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OBJECTIVES: Management of acute abdomen (AA) differs due to the heterogeneity of underlying pathophysiology. Complications of AA and its overall outcome after cardiac surgery are known to be associated with poor results. The aim of this retrospective analysis was to evaluate risk factors for AA in patients undergoing cardiac surgery. METHODS: Between December 2011 and December 2014, a total of 131 patients with AA after cardiac surgery were identified and retrospectively analyzed using our institutional database. Statistical analysis of risk factors concerning in-hospital mortality of mentioned patient cohort was performed using IBM SPSS Statistics. RESULTS: Overall in-hospital mortality was 54.2% (71/131). Analyzing in-hospital non-survivors (NS) versus in-hospital survivors (S) peripheral artery disease (28.2% vs. 11.7%; p = 0.03), the need for assist device therapy (33.8% vs. 16.7%; p = 0.03) and the requirement of hemodialysis (67.6% vs. 23.3%; p < 0.01) were significantly higher in NS. Furthermore, lactic acid values at onset of symptoms were shown to be significantly higher in NS (5.7 ± 5.7 mmol/L vs. 2.8 ± 2.9 mmol/L; p < 0.01). Assured diagnosis of mesenterial ischemia was strongly associated with worse outcome (odds ratio 10.800, 95% confidence interval 2.003-58.224; p = 0.006). CONCLUSION: In conclusion, in critically ill patients after performed cardiac surgery peripheral vascular disease, need for supportive hemodynamic assist device systems and occurrence of renal failure are risk factors associated with worsen outcome. Additionally, rise of lactic acid could potentially be associated with onset of intestinal malperfusion and should be taken into account in therapeutic decisions preventing fatal mesenterial ischemia.

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The starvation-predation hypothesis predicts that, during resource shortages, prey forego antipredator behavior and forage as much as possible to avoid starvation, even when risk of predation is high. We tested this hypothesis using GPS locations collected simultaneously from moose (Alces alces) and wolves (Canis lupus) in the Greater Yellowstone Ecosystem of North America. We assessed shifts in the speed, displacement, and habitat selection of moose 24 h following encounter with wolves (0-1,500 m distance). We examined whether the strength of antipredator behaviors would weaken as winter progressed and the nutritional condition of moose declined. Moose responded to wolf encounters by increasing their rate of movement in early winter, but only within 500 m distance. Importantly, these responses attenuated as winter progressed. Moose did not avoid their preferred foraging habitat (riparian areas) following encounters with wolves at any distance, and instead they more strongly selected riparian areas, especially in early winter. Our findings support theoretical predictions that resource deficits should dampen prey antipredator behavior, and suggest that nutritional condition of prey may buffer against run-away risk effects in food webs involving large mammalian predators and prey.

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Out-of-hospital extracorporeal membrane oxygenation (ECMO) implantation and ECMO transport have become a growing field useful for emergent treatment of heart or lung failure with increasing number of centers launching such service. This study was designed to present risk factors predicting 30-day mortality for patients receiving ECMO support in a newly launched ECMO retrieval service. From 01/2015 till 01/2017 28 consecutive patients received ECMO support in peripheral hospitals using a miniaturized portable Cardiohelp System® (Maquet, Rastatt Germany) for heart, lung or heart/lung failure as a bridge-to-decision as a part of our newly launched ECMO retrieval service. Outcomes and predictors for 30-day mortality were presented. The mean age was 56 ± 15 (maximum 78) years. The mean ECMO support duration was 97 ± 100 h, whereas 11 patients (40%) were weaned off support and discharged from hospital. Presence of hemolysis (p = 0.041), renal failure (p = 0.016), lower platelet count before ECMO implantation (p = 0.001), and higher lactate 24 h after initiation of support (p = 0.006) were factors associated with 30-day mortality. Initial success of an ECMO retrieval service depends on logistic organization and clinical management. Taking into consideration highly deleterious effects of hemodynamic malperfusion of end organs, rapid initiation of ECMO support is a vital factor for survival. This is highlighted by predictive factors of early mortality that are associated with peripheral organ failure or complications.

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Surgical aortic valve replacement still represents the gold standard in patients with severe symptomatic aortic valve stenosis. In addition to conventional aortic valve replacement by mechanical or biological prostheses via a median sternotomy, novel approaches including minimally invasive strategies and new devices, such as so-called rapid deployment prostheses, are becoming increasingly more established. Autologous replacement strategies including the Ross and the Ozaki procedures have evolved into reliable options at selected centers of excellence. These novel treatment approaches in aortic valve surgery result in excellent short and long-term outcomes with a reduction of procedure-related complications. Taken together, these modern surgical replacement strategies enable a personalized surgical treatment in patients with aortic valve stenosis, which are tailored to the individual patient.

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BACKGROUND: Reference intervals (RIs) or mean values for normal total nasal airflow resistance are essential for the diagnosis of nasal obstruction. Data relating to nasal airflow are not standardised, and valid and reliable RIs do not exist for the time being. This meta-analysis aimed to determine such "standard" 95%-RIs. METHODOLOGY: Research of related literature listed in Medline, Embase, Cochrane, and Web of Science databases. RESULTS: Airflow resistance data were gathered from 38 studies using active anterior rhinomanometry at a differential pressure of 150Pa to examine patients under congested and decongested mucosal conditions. In the meta-analysis overall values and RIs for normal total nasal airflow resistance under congested nasal mucosal conditions were calculated for all subjects at 0.25Pa/cm3/s (95%-RI 0.10-0.40Pa/cm3/s), adults regardless of gender at 0.25Pa/cm3/s (95%-RI 0.12-0.38Pa/cm3/s), men at 0.24Pa/cm3/s (95%-RI 0.09-0.39Pa/cm3/s), and women at 0.26Pa/cm3/s (95%-RI 0.08-0.44Pa/cm3/s). Asian, African and Caucasian ethnic groups exhibited rising airflow resistance mean values: 0.23Pa/cm3/s (95%-RI 0.08-0.39Pa/cm3/s), 0.25Pa/cm3/s (95%-RI 0.11-0.38Pa/cm3/s) and 0.26Pa/cm3/s (95%-RI 0.13-0.38Pa/cm3/s), respectively. Lower overall mean values resulted under decongested nasal mucosal conditions. CONCLUSION: The reference intervals and mean values ascertained in this meta-analysis improve the diagnosis of nasal obstruction and may represent a useful supplement in existing guidelines for the standardisation of rhinomanometric measurements.

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The restricted area of space used by most mobile animals is thought to result from fitness-rewarding decisions derived from gaining information about the environment. Yet, assessments of how animals deal with uncertainty using memory have been largely theoretical, and an empirically derived mechanism explaining restricted space use in animals is still lacking. Using a patch-to-patch movement analysis, we investigated predictions of how free-ranging bison (Bison bison) living in a meadow-forest matrix use memory to reduce uncertainty in energy intake rate. Results indicate that bison remembered pertinent information about location and quality of meadows, and they used this information to selectively move to meadows of higher profitability. Moreover, bison chose profitable meadows they had previously visited, and this choice was stronger after visiting a relatively poor quality meadow. Our work demonstrates a link between memory, energy gains and restricted space use while establishing a fitness-based integration of movement, cognitive and spatial ecology.

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Prenatal toxicity studies with N,N-dimethylformamide (DMF) in rabbits, rats and mice were carried out using the oral (gavage), dermal, inhalation and ip injection routes of administration. Administration of DMF by gavage led to an increase in malformations in rats and mice in the absence of overt maternal toxicity. The lowest-observable-effect level was 182 mg/kg body weight/day in mice and 166 mg/kg body weight/day in rats. After dermal administration a dose-dependent incidence of teratogenicity was observed in rats at 94-944 mg/kg/body weight/day in the absence of overt maternal toxicity. In rabbits dermal administration led to a steeper increase in the dose-response relationship and at 400 mg/kg body weight/day to a clear teratogenic effect in the presence of slight maternal toxicity. The 200 mg/kg body weight/day dose appeared to be the no-adverse-effect level. Inhalation in rats caused foetotoxicity and embryolethality at 287 ppm. A clear teratogenic effect was shown in rabbits at 450 ppm and a marginal effect at 150 ppm. The no-effect level for does and foetuses was 50 ppm. Ip injection in mice caused clear teratogenicity at 944 mg/kg body weight/day and slight embryotoxicity at 378 mg/kg body weight/day. The rabbit appears to be more sensitive than the rat to DMF-related prenatal toxicity and should, therefore, be used as the basis for the evaluation of teratogenic risk in humans.

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Di-2-ethylhexylphthalate (DEHP) was investigated in Wistar rats for developmental toxicity after head-nose exposure to aerosol concentrations of 0, 0.01, 0.05 and 0.3 mg/l for 6 h per day from gestation day 6 through 15. A range finding study revealed peroxisome proliferation in the liver of the dams throughout exposure levels of 0.2, 0.5 and 1.0 mg/l with an increasing trend. 0.3 mg/l was therefore regarded as an exposure level leading to peroxisome proliferation as a marker for maternal effects. All concentrations were tolerated without clinical signs of maternal toxicity. The fetuses of 20 animals per exposure group were investigated for structural defects. Five additional animals per group were allowed to litter and the offsprings were raised and observed for postnatal signs of toxicity. No significant developmental toxicity or changes in the postnatal physical development were observed. DEHP is assumed not to exhibit developmental toxicity under the experimental conditions employed.

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2-Methoxypropylacetate-1 was investigated in Wistar rats and Himalayan rabbits for embryotoxic potential. Rats after inhalation exposure to 0, 0.6, 3.0, or 14.9 mg/liter (approximately 0, 110, 550, or 2700 ppm, respectively) for 6 hr per day from gestation Days 6 through 15 exhibited some degree of maternal toxicity at 2700 and 550 ppm. At 2700 ppm an increase of skeletal anomalies of the thoracic vertebrae among the fetuses was observed and interpreted as an exposure-related slight teratogenic effect. In Himalayan rabbits exposed via inhalation to 0, 0.2, 0.8, or 3.0 mg/liter (approximately 0, 36, 145, or 550 ppm, respectively) for 6 hr per day from gestation Days 6 through 18 teratogenicity was much more pronounced: at 550 ppm, in the absence of clear maternal toxicity, the fetuses of all litters showed severe malformations. No maternal or fetal effects were observed at 145 and 36 ppm. Dermal application of 1000 and 2000 mg/kg to Himalayan rabbits from gestation Days 6 through 18 failed to produce maternal or fetal toxicity.

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Most studies for determining the reproductive toxicity of a chemical have to be conducted with whole animals. Test procedures used to investigate parts or the whole of the reproductive cycle are described in current guidelines. Other techniques, such as in vitro methods, and those for investigating specific events in the cycle, are under development. Epidemiological studies can give valuable information, although they are difficult to perform and interpret in practice. There is a need for more epidemiological studies of exposed populations and for recording and quantifying the concentrations of chemicals to which such populations are exposed. It is suggested that animal experiments should be programmed in a stepwise manner, and should take into account effects seen in previous toxicity studies. The programme of tests for determining reproductive toxic potential should be established on a case-by-case basis, since many factors will influence the choice of studies and the sequence in which they should be performed.

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Tridemorph (N-tridecyl-2,6-dimethylmorpholine), the active ingredient of the commercially formulated fungicide Calixin, is a teratogen in rats and mice. The no-effect level for embryotoxic effects was 27.5 mg/kg for mice and 20.6 mg/kg for rats. By contrast, when Calixin, which contains 83% tridemorph, was administered orally at dose levels of 0.156, 0.722, and 3.909 mg/kg, no embryotoxic effects were observed in two strains of rats. Our extensive investigations, carried out under exposure conditions resembling as closely as possible those reported in another study, did not reproduce the previous findings of teratogenicity of Calixin.

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n-Butyl acrylate was examined for its prenatal toxicity in Sprague-Dawley rats. Inseminated rats were exposed to concentrations of 0, 25, 135 and 250 ppm for a duration of 6 hours per day from the 6th to 15th day post coitum. Subsequently the animals were held to the 20th day post coitum. During the inhalation period concentrations of 135 and 250 ppm n-butyl acrylate led to maternal toxicity (delayed body weight gain depending on the concentration, clinical signs of irritation). At the end of the exposure period the signs subsided. The same concentrations induced embryolethality (increased number of dead implantations depending on the concentration). 25 ppm of n-butyl acrylate did not lead to maternal toxicity or embryolethality. Under the conditions chosen, a teratogenic effect of the test substance was not detected at any concentration.

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The acid amides acetamide, monomethylacetamide, dimethylacetamide, formamide, monoethylformamide and dimethylformamide were investigated for prenatal and teratogenic effects in rabbits. The compounds were administered by stomach tube to the animals as aqueous solutions from the 6th to the 18th day post insemination. In rabbits monomethylformamide caused the most serious teratogenic effect. A teratogenic effect was also caused by monomethylacetamide. Formamide showed an embryotoxic and weak teratogenic effect when it was given in a non-toxic maternal dosage whereas acetamide and dimethylacetamide had an embryolthal effect only in toxic maternal dosages. The rabbit seems to be more sensitive to dimethylformamide than are other animal species because foetuses with anomalies were already seen when the substance was given in non-toxic dosages.

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Povidone-iodine USP was tested for mutagenicity in mice by the dominant lethal assay or micronucleus test and in Chinese hamsters by the bone marrow test. None of the three tests revealed any evidence of mutagenic effect.

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