Radically rethinking agriculture for the 21st century.

Population growth, arable land and fresh water limits, and climate change have profound implications for the ability of agriculture to meet this century's demands for food, feed, fiber, and fuel while reducing the environmental impact of their production. Success depends on the acceptance and use of contemporary molecular techniques, as well as the increasing development of farming systems that use saline water and integrate nutrient flows.

Predictive value of interleukin 6 (IL-6), interleukin 8 (IL-8) and gastric intramucosal pH (pH-i) in major abdominal surgery.

OBJECTIVE: To study plasma concentrations of interleukin 6 (IL-6) and interleukin 8 (IL-8) in patients with splanchnic hypoxia, as documented by gastric intramucosal measurements (pH-i), during major abdominal surgery and the relationship between IL-6 and IL-8 concentrations and postoperative complications as well as clinical outcome. DESIGN: A prospective study. PATIENTS: Twelve patients scheduled for major abdominal surgery with no evidence of coexisting infectious disease. RESULTS: Six out of seven samples from patients with postoperative complications showed intraoperative pH-i levels lower than 7.32 and IL-6 levels higher than 300 pg/ml. Seven out of nine samples from patients without complications showed pH-i levels higher than 7.32 and IL-6 levels lower than 300 pg/ml. The difference in the pattern of distribution was statistically significant (p < 0.01). Only two out of seven samples of patients with postoperative complications showed intraoperative pH-i levels lower than 7.32 and IL-8 levels higher than 60 pg/ml. It was not possible to identify a clear distribution pattern of data points for IL-6 and IL-8 during the postoperative period. CONCLUSIONS: Intraoperative splanchnic ischemia, as documented by gastric intramucosal pH-i, is directly correlated to the increase of IL-6 plasma levels and to the incidence of postoperative complications, while IL-8 levels showed no correlation with surgical complications.

[Monitoring of cuff pressure in double-lumen endotracheal tubes during anesthesia for thoracic surgery]. / Il monitoraggio della pressione di cuffia in tubi endotracheali a doppio lume durante anestesia per chirurgia toracica.

It is well known that cuff overinflation in endotracheal tubes may cause serious damage to the tracheal mucosa. Cuff overinflation is also related to the diffusion of nitrous oxide across the cuff membrane, thus giving way to a progressive volume/pressure increase up to overcoming, critical capillaric perfusion pressure. The kinetics of hi-lo cuff-pressure in single-lumen endotracheal tubes during general anesthesia using nitrous oxide has been well documented. The authors have investigated the cuff-pressure modifications in 40 left double-lumen tubes (DLTs), monitoring the inflation pressure for both the endotracheal and endobronchial cuffs at the sealing of the airways and at different phases of the anesthetic procedures performed using nitrous oxide, in 40 male patients undergoing thoracic surgery. In ten of these case, special equipment was used in order to keep the cuff-pressures steady and at the lowest sealing level. The pressure shows the same trend in both cuffs but, depending on the medium calibre of the main left bronchus and the volume/pressure relations of the endobronchial cuffs, the pressure in the latter increases faster. The investigation was performed using an original equipment developed by the authors; such equipment is able not only to monitor the cuff-pressures, but also to maintain them at steady controlled levels (below 20 cm water seal), by means of counterregulating all the volume variations due either to anesthetic requirements, or to the diffusion of nitrous oxide.(ABSTRACT TRUNCATED AT 250 WORDS)