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Abstract: Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome. Methods: International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19%1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97%1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.
Keywords: critical care, critical illness, urine, oliguria, kidney, renal insufficiency, kidney diseases, acute kidney failure, mortality, urine output, renal replacement therapy
Published in DiRROS: 18.11.2020; Views: 1683; Downloads: 1042
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Abstract: Izhodišče: Zdravilo bevacizumab uporabljamo v sklopu primarnega sistemskega zdravljenja napredovalega epitelijskega raka jajčnikov v kombinaciji s paklitakselom in karboplatinom od leta 2013. Namen: Prikazati učinkovitost in varnost zdravljenja z bevacizumabom v redni klinični praksi v sklopu primarnega zdravljenja raka jajčnikov. Metode: V retrospektivno analizo smo vključili bolnice z epitelijskim rakom jajčnikov, ki so se zdravile z bevacizumabom na Onkološkem inštitutu Ljubljana v obdobju od 1. 1. 2013 do 31. 12. 2016. Cilja raziskave sta bila varnost in učinkovitost (preživetje brez ponovitve bolezni, celokupno preživetje) zdravljenja z bevacizumabom. Raziskavo je odobrila etična komisija na Onkološkem inštitutu Ljubljana. Rezultati: V opazovanem obdobju je bilo z bevacizumabom zdravljenih 111 bolnic z napredovalim epitelijskim rakom jajčnikov. Najpogostejši neželeni učinki so bili: bolečine (52 %), krvavitev (45 %), arterijska hipertenzija (44 %). Resne neželene učinke (stopnja 3/4) je imelo 12 % bolnic: venska tromboza/ embolija (3 %), proteinurija (3 %), arterijska hipertenzija (2 %), krvavitev (2 %), bolečine (1 %), fistula (1 %). Mediani čas sledenja je bil 59 mesecev. Mediano preživetje brez ponovitve bolezni je bilo 18 mesecev, mediano celokupno preživetje pa 41 mesecev. Zaključki: Zdravljenje z bevacizumabom v redni klinični praksi je varno in učinkovito ‒ v skladu z do zdaj znanimi rezultati prospektivnih raziskav GOG 218 in ICON 7.
Keywords: rak jajčnikov, epitelijski rak, bevacizumab, kemoterapija
Published in DiRROS: 09.09.2020; Views: 1983; Downloads: 518
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Keywords: ONKOLOGIJA-STOJIŠČE, onkologija, ginekologija
Published in DiRROS: 10.06.2020; Views: 1871; Downloads: 575
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Abstract: We explored the inter-individual variability in bud-burst and its potential drivers, in homogeneous mature stands of temperate deciduous trees. Phenological observations of leaves and wood formation were performed weekly from summer 2017 to summer 2018 for pedunculate oak, European beech and silver birch in Belgium. The variability of bud-burst was correlated to previous' year autumn phenology (i.e. the onset of leaf senescence and the cessation of wood formation) and tree size but with important differences among species. In fact, variability of bud-burst was primarily related to onset of leaf senescence, cessation of wood formation and tree height for oak, beech and birch, respectively. The inter-individual variability of onset of leaf senescence was not related to the tree characteristics considered and was much larger than the inter-individual variability in bud-burst. Multispecies multivariate models could explain up to 66% of the bud-burst variability. These findings represent an important advance in our fundamental understanding and modelling of phenology and tree functioning of deciduous tree species.
Keywords: leaf unfolding, wood formation, coloration, Pedunculate oak, European beech, Silver birch
Published in DiRROS: 10.06.2020; Views: 1932; Downloads: 1130
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Keywords: zdravstvena obravnava, smernice, rak jajčnikov, ginekologija, neoplazme, ginekološki raki
Published in DiRROS: 09.06.2020; Views: 1821; Downloads: 570
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