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  • 1
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusions In this population of severely ill patients, SOFA score decrease over time, both in survivors and in non-survivors; it's discriminative power increases, but remains lower than general severity scores. At admission, best discrimination was achieved by cardiovascular failure, but after 5 days in the ICU, respiratory failure was superior. The impact on prognosis of organ failure was analysed, with cardiovascular failure at admission, and respiratory, renal, and hematological on 5th day having the greatest impact on prognosis. The relationships among the six organic systems analysed can be described in terms of a two dimensional structure; this point needs further research, since it can reveal new insights in the sequence and patterns of evolution of multiple organ disfunction/failure syndrome.
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Severity of illness ; index ; Intensive care ; Critical care ; Mortality prediction ; Simplified Acute Physiology Score (SAPS II) ; Acute Physiology and Chronic Health Evaluation (APACHE II)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To compare the performance of the New Simplified Acute Physiology Score (SAPS II) and Acute Physiology and Chronic Health Evaluation (APACHE) II in an independent database, using formal statistical assessment. Design: Analysis of the database of a multicentre, prospective study. Setting: 19 intensive care units (ICUs) in Portugal. Patients: Data for 1094 patients consecutively admitted to the ICUs were collected over a period of 4 months. Following the original SAPS II and APACHE II criteria, the analysis excluded patients younger than 18 years of age, readmissions, acute myocardial infarction, burns, patients in the post-operative period after coronary artery bypass surgery, and patients with a length of stay in the ICU of less than 24 h. The group analysed comprised 982 patients. Interventions: Collection of the first 24 h admission data necessary for the calculation of SAPS II, APACHE II, Therapeutic Intervention Scoring System (TISS), Simplified TISS, organ system failure and basic demographic statistics. Vital status at discharge from the hospital was registered. Measurements and results: In this cohort, discrimination was better for SAPS II than for APACHE II (SAPS II: area under the receiver operating characteristic curve 0.817, standard error 0.015; APACHE II: 0.787, 0.015; p 〈 0.001); however, both models presented a poor calibration, with significant differences between observed and predicted mortality (Hosmer-Lemeshow goodness-of-fit tests H and C, p 〈 0.001). In a stratified analysis, this study was unable to demonstrate any definite pattern of association between the poor performance of the models and specific subgroups of patients except for the most severely ill patients, where both models overestimated mortality. Conclusions: SAPS II performed better than APACHE II in this independent database, but the results do not allow its use, at least without being customised, to analyse quality of care or performance among ICUs in the target population.
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  • 3
    ISSN: 1432-1238
    Keywords: Key words Therapeutic Intervention Scoring System ; Simplified Therapeutic Intervention Scoring System ; TISS-28 ; Intensive care unit ; Nursing workload
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the performance of the Simplified Therapeutic Intervention Scoring System on an independent database and determine its relation with the Therapeutic Intervention Scoring System in the quantification of nursing workload in intensive care. Design: Analysis of the database of a multicenter prospective Portuguese study. Setting: 19 intensive care units (ICUs) in Portugal. Patients: Data on 1094 patients consecutively admitted to the ICUs were collected during a period of 3 months. Methods: Collection of the data necessary for the calculation of the Therapeutic Intervention Scoring System (TISS-76) and the Simplified Therapeutic Intervention Scoring System (TISS-28) during the first 24 h in the ICU. Basic demographic statistics and all the variables necessary for the computation of the Simplified Acute Physiology Score II were also collected. Vital status at discharge from the hospital was registered. Regression techniques, Pearson's correlation and paired sample t-test were used. Results are presented as mean ± standard deviation except when stated otherwise. Reliability was evaluated by the use of intraclass correlation coefficients in a 5 % random sample. Measurements and results: After exclusion of all the patients with missing data, 1080 patients were analysed. The overall mean TISS-28 (29.82 ± 10.64) was significantly lower than the mean TISS-76 (31.14 ± 11.95). Both systems showed very significant differences between ICUs (p 〈 0.001). The correlation between the two was good, with TISS-28 explaining 72 % of the variation of TISS-76 (r = 0.85, r 2 = 0.72). The relation between the two systems was TISS-28 = 6.22 + 0.85 TISS-76. In this cohort, reliability of data collection was very high, with intraclass correlation coefficients greater than 0.90 for both systems. Conclusions: TISS-28 was validated on this independent population. The results indicate that TISS-28 can replace TISS-76 for the measurement of the nursing workload in Portuguese ICUs
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  • 4
    ISSN: 1573-6776
    Source: Springer Online Journal Archives 1860-2000
    Topics: Process Engineering, Biotechnology, Nutrition Technology
    Notes: Summary Strains of Saccharomyces spp. from tropical substrates tolerated temperatures up to 40 ° C, sucrose concentrations up to 50% (w/v) and ethanol concentrations up to 20 g/L in fermentation conditions. Strain TD200 tolerated 20 g/l of ethanol. The ethanol produced by strain DR1459 was comparable to that of industrial strain HTYM-81. These strains have potential use for the production of fuel alcohol.
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  • 5
    ISSN: 1432-1939
    Keywords: Yeast communities ; Cactophilic yeasts ; Drosophila fasciola subgroup
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Yeast communities associated with four species of the Drosophila fasciola subgroup (repleta group) in tropical rain forests were surveyed in an abandoned orchard, and rain forest sites of Rio de Janeiro and Ilha Grande, State of Rio de Janeiro, Brazil. Adult flies of Drosophila carolinae, Drosophila coroica, Drosophila fascioloides and Drosophila onca frequently carried Candida colliculosa, Geotrichum sp, Kloeckera apiculata and a Pichia membranaefaciens-like species. The most frequent yeasts in the crop of flies included Candida collicullosa, C. krusei, Pichia kluyveri and a P. membranaefaciens-like species. The physiological abilities and species composition of these yeast communities differed from those of other forest-inhabiting Drosophila. The narrow feeding niches of the fasciola subgroup suggested the use of only part of the substrates available to the flies as food in the forest environment, as noted previously for cactophilic Drosophila serido (mulleri subgroup of the repleta group) in a sand dune ecosystem. The cactophilic yeasts that were isolated have not been previously found in forests. The fasciola subgroup probably used epiphytic cactus substrates as breeding and feeding sites in the forest. The physiological profile of yeasts associated with the fasciola flies was broader than that of yeasts associated with the cactophilic Drosophila serido, suggesting that the fasciola subgroup represents an older lineage from which the South American repleta species evolved.
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