The role of maximum compressed thickness of the quadriceps femoris muscle measured by ultrasonography in assessing nutritional risk in critically-ill patients with different volume statuses

SUMMARY PURPOSE In this prospective observational study, we aimed to investigate the role of the maximum compressed (MC) and uncompressed (UC) thickness of the quadriceps femoris muscle (QFMT) measured by ultrasonography (USG) in the detection of nutritional risk in intensive care patients (ICPs) with different volume status. METHODS 55 patients were included. Right, left, and total ucQFMT and mcQFMT measurements were obtained by a standard USG device within the first 48 hours after ICU admission. Clinical examination and the USG device were used to determine the volume status of the patients. SOFA, APACHE II, modified NUTRIC scores, and demographic data were collected. RESULTS There was a significant difference between the nutritional risk of patients in terms of left, right, and total mcQFMT measurements (p=0.025, p=0.039; p=0.028, respectively), mechanical ventilation requirement (p=0.014), presence of infection (p=0.019), and sepsis (p=0.006). There was no significant difference between different volume statuses in terms of mcQFMT measurements. In the multi-variance analysis, mcQFMT measurements were found to be independently associated with high nutritional risk (p=0.019, Exp(B)=0.256, 95%CI=0.082-0.800 for modified NUTRIC score ≥ 5), and higher nutritional risk (p=0.009, Exp(B)=0.144, 95%CI=0.033-0.620 for modified NUTRIC score ≥ 6). a Total mcQFMT value below 1.36 cm was a predictor for higher nutritional risk with 79% sensitivity and 70% specificity (AUC=0.749, p=0.002, likelihood ratio=2.04). CONCLUSION Ultrasonographic measurement of total mcQFMT can be used as a novel nutritional risk assessment parameter in medical ICPs with different volume statuses. Thus, patients who could benefit from aggressive nutritional therapy can be easily identified in these patient groups.

RESUMO OBJETIVO Neste estudo observacional prospectivo, objetivamos investigar o papel da espessura do músculo quadríceps femoral (QFMT) comprimido (mc) e não comprimido (uc) medida pela ultrassonografia (USG) na detecção do risco nutricional em pacientes de terapia intensiva (ICPs) com status de volume diferente. MÉTODOS Cinquenta e cinco pacientes foram incluídos. As medidas direita, esquerda e total de ucQFMT e mcQFMT foram obtidas por um dispositivo USG padrão nas primeiras 48 horas após a admissão na UTI. O exame clínico e o dispositivo USG foram usados para determinar o status volumétrico dos pacientes. Sofa, Apache II, escores Nutric modificados e dados demográficos foram coletados. RESULTADOS Houve diferença significativa entre o risco nutricional dos pacientes em termos de medidas da QTFMT esquerda, direita e total (p=0,025, p=0,039; p=0,028, respectivamente), necessidade de ventilação mecânica (p=0,014), presença de infecção (p=0,019) e sepse (p=0,006). Não houve diferença significativa entre os diferentes status de volume em termos de medidas de mcQFMT. Na análise de variância múltipla, verificou-se que as medidas da FCFMT estavam independentemente associadas a alto risco nutricional (p=0,019, Exp (B)=0,256, 95%CI=0,082-0,800 para escore Nutric modificado ≥ 5) e maior risco nutricional (p=0,009, Exp (B)=0,144, 95%CI=0,033-0,620 para o escore Nutric modificado ≥ 6). O valor total de mcQFMT abaixo de 1,36 cm foi um preditor de maior risco nutricional com sensibilidade de 79% e especificidade de 70% (ASC=0,749, p=0,002, razão de verossimilhança = 2,04). CONCLUSÃO A medida ultrassonográfica do mcQFMT total pode ser usada como um novo parâmetro de avaliação de risco nutricional em ICPs médicas com diferentes status de volume. Assim, pacientes que podem se beneficiar de uma terapia nutricional agressiva podem ser facilmente identificados nesses grupos de pacientes.

Survey of contagious caprine pleuropneumonia in goat herds in the Thrace region of Turkey.

Contagious caprine pleuropneumonia (CCPP) was detected for the first time on the European continent in the Thrace region of Turkey in 2002 following outbreaks of an unusually severe respiratory disease in goats. Mycoplasma capricolums ubspecies capripneumoniae (Mccp), the causative agent, was identified in many infected herds throughout the region by serological, bacteriological and molecular biological techniques. However, as no quantitative data on the prevalence and distribution of the disease have been gathered in the intervening years, the extent of infection is unknown. Consequently, in 2014, a random sample of 2,400 goats was drawn from a population of over 167,000 goats in the region by multistage sampling. Serum samples were collected and tested by a monoclonal antibodybased competitive enzyme-linked immunosorbent assay (cELISA). The overall prevalence of CCPP in Thrace was found to be just over 8%. The prevalence in the individual provinces was approximately 18%, 7%, 8% and 6% for Çanakkale, Edirne, K?rklareli and Tekirda?, respectively, while Istanbul province appeared to be CCPP-free. The results showed that CCPP has spread throughout the region and has become endemic, and may pose a potential risk to the neighbouring countries of Greece and Bulgaria. Mccp was regularly detected from lung samples of suspect goats until 2015 but since then there has been no further detection from clinical samples.

La pleuropneumonie contagieuse caprine (PPCC) était détectée pour la première fois sur le continent européen en Thrace orientale (Turquie) en 2002, à la suite de foyers d'une maladie respiratoire particulièrement sévère affectant le cheptel caprin. L'agent causal identifié par diverses méthodes sérologiques, bactériologiques et de biologie moléculaire dans plusieurs troupeaux infectés de la région était Mycoplasma capricolum sous-espèce capripneumoniae (Mccp). Cependant, en l'absence de données quantitatives sur la prévalence et la distribution de la maladie depuis ces foyers, l'extension de l'infection est restée inconnue. Pour y remédier, un échantillonnage stratifié et aléatoire de2 400 chèvres parmi une population de plus de 167 000 chèvres de la région a été réalisé en 2014. L'analyse par la méthode immunoenzymatique de compétition (cELISA) faisant appel à des anticorps monoclonaux des sérums collectés a montré que la prévalence globale pour la Thrace orientale était un peu au-dessus de 8 %. Dans les provinces de Çanakkale, d'Edirne, de K?rklareli et de Tekirda?, la prévalence était respectivement de 18 %, 7 %, 8 % et 6 % tandis qu'Istanbul était indemne de PPCC. Ces résultats montrent que la PPCC est devenue endémique dans l'ensemble de la région et représente un risque potentiel pour les pays avoisinants, c'est-à-dire la Grèce et la Bulgarie. Jusqu'en 2015, Mccp a été régulièrement détectée dans les échantillons de poumon prélevés chez des chèvres suspectées infectées mais depuis cette date aucun échantillon clinique n'a été testé positif.

En 2002 se detectó por primera vez la pleuroneumonía contagiosa caprina en el continente europeo, a raíz de una serie de brotes de enfermedad respiratoria de inusitada gravedad que afectaron a cabras de la región turca de Tracia. Empleando técnicas serológicas, bacteriológicas y de biología molecular, se detectó en muchos rebaños infectados de toda la región la presencia del agente causal, Mycoplasma capricolum subespecie capripneumoniae (Mccp). Sin embargo, se desconoce el alcance de la infección, porque en los años transcurridos desde entonces no se han reunido datos cuantitativos sobre la prevalencia y distribución de la enfermedad. Por consiguiente en 2014, a partir de una población de más de 167.000 cabras de la región, se obtuvo por muestreo multietápico una muestra aleatoria de 2.400 ejemplares, a los que se extrajeron muestras de suero que fueron sometidas a un ensayo inmunoenzimático de competición (ELISAc) con anticuerpos monoclonales. Se calculó que la prevalencia global de pleuroneumonía contagiosa caprina en Tracia era algo superior al 8%. Por provincias, la prevalencia resultó de alrededor de un 18%, un 7%, un 8% y un 6% en las provincias de Çanakkale, Edirne, K?rklareli y Tekirda?, respectivamente, mientras que la provincia de Estambul resultó estar libre de la infección. Estos resultados demostraron que la enfermedad se ha extendido por toda la región, ha cobrado carácter endémico y puede amenazar a los países vecinos, como Grecia y Bulgaria. Hasta 2015 se detectó regularmente la presencia de Mccp en muestras pulmonares de cabras sospechosas, pero desde entonces no se ha vuelto a observar tal cosa en ninguna muestra clínica.

Correlation between birth weight, leptin, zinc and copper levels in maternal and cord blood.

Leptin and zinc are involved in the regulation of appetite. Copper is a trace element regulating the functions of several cuproenzymes that are essential for life. To evaluate the relationship between zinc and copper status and the leptin system in humans, we examined whether leptin concentrations in the mother and the newborn correlate with the weight of mother, placenta and newborn. A total of 88 pregnant women at 38-42 weeks' gestation were studied. All infants were categorized as small for gestational age (SGA) (n = 16), average for gestational age (AGA) (n = 59) or large for gestational age (LGA) (n = 13). Leptin, zinc, and copper levels were measured in maternal and cord serum at birth. Maternal BMI and placental weight of the LGA groups were significantly higher than those of the SGA and AGA groups. Cord and maternal leptin levels of the SGA groups were significantly lower than those of the AGA and LGA groups. Maternal serum leptin levels were positively correlated with BMI and maternal zinc levels in all groups. Cord serum leptin levels of all groups were positively correlated with birth weight and placental weight. Birth weight was negatively correlated with maternal and cord copper level of all groups. Umbilical leptin concentrations of SGA newborns correlated with leptin concentrations of their mothers. In all pregnancies, birth weight increases in association with increase in cord leptin level. Our results suggest that maternal zinc but not copper level has an effect on maternal serum leptin levels. The increase in copper level in both maternal and cord blood may contribute to restriction in fetal growth.

Correlation between birth weight, leptin, zinc and copper levels in maternal and cord blood

Leptin and zinc are involved in the regulation of appetite. Copper is a trace elementregulating the functions of several cuproenzymes that are essential for life. Toevaluate the relationship between zinc and copper status and the leptin system inhumans, we examined whether leptin concentrations in the mother and the newborncorrelate with the weight of mother, placenta and newborn. A total of 88 pregnantwomen at 38-42 weeks’ gestation were studied. All infants were categorized as smallfor gestational age (SGA) (n=16), average for gestational age (AGA) (n=59) or largefor gestational age (LGA) (n=13). Leptin, zinc, and copper levels were measured inmaternal and cord serum at birth. Maternal BMI and placental weight of the LGAgroups were significantly higher than those of the SGA and AGA groups. Cord andmaternal leptin levels of the SGA groups were significantly lower than those of theAGA and LGA groups. Maternal serum leptin levels were positively correlated withBMI and maternal zinc levels in all groups. Cord serum leptin levels of all groupswere positively correlated with birth weight and placental weight. Birth weight wasnegatively correlated with maternal and cord copper level of all groups. Umbilicalleptin concentrations of SGA newborns correlated with leptin concentrations of theirmothers. In all pregnancies, birth weight increases in association with increase in cordleptin level. Our results suggest that maternal zinc but not copper level has an effecton maternal serum leptin levels. The increase in copper level in both maternal andcord blood may contribute to restriction in fetal growth (AU)

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Correlation between birth weight, leptin, zinc andcopper levels in maternal and cord blood

Leptin and zinc are involved in the regulation of appetite. Copper is a trace elementregulating the functions of several cuproenzymes that are essential for life. Toevaluate the relationship between zinc and copper status and the leptin system inhumans, we examined whether leptin concentrations in the mother and the newborncorrelate with the weight of mother, placenta and newborn. A total of 88 pregnantwomen at 38-42 weeks’ gestation were studied. All infants were categorized as smallfor gestational age (SGA) (n=16), average for gestational age (AGA) (n=59) or largefor gestational age (LGA) (n=13). Leptin, zinc, and copper levels were measured inmaternal and cord serum at birth. Maternal BMI and placental weight of the LGAgroups were significantly higher than those of the SGA and AGA groups. Cord andmaternal leptin levels of the SGA groups were significantly lower than those of theAGA and LGA groups. Maternal serum leptin levels were positively correlated withBMI and maternal zinc levels in all groups. Cord serum leptin levels of all groupswere positively correlated with birth weight and placental weight. Birth weight wasnegatively correlated with maternal and cord copper level of all groups. Umbilicalleptin concentrations of SGA newborns correlated with leptin concentrations of theirmothers. In all pregnancies, birth weight increases in association with increase in cordleptin level. Our results suggest that maternal zinc but not copper level has an effecton maternal serum leptin levels. The increase in copper level in both maternal andcord blood may contribute to restriction in fetal growth (AU)

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Urinary tract infections due to Mycoplasma canis in dogs.

Urine samples were obtained from 100 dogs with symptoms of lower urinary tract disease by cystocentesis and were examined for mycoplasmas. Urinalysis, haematological and biochemical analyses were also performed. Bacteria were isolated from urine in 41 of 100 dogs; Mycoplasma canis was isolated from four of 100 (4%) urine samples and three were pure culture. Selective mycoplasma media were used for isolation. In growth inhibition test, propagation of the four M. canis isolates was inhibited by their specific hyperimmune sera and there was no cross reactivity between isolates and hyperimmune sera of other mycoplasmas. Dogs in which M. canis was isolated were azotemic. All dogs were treated with enrofloxacin, furosemide, and supportive therapy (fluid therapy, ascorbic acid). In all animals, clinical improvements were observed after treatment.

Effect of danofloxacin (Advocin A180) on goats affected with contagious caprine pleuropneumonia.

The efficacy of danofloxacin (Advocin A180) was evaluated for the treatment of contagious caprine pleuropneumonia (CCPP) caused by Mycoplasma capricolum subsp. capripneumoniae. Ten healthy Angora goats, confirmed free of CCPP, were exposed to clinically affected animals from a natural outbreak in Thrace, Turkey. After 14 days exposure, 8 goats showed pyrexia ( > or = 41 degrees C). Shortly after, the Angora goats were divided randomly into two groups. Five of these were injected with danofloxacin (6 mg/kg subcutaneously), which was repeated after 48 h; the five remaining animals received saline. Goats were monitored clinically and blood samples were collected for serology. Animals with severe disease were withdrawn from the trial. Goats completing the study were euthanized at day 42. Lung tissue and bronchial fluid were collected for mycoplasma isolation. All danofloxacin-treated goats showed resolution of clinical disease by the end of the trial. Two saline-treated goats failed to complete the study owing to CCPP. Danofloxacin-treated goats showed fewer lung lesions and had significantly lower combined clinical scores than saline controls (p < 0.001). Danofloxacin was found to be highly effective in the treatment of CCPP in goats.

Redox characteristics of manganese and cobalt complexes obtained from pyridine N-oxide.

Manganese and cobalt complexes, using pyridine N-oxide as ligand, have been synthesized, and their cyclic and square-wave voltammetric measurements have been carried out. The results reveal that the complexes exhibit different voltammetric pattern, which suggests that the redox processes are most probably metal-centered. In both complexes, extra redox activity is observed once the potential exceeds certain value of the voltage. The observation of an oxidation wave in manganese complex at + 0.75 V vs. Ag/AgCl or + 0.95 V vs. NHE strongly suggests that this complex can bring about oxidation of water and can, thus, serve as a synthetic analogue of water oxidizing complex (WOC) of PS II.

Redox characteristics of Schiff base manganese and cobalt complexes related to water-oxidizing complex of photosynthesis.

In an effort to obtain synthetic analogues of water-oxidizing complex (WOC) of photosystem II (PS II) of plant photosynthesis, a Schiff base manganese and a cobalt complex, employing Niten, a SALEN type ligand, have been prepared. Cyclic and square wave voltammetric measurements have been performed to assess their redox characteristics. Both complexes undergo several reduction processes in cathodic negative potential region at more or less similar potentials. In view of these reductions being independent of the nature of the metal, they are thought to be ligand-localized. Although similar in negative region, a marked difference in the behavior of the complexes is observed in anodic region. While the cobalt complex is electrochemically inactive in the positive potentials up to +1.0 V vs. Ag/AgCl, the manganese complex displays two oxidation waves at +0.25 and +0.5 V vs. Ag/AgCl. The presence of oxidation wave in manganese complex at +0.5 V vs. Ag/AgCl or +0.7 V vs. NHE suggests that this complex can catalyze the oxidation of water and can, thus, simulate the WOC of PS II.