Early mobilization: Why, what for and how?

Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results. The main techniques used were kinesitherapy, transfer and locomotion training, as well as neuromuscular electrical stimulation and cycle ergometry. Although two trials and a meta-analysis found no positive results with mobilization, programs that focus on specific populations, such as patients with weakness due to immobility and with preserved neuromuscular excitability can derive more positive effects from such treatment.

Correlation of serum sialic acid fractions as markers for carcinoma of the uterine cervix.

Serum total sialic acid (TSA) and lipid-bound sialic acid (LSA) levels have aroused considerable interest as markers of malignancy. FSA (Free Sialic Acid) has not been considered as a potential tumor marker due to a lack of sensitivity of the methods used in the studies performed up to now. The present investigation determined the TSA, CLSA (Corrected Lipid Sialic Acidi) and FSA values for 20 normal females, 10 patients with benign gynecological disease and 32 patients with various stages of carcinoma of the uterine cervix. Data analysis indicated significant (0.01 < P < 0.05) increases of TSA value only in the mean values (671 +/- 126 micrograms mL-1) in stage II A of carcinoma of the uterine cervix when compared to normal controls (mean 534 +/- 102 micrograms mL-1). It showed, instead, significant (0.01 < P < 0.1) increases of CLSA values only in the mean values (6.41 +/- 1.32 micrograms mL-1) found on stage I B of carcinoma of the uterine cervix when compared to normal controls (mean 5.33 +/- 1.50 micrograms mL-1). In the case of FSA significant differences were found with respect to normal controls (mean 0.316 +/- 0.081 micrograms mL-1) in all stages of carcinoma of the uterine cervix. The mean values found were 0.485 +/- 0.118 micrograms mL-1 (0.001 < P < 0.01) in patients with stage I A, 0.666 +/- 0.176 micrograms mL-1 (P < 0.001) in patients with stage I B and 0.572 +/- 0.164 +/- micrograms mL-1 (0.001 < P < 0.01) in patients with stage II A. TSA and CLSA separated measurements appeared to be of limited value in the detection of carcinoma of the uterine cervix. However, results show that FSA was the most sensitive of the three markers tested for detecting malignancies.

A hydrolysis method using microwaves: determination of N-acetyl- and N-glycolylneuraminic acids in biological systems by fluorometric high-performance liquid chromatography.

A simple, rapid, and extremely sensitive method for determining N-acetyl- and N-glycolylneuraminic acids in serum and in submandibular, sublingual, and parotid glands using high-performance liquid chromatography with a fluorometric detector is described. The neuraminic acids contained in the samples are released in the presence of 2 M CH3COOH by means of microwave hydrolysis (only 10 min required) and are subsequently converted using 1,2-diamino-4,5-methylenedioxybenzene, a fluorogenic reagent for alpha-ketoacids, into highly fluorescent derivatives. In order to optimize the release of sialic acids and to minimize the effect of destruction, the following analytical variables were investigated: temperature, time, and concentration of the acid. Within 12 min after derivatization, the compounds were separated on a reversed-phase column by means of isocratic elution using a mobile phase of water (pH 3 with H3PO4)-methanol-acetonitrile (86:6:8, v/v). Fluorescence detection was performed at an excitation wavelength of 373 nm and an emission wavelength of 448 nm.