Short-Term Risk Stratification at Admission Based on Simple Clinical Data in Acute Myocardial Infarction

in American Journal of Cardiology (1988), 61(4), 216-9

Simple clinical data, available in all coronary care units, were recorded in 1,013 consecutive patients with acute myocardial infarction (AMI). In order to identify the patients at highest and lowest risk ... [more ▼]

Simple clinical data, available in all coronary care units, were recorded in 1,013 consecutive patients with acute myocardial infarction (AMI). In order to identify the patients at highest and lowest risk of mortality during hospital stay, a prognostic index was established from a stepwise logistic discriminant analysis of 10 clinical variables obtained at admission in a consecutive series of 477 patients hospitalized in 1 of 2 coronary care units admitting new patients on alternate days and treating them similarly. This prognostic index was applied to a comparison group of 536 consecutive patients admitted to the other coronary care unit. In the experimental group, 57 of the 477 patients (12%) died during hospital stay; 60 of the 536 patients (11%) died in the comparison group. As individual variables, age, previous history of AMI, anterior site and left ventricular function on admission were associated with increased mortality. Three variables were selected from the stepwise logistic discriminant analysis of the experimental group: age; site (anterior = 1, other = 0); and grade of left ventricular function (0 to 4). Prognostic index = 5.9019 - 0.8961 function - 0.5708 location - 0.0369 age. This index was validated in the comparison group. Patients were allocated into different classes with increasing index values associated with decreasing risk. Three subgroups of patients were identified: high risk of hospital mortality (index less than or equal to 1; mortality: 51%), intermediate risk (index 1 to 3; mortality: 18%) and low risk (index greater than 3; mortality: 4%). The use of this simple prognostic index may improve clinical management and selection of patients for intervention trials. [less ▲]

Short-term temperature impact on soil heterotrophic respiration in limed agricultural soil samples

in Biogeochemistry (2013), 112(1-3), 441-455

This study sought to investigate the hourly and daily timescale responses of soil CO2 fluxes to temperature in a limed agricultural soil. Observations from different incubation experiments were compared ... [more ▼]

This study sought to investigate the hourly and daily timescale responses of soil CO2 fluxes to temperature in a limed agricultural soil. Observations from different incubation experiments were compared with the results of a model combining biotic (heterotrophic respiration) and abiotic (carbonate weathering) components. Several samples were pre-incubated for 8-9 days at three temperatures (5, 15 and 25°C) and then submitted to short-term temperature cycles (where the temperature was increased from 5 to 35°C in 10°C stages, with each stage being 3 h long). During the temperature cycles (hourly timescale), the soil CO2 fluxes increased significantly with temperature under all pre-incubation temperature treatments. A hysteresis effect and negative fluxes during cooling phases were also systematically observed. At a given hourly timescale temperature, there was a negative relationship of the CO2 fluxes with the pre-incubation temperature. Using the combined model allowed the experimental results to be clearly described, including the negative fluxes and the hysteresis effect, showing the potentially large contribution of abiotic fluxes to total fluxes in limed soils, after short-term temperature changes. The fairly good agreement between the measured and simulated flux results also suggested that the biotic flux temperature sensitivity was probably unaffected by timescale (hourly or daily) or pre-incubation temperature. The negative relationship of the CO2 fluxes with the pre-incubation temperature probably derived from very labile soil carbon depletion, as shown in the simulations. This was not, however, confirmed by soil carbon measurements, which leaves open the possibility of adaptation within the microbial community. [less ▲]

Short-term temperature impacts on soil respiration.

Poster (2009, June)

Despite considerable recent work on soil heterotrophic respiration, a mechanistic understanding of this process is still missing. Temperature is one of the most important driving factors. It can influence ... [more ▼]

Despite considerable recent work on soil heterotrophic respiration, a mechanistic understanding of this process is still missing. Temperature is one of the most important driving factors. It can influence the mechanism through multiple ways, whose importance may vary with time. An incubation experiment is set up to study short-term temperature influences on soil microbial respiration and its evolution through time. Soil samples are taken in spring from the surface layer (0-25cm) of a bare agricultural loamy soil situated in Lonzée in Belgium (Hesbaye region) and are homogenized before being placed into incubators at three different temperatures, namely 5, 15 and 25°C. Temperature is regulated by Peltier systems that warm up or cool down a sand bath containing jars with soil samples. Once a week, incubation temperatures are increased and decreased by 5°C-steps, starting from each incubator temperature, to achieve a one-day temperature cycle between 5 and 35°C. CO2 flux measurements are performed at each temperature step by a closed dynamic chamber system, after the temperature has stabilized in the samples. Microbial biomass (C and N) is determined four times during the temperature cycle by the fumigation-extraction technique and soil labile carbon is measured at the beginning of each cycle by the hot-water extraction method. Moisture levels in soil samples are regularly checked and adjusted to keep optimal soil moisture content. Between CO2 flux measurements, jars are left open to ensure that anaerobic conditions do not occur. Further investigations could include an assessment of the importance of substrate availability and depletion on microbial activity, and a model development related to the results provided by this experiment. [less ▲]

Short-term variations of the partial pressure of CO2 in surface waters of the Galician upwelling system

in Progress in Oceanography (2001), 50(2-4), 283-302

The partial pressure of CO2 (pCO2) and dissolved oxygen saturation level (%O2) were monitored continuously during a cruise in August 1998, which sampled surface waters off the Galician coast. Data are ... [more ▼]

The partial pressure of CO2 (pCO2) and dissolved oxygen saturation level (%O2) were monitored continuously during a cruise in August 1998, which sampled surface waters off the Galician coast. Data are presented from two Lagrangian experiments carried out in an upwelling on the continental shelf and in the core of an offshore filament. The data show that daily variations in surface pCO2 and oxygen (%O2) were controlled by the diurnal cycle of primary production/respiration, temperature variations and air–sea exchange. Data obtained during various cross-shelf and cross-filament transects are also discussed and give an insight into the processes controlling large scale variations of pCO2 and %O2 in the Galician upwelling system. These data suggest that upwelling filaments are an important feature of the inorganic carbon cycle of upwelling systems. However more field data in the various eastern boundary current systems worldwide are needed. [less ▲]

Shortened first-line high-dose chemotherapy for patients with poor-prognosis aggressive lymphoma

in Journal of Clinical Oncology (2002), 20(10), 2472-2479

Purpose: Randomized trial LNH93-3 was conducted on patients who had poor-prognosis aggressive lymphoma and were younger than 60 years with two to three factors of the age-adjusted International Prognostic ... [more ▼]

Purpose: Randomized trial LNH93-3 was conducted on patients who had poor-prognosis aggressive lymphoma and were younger than 60 years with two to three factors of the age-adjusted International Prognostic Index to evaluate the benefit of early high-dose therapy (HDT) with autologous stem-cell transplantation (ASCT). Patients and Methods: Patients were randomized between doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (ACVBP) chemotherapy followed by sequential consolidation and an experimental shortened treatment consisting of three cycles with escalated doses of cyclophosphamide, epirubicin, vindesine, bleomycin, and prednisone and collection of peripheral-blood stem cells. On day 60, HDT was administered with 1,3-bis(2-chloroethyl)-1-nitrosourea, etoposide, cytarabine, and melphalan followed by ASCT. Results: Eligible patients (n = 370) with aggressive lymphoma were analyzed. For ACVBP (181 patients) and HDT (189 patients), respective complete remission rates were 64% and 63%. With a median follow-up of 60 months, 5-year overall survival and event-free survival for ACVBP and HDT were 60% +/- 8% and 46% +/- 8% (P = .007) and 52 +/- 8% and 39 8% (P = .01), respectively. Survival was independently affected by age greater than 40 years (P = .0003), T-cell phenotype (P = .009), bone marrow involvement (P = .003), and HDT treatment group (P = .04). Conclusion: Early HDT with ASCT in high-risk patients was inferior to the ACVBP chemotherapy regimen. These results indicate that the received dose-intensity before HDT was too low when compared with ACVBP and HDT and was given too early. (C) 2002 by American Society of Clinical Oncology. [less ▲]

Shortsea shipping from hinterland ports by sea-river going vessels: study of the influence of a free cabotage policy.

Conference (1994, June)

Should patients under long-term anti-TNF therapies be followed for tuberculosis contamination?

in Inflammatory Bowel Diseases (2010), 16(8), 1271-2

Shoulder function after latissimus dorsi transfer in breast reconstruction

in Clinical Physiology & Functional Imaging (2010), 30(6), 406-412

Background ⁄ Aims: Latissimus dorsi (LD) transfer in the case of breast reconstruction remains frequently used because this muscle provides a good size source of tissue in reconstructive surgery. Given ... [more ▼]

Background ⁄ Aims: Latissimus dorsi (LD) transfer in the case of breast reconstruction remains frequently used because this muscle provides a good size source of tissue in reconstructive surgery. Given that, the consequences of the LD removal on shoulder function and the actual loss of maximal strength developed must be investigated. Methods: Twenty women (50 ± 7Æ5 years old) were evaluated before surgery, 3 and 6 months after an unilateral transfer of a pedicle flap of LD muscle used for breast reconstruction. Women performed a bilateral shoulder isokinetic assessment [for the internal rotators (IRs) and external rotators and for the abductor and adductor (ADD) muscles] allowing the establishment of bilateral muscular deficit status and the study of agonist ⁄ antagonist muscle ratios. The algofunctional and clinical status of the shoulders was analysed by the means of Constant score and specific shoulder clinical tests. The women did not perform any specific strengthening of muscle shoulder after surgery. Results: The isokinetic assessment showed a muscle weakness 3 and 6 months after LD transfer, mainly on the ADDs (33 ± 9% at 6 months) and on the IRs (16 ± 11% at 6 months). The Constant score significantly decreased after surgery on the operated shoulder. Women with a Constant score impairment showed pain during specific shoulder clinical tests. We also found a correlation between Constant score impairment and internal rotators weakness or rotator muscle imbalance. Conclusion: Given those results, we could advocate a specific shoulder strengthening after LD transfer, focused mainly on the IRs and ADDs. [less ▲]

Shoulder isokinetic assessment: a critical analysis

in Isokinetics & Exercise Science (2005, March), 13(1), 59-60

Shoulder isokinetic profile after Latarjet's technique

in Isokinetics & Exercise Science (2005), 13(1), 71-76

The following procedures were performed on 23 patients (15 of them males): a shoulder strength isokinetic evaluation of the internal (IR) and external (ER) rotators (with the shoulder 45 degrees and 90 ... [more ▼]

The following procedures were performed on 23 patients (15 of them males): a shoulder strength isokinetic evaluation of the internal (IR) and external (ER) rotators (with the shoulder 45 degrees and 90 degrees abducted in the frontal plane), a passive range of motion measurement, a Rowe score and a scanner exam. These patients had previously undergone open coracoid transposition using Latarjet's technique according to two different surgical procedures: a tenotomy (n = 6) or a splitting (n = 17) of the subscapularis muscle approach. In our retrospective study, the period of time between surgery and assessment was an average of 30 months. The average Rowe score was 89 on a scale of 100, with a good pattern of passive mobility. The isokinetic data showed an external rotator weakness (in all testing conditions), most notably at 60 degrees/s in 45 degrees of abduction position (p < 0.001 - 12.2%). By contrast, the internal rotators were only significantly (p < 0.05) impaired (8.2%) at 60 degrees/s in the 90 degrees of abduction position. Consequently, the external/internal rotator ratio (ERAR) was reduced in the 45 degrees of abduction installation only, highlighting the influence of testing position on the isokinetic results and therefore on the shoulder muscle profile. Surgical technique comparison revealed that only the tenotomy procedure entailed an IR deficit (17%) measured at 45 degrees of abduction installation. Shoulders (n = 5) presenting a fatty degeneration of the subscapularis muscle >= stage II (corresponding exclusively to the tenotomy surgical approach) showed an internal rotator weakness (19%) measured in 45 degrees of abduction. Patients (n = 13) without subscapularis fatty degradation (corresponding solely to the horizontal splitting approach) did not develop any impairment of strength in internal rotators. Furthermore, no correlation between mobility pattern and strength impairment was observed in the study. [less ▲]