steel IJmuiden 1970 CAThe Netherlands

The steel industry,known for its complexity and the need to reduce CO_(2)emissions,is adopting advanced digitalization tools to move towards a more sustainable,integrated,and agile operating *** twins with artificial intelligence-based optimization and scheduling models can improve decision-making in logistics,refractory maintenance,and energy *** incorporating advanced AI algorithms into this decision support system,the hot metal route scenarios can be evaluated,resulting in minimized hot metal temperature losses and increased scrap *** paper integrated digital twins with reinforcement learning algorithms to investigate the logistics of torpedoes and hot metal *** considered important input parameters such as the ladles and torpedoes'thermal state and location,refractory thickness,hot metal volume and temperature,and crane *** incorporating advanced AI algorithms into this decision support system,energy-efficient scenarios can be evaluated,increasing scrap utilization and resulting in a possible reduction of 15°C in hot metal temperature losses.

关键词： hot metal logistics energy efficiency artificial intelligence

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Artemisia vulgaris Induces Tumor-Selective Ferroptosis and Necroptosis via lysosomal Ca^(2+) Signaling

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Chinese Journal of Integrative Medicine 2024年第6期30卷 525-533页

作者： lucas dos Santos Zamarioli Michele Rosana Maia Santos Adolfo garcia Erustes Vanessa Marques Meccatti Thais Cristine Pereira Soraya S Smaili maria Cristina Marcucci Carlos Rocha Oliveira Gustavo JS Pereira Claudia Bincoletto Department of Pharmacology Paulista School of MedicineFederal University of São PauloSão PauloSP04044-020Brazil Research Group on Phytocomplexes and Cell Signaling School of Health SciencesAnhembi Morumbi UniversitySão PauloSP03164-000Brazil Department of Biosciences and Oral Diagnosis Institute of Science and TechnologySão Paulo State University(ICT-UNESP)São PauloSP12231-280Brazil

Objective To evaluate the chemical composition and effects of Artemisia vulgaris(AV)hydroalcoholic extract(HEAV)on breast cancer cells(MCF-7 and SKBR-3),chronic myeloid leukemia(K562)and NIH/3T3 *** Phytochemical analysis of HEAV was done by high-performance liquid chromatography-mass(HPlC)*** and cell death studies were performed using trypan blue and Annexin/FITC-7AAD,***-1(Fer-1)and necrostatin-1(Nec-1)were used to assess the mode of HEAV-induced cell death and acetoxymethylester(BAPTA-AM)was used to verify the involvement of cytosolic calcium in this *** calcium measurements were made using *** HEAV decreased the viability of MCF-7,SKBR-3 and K562 cells(Pviability of HEAV-treated K562 cells was reduced compared to HEAV-exposed fibroblasts(Plls with HEAV induced cell death primarily by late apoptosis and necrosis in assays using annexin V-FITC/7-AAD(Pviability of K562 cells treated with HEAV relative to cells exposed to HEAV alone(Please mainly from lysosomes in K562 cells(Pllular Ca^(2+)chelator,decreased the number of non-viable cells treated with HEAV(Plusions HEAV is cytotoxic and activates several modalities of cell death,which are partially dependent on lysosomal release of Ca^(2+).These effects may be related to artemisinin and caffeoylquinic acids,the main compounds identified in HEAV.

关键词： Artemisia vulgaris necroptosis ferroptosis late apoptosis Ca^(2+)signaling

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Prioritizing Strategies for Building the Resilience of Public Health Systems to Disasters Across Multiple Communities and Countries

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International Journal of Disaster Risk Science 2024年第1期15卷 1-17页

作者： Benjamin J.Ryan Mayumi Kako Shelby Garner Rok Fink Ismail Tayfur Jonathan Abrahams Sanjaya Bhatia Adriana Campelo Matthew Fendt Alicia Fontenot Nahuel Arenas garcia Tim Hatch Ryoma Kayano laShonda Malrey‑Horne Makiko MacDermot Md Moshiur Rahman Chaverle Noel Shuhei Nomura Jeremy P.Novak maria Opazo Kendell Oliver luciana Peters Sohel Rahman PerihanŞimşek Andrew Stricklin Raymond Swienton Bryan W.Brooks Frist College of Medicine Belmont UniversityNashvilleTN 37212USA Department of Environmental Science Environmental Health Science ProgramCollege of Arts and SciencesBaylor UniversityWacoTX 76798USA Division of Nursing Science School of Biomedical and Health SciencesHiroshima UniversityHiroshima 734-8553Japan Gordon E.Inman College of Health Sciences and Nursing Belmont UniversityNashvilleTN 37212USA Faculty of Health Sciences University of Ljubljana1000 LjubljanaSlovenia Department of Emergency Medicine University of Health Sciences34668 IstanbulTurkey Monash University Accident Research Center MelbourneVIC 3800Australia Global Education and Training Institute United Nations Ofce for Disaster Risk ReductionIncheon 22004Republic of Korea Regional Ofce for the Americas and Caribbean United Nations Ofce for Disaster Risk ReductionPanama City 0843-03441Panama Engineering and Computer Science Baylor UniversityWacoTX 76798USA Department of Public Health Robbins College of Health and Human SciencesBaylor UniversityWacoTX 76798USA Alabama Department of Public Health MontgomeryAL 36092USA World Health Organization Centre for Health Development(WHO Kobe Centre) Kobe 651-0073Japan Waco-Mclennan County Public Health District WacoTX 76707USA Department of Health Policy and Management School of MedicineKeio UniversityTokyo 160-8582Japan Department of Global Health Policy Graduate School of MedicineThe University of TokyoTokyo 113-0033Japan Tokyo Foundation for Policy Research Tokyo 106-6234Japan Global Development College BrisbaneQLD 4000Australia Municipality of Pudahuel 13124 PudahuelChile City Hall of Porto Alegre Porto Alegre 90010-170Brazil Ministry of Health and Family Welfare Government of the People’s Republic of BangladeshDhaka 1000Bangladesh Department of Emergency Aid and Disaster Management Trabzon University61335 TrabzonTurkey Department of Emergency Medicine UT SouthwesternDallasTX 75390USA

The COVID-19 pandemic highlighted the urgent need to strengthen public health *** response,the United Nations Disaster Risk Reduction(UNDRR) Public Health System Resilience Scorecard(Scorecard) was applied in workshops across multiple *** aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system *** conducted a workshop from 14 to 16 March 2023,at the UNDRR Global Education and Training Institute in Incheon,Republic of Korea.A sequential modified Delphi method was utilized to develop a set of prioritized resilience *** were drawn from 70 strategies identified from 13 distinct workshops in eight *** two surveys,23 strategies were *** received ratings of "High" or Very High" from89% of *** related to the inclusion of public health risks in emergency plans,integrating multidisciplinary teams into public health,enabling local transport mechanisms,and improving the ability to manage an influx of *** Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system *** leveraging this methodology,our study demonstrated how resilience strategies could inform disaster risk reduction funding,policies,and actions.

关键词： Health system resilience Public policy Resilience scorecard Workshops

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Antimicrobial Activity, Structural, Crystallographic and Thermal Characteristics of Alpha-Titanium Phosphate Promoted by Silver Ions

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Materials Sciences and Applications 2024年第8期15卷 253-269页

作者： Enzo Erbisti garcia Agnes maria Cupertino Fernandes Araujo Gerson Alberto Valencia Albitres Daniela de França da Silva Freitas Danielle Mattos mariano Carlos Magno Fialho Soares Sibele Piedade Cestari Marco Antônio lemos Miguel luis Claudio Mendes Institute of Macromolecules Professora Eloisa Mano Federal University of Rio de Janeiro Avenida Horacio Macedo 2030 Centro de Tecnologia Bloco J Ilha do Fundo Rio de Janeiro Brazil Institute of Microbiology Paulo de Ges Federal University of Rio de Janeiro Centro de Ciencias da Saude Bloco I Ilha do Fundo Rio de Janeiro Brazil Innovation in Polymer Engineering (PIEP) University of Minho Guimares Portugal

The recent global spread of the pandemic underscores the necessity of seeking new materials effective against microorganisms. Nanotechnology offers avenues for developing multifunctional materials. In this study, alpha-titanium phosphate (α-TiP) nanoparticles were synthesized and treated with silver salt to enhance their antimicrobial properties. The physicochemical characteristics and antimicrobial activity were evaluated. It was revealed by X-ray diffraction analysis that the structural integrity of α-TiP was influenced by ethylenediamine and silver ions. Distinct degradation profiles for each chemical modification were shown by thermogravimetric analysis. Infrared spectroscopy detected shifts and new absorption peaks in the spectra depending on the type of modification. Energy dispersive spectroscopy confirmed the disaggregation of α-TiP galleries following the addition of silver salt, which increased their effectiveness against microorganisms. Notably, only the sample treated with silver ions exhibited antimicrobial action. Antimicrobial activity was tested against the bacteria of medical importance Escherichia coli, Salmonella Enteritidis, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, listeria momocytogenes and the yeast Candida albicans. All microorganisms were inhibited by sample containing silver. Minor inhibition was observed against the Gram-positive bacteria l. monocytogenes and Bacillus cereus, while the greatest inhibition occurred against the fungus (yeast) C. albicans. The results revealed a potential application of the nanoparticles for control of microorganisms in public health.

关键词： Titanium Phosphate Silver Nitrate Antimicrobial Action

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Real-time cell analysis and heat shock protein gene expression in the TcA Tribofium castaneum cell line in response to environmental stress conditions

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Insect Science 2017年第3期24卷 358-370页

作者： Andres garcia-Reina maria Juliana Rodriguez-garcia Guillermo Ramis Jose Galian Department of Zoology and Physical Anthropology University of MurciaCampus Mare Nostrum E-30100 Murcia Spain Department of Animal Production Faculty of Veterinary University of MurciaCampus Mare Nostrum E-30100 Murcia Spain

The rust red flour beetle, Tribolium castaneum （Herbst, 1797）（Coleoptera： Tenebrionidae）, is a pest of stored grain and one of the most studied insect model species. Some of the previous studies involved heat response studies in terms of survival and heat shock protein expression, which are regulated to protect other proteins against environ- mental stress conditions. In the present study, we characterize the impedance profile with the xCElligence Real-Time Cell Analyzer and study the effect of increased temperature in cell growth and viability in the cell line BCIRl-TcA-ClG 1 （TcA） of T castaneum. This novel system measures cells behavior in real time and is applied for the first time to insect cells. Additionally, cells are exposed to heat shock, increased salinity, acidic pH and UV-A light with the aim of measuring the expression levels of lisp27, Hsp68a, and Hsp83 genes. Results show a high thermotolerance of TeA in terms of cell growth and viability. This result is likely related to gene expression results in which a significant up-regulation of all studied Hsp genes is observed after 1 h of exposure to 40 ~C and UV light. All 3 genes show similar expression patterns, but Hsp27 seems to be the most affected. The results of this study validate the RTCA method and reveal the utility of insect cell lines, real-time analysis and gene expression studies to better understand the physiological response of insect cells, with potential applications in different fields of biology such as conservation biology and pest management.

关键词： environmental stress gene expression heat shock proteins insect cells,real-time cell analysis (RTCA) red flour beetle

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Development of a Ready-to-Use PSMA-11 Kit Formulation and Biological Evaluation of Binding Affinity

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Advances in Molecular Imaging 2024年第2期13卷 7-22页

作者： maria Renata Valente Brandão Freire Natália Marchesan Bexiga Marco Antonio Stephano João Ezequiel Oliveira Carlos Roberto Jorge Soares Ana Cláudia Camargo Miranda Anna Carolina de Alcântara Barbosa Marycel Figols de Barboza laura Fernanda garcia luiz Felipe S. Teixeira maria Helena Marumo Bellini Natanael Gomes da Silva luiza Mascarenhas Balieiro Joel Mendes Elaine Bortoleti de Araújo Centro de Radiofarmcia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil Departamento de Tecnologia Farmacutica Faculdade de Cincias Farmacuticas (USP) Cidade Universitria So Paulo Brasil Centro de Biotecnologia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil Departamento de Medicina Nuclear do Hospital Israelita Albert Einstein So Paulo/SP Brasil

Introduction: 68Ga-PSMA-11 is considered the gold standard in detection of micro and oligometastases in advanced prostate cancer, being used for therapeutic planning, as well as, potentially, for evaluating response to treatment. The development of ready-to-use lyophilized kit of PSMA-11 adds quality and safety to the routine use of this radiopharmaceutical and represents a pharmacotechnical challenge as it must preserve the integrity and specificity of the ligand. Methods: PSMA-11 kit formulation was proposed, considering radiolabeling parameters and the preservation of the peptide during the lyophilization process, using mannitol as an excipient. Critical temperature characterization studies were carried out using DSC equipment and the freeze-drying process was developed. The direct radiolabeling conditions were evaluated and standardized using 68Ge/68Ga generator eluate from two different manufacturers (ITG and Eckert & Ziegler). The radiochemical purity was evaluated by TlC and HPlC. Biological evaluation was carried out with lyophilized PSMA-11 to demonstrate the integrity of the peptide and preservation of biological activity after the lyophilization process. Results: Based on critical temperature characterization studies, the freeze-drying cycle was designed to reach a freezing temperature of around −40˚C and primary drying at 2˚C. Using 20 mg of mannitol, an intact and elegant lyophilized cake was obtained. PSMA-11 lyophilized kit was directly labeled with 68Ga eluate from 68Ge/68Ga GMP generators (ITG and Eckert & Ziegler) resulting in % RP > 95% at pH 4.0 to 4.5. The results obtained from in vitro and in vivo biological competition studies confirmed the preservation of PSMA-11 affinity for the receptor after lyophilization. Conclusion: A lyophilized formulation (Kit) of PSMA-11 was successfully obtained, which preserved the integrity and biological activity of the peptide and guaranteed radiolabeling efficiency.

关键词： 68Ga-PSMA-11 Prostate-Specific Membrane Antigen (PSMA) Ready-to-Use Kit GMP-Grade Generators Metastatic Prostate Cancer PET Imaging

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