Positive fluid balance is associated with reduced survival in critically ill patients with cancer.

BACKGROUND: There are no studies that describe the impact of the cumulative fluid balance on the outcomes of cancer patients admitted to intensive care units ICUs. The aim of our study was to evaluate the relationship between fluid balance and clinical outcomes in these patients. METHOD: One hundred twenty-two cancer patients were prospectively evaluated for survival during a 30-day period. Univariate (Chi-square, t-test, Mann-Whitney) and multiple logistic regression analyses were used to identify the admission parameters associated with mortality. RESULTS: The mean cumulative fluid balance was significantly higher in non-survivors than in survivors [1675 ml/24 h (471-2921) vs. 887 ml/24 h (104-557), P = 0.017]. We used the area under the curve and the intersection of the sensibility and specificity curves to define a cumulative fluid balance value of 1100 ml/24 h. This value was used in the univariate model. In the multivariate model, the following variables were significantly associated with mortality in cancer patients: the Acute Physiology and Chronic Health Evaluation II score at admission [Odds ratio (OR) 1.15; 95% confidence interval (CI) (1.05-1.26), P = 0.003], the Lung Injury Score at admission [OR 2.23; 95% CI (1.29-3.87), P = 0.004] and a positive fluid balance higher than 1100 ml/24 h at ICU [OR 5.14; 95% CI (1.45-18.24), P = 0.011]. CONCLUSION: A cumulative positive fluid balance higher than 1100 ml/24 h was independently associated with mortality in patients with cancer. These findings highlight the importance of improving the evaluation of these patients' volemic state and indicate that defined goals should be used to guide fluid therapy.

Re-induction of obese body weight occurs more rapidly and at lower caloric intake in beagles.

For the purpose of investigating the mechanism of obesity-induction/re-induction including weight-cycling in beagles, a study was conducted using commercially available dog food combined with human food to mimic at home-snacking and diet-supplementation behaviours. Adult female beagles, which had free access to water and exercise, were used (n = 9). All dogs were initially offered two times their daily calculated number of calories using a dry extruded diet plus blend of canola and soybean oils and allowed to eat ad libitum. After 3 weeks, Pecan shortbread cookies were added to the diet mixture. Obesity was induced during a 19-week period with 1875-2250 kcal/day consumed, on average, during this period. The dogs were then subjected to a weight-loss regimen while consuming 490-730 kcal/day. After weight loss, a similar degree of obesity was re-induced for 17 weeks even though dogs consumed only 1125-1250 kcal/day. Body weight, body condition scores, kcal consumption and food efficiency were recorded. Results indicated that less time and fewer kcal were required to re-induce the same degree of obesity compared with the initial obesity induction. Human snack foods appeared to stimulate appetite and thus contribute to the obese state. Food efficiency was also increased during the obesity-reinduction period compared with the induction period. This information may help pet owners better understand the need to limit table scraps and human-type food snacks in dogs prone to obesity as well as weight maintenance after weight loss.

Ultracytochemistry of glycosaminoglycans in the canine knee synovium.

The accurate localization and nature of glycosaminoglycans (GAGs) in the canine knee synovium were studied by ultracytochemical methods that involved high or low iron diamine-thiocarbohydrazide-silver proteinate (physical development) staining in combination with enzyme digestion control procedures. The results obtained indicated that heparan sulfates and hyaluronan were present mainly in the plasma membrane of the B (fibroblast-like) cells. In contrast, the plasma membrane of the A (macrophage-like) cells showed negative reactions after the histochemical examination. Dermatan sulfates, chondroitin sulfates (A and/or C) and hyaluronan were localized in the extracellular matrix of the synovial intima, whereby dermatan sulfates were confined to the fibrous component, whereas chondroitin sulfates and hyaluronan were found in the interfibrous matrix. Heparan sulfate was the only notable GAG molecular species localized in the basement membrane of the capillary wall. It is obvious that differences in the quality and localization of glycosaminoglycans in the canine synovial tissue are of specific interest in understanding normal functions as well as pathological alterations of the knee synovium in mammals.

Histochemical analyses of glycosaminoglycans in the synovial membrane of the canine knee joint.

The accurate localization and nature of glycosaminoglycans in the synovial membrane of the canine knee joint were examined histochemically by means of the selective sensitized diamine procedures based upon high and low iron diamine stainings in combination with enzyme digestions. Using these methods, it was possible to clearly and easily detect exceedingly small amounts of glycosaminoglycans in synovial tissues, which cannot be visualized by methods employed to date. The sensitized high iron diamine (S-HID) procedure resulted in positive reactions of varying intensities in the intercellular matrix of synovial intima, and in the extracellular matrix and small capillary walls of the superficial layer in the synovial subintima, and also reacted vividly in the extracellular matrix and blood vessel walls of the deeper layer in the synovial subintima. In particular, the sensitized low iron diamine (S-LID) procedure resulted in positive reactions of the extracellular matrix in the synovial subintimal layers. The S-HID and S-LID procedures combined with the enzyme digestions proved that glycosaminoglycan molecular species such as chondroitin sulfate A/C, dermatan sulfate, heparan sulfate and hyaluronic acid are present in various concentrations in the synovial membrane of the canine knee joint. The present results were discussed with reference to the histophysiological and pathophysiological functions of glycosaminoglycans in the synovium of domestic mammals.

Hipposulfates A and B, new sesterterpene sulfates from an Okinawan sponge, Hippospongia cf. metachromia.

Two new sesterterpene sulfates, hipposulfates A (1) and B (2), have been isolated from an Okinawan sponge, Hippospongia cf. metachromia and their structures elucidated by interpretation of spectroscopic data. Both compounds contain an enolsulfate functionality. Hipposulfate A (1) showed moderate cytotoxicity.

Lectin histochemistry of the canine anal glands.

The distribution and selectivity of complex carbohydrates in the canine anal glands were studied by means of lectin histochemistry, using PO-labeled lectins. The secretory epithelium of the anal glands and the excretory duct system exhibited large amounts of mainly neutral glycoproteins with various terminal sugars (alpha-D-mannose, beta-N-acetyl-D-glucosamine, alpha-N-acetyl-D-galactosamine, alpha-D-galactose, alpha-L-fucose, N-acetyl-neuraminic acid). Distinctly prominent in the secretion were alpha-L-fucose residues. This relatively hydrophobic sugar may in particular modify or control the viscoelastic properties of the anal gland mucus, so that a stable mucous coat of the rather dry faeces can be formed. In addition, it was obvious that the major part of the excretory duct system is also involved in secretion production, and that the essential function of the saccular dilatations of the excretory ducts is to ensure secretion maturation.