| 1. |
- Murdoch, David R, et al.
(författare)
-
Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.
- 2009
-
Ingår i: Archives of internal medicine. - : American Medical Association (AMA). - 1538-3679 .- 0003-9926. ; 169:5, s. 463-73
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. RESULTS: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hallmarks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. CONCLUSIONS: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.
|
|
| 2. |
- Parawira, Wilson, et al.
(författare)
-
Energy production from agricultural residues: high methane yields in pilot scale two-stage anaerobic digestion
- 2008
-
Ingår i: Biomass & Bioenergy. - : Elsevier BV. - 1873-2909 .- 0961-9534. ; 32:1, s. 44-50
-
Tidskriftsartikel (refereegranskat)abstract
- There is a large, unutilised energy potential in agricultural waste fractions. In this pilotscale study, the efficiency of a simple two-stage anaerobic digestion process was investigated for stabilisation and biomethanation of solid potato waste and sugar beet leaves, both separately and in co-digestion. A good phase separation between hydrolysis/ acidification and methanogenesis was achieved, as indicated by the high carbon dioxide production, high volatile fatty acid concentration and low pH in the acidogenic reactors. Digestion of the individual substrates gave gross energy yields of 2.1–3.4 kWh/kg VS in the form of methane. Co-digestion, however, gave up to 60% higher methane yield, indicating that co-digestion resulted in improved methane production due to the positive synergism established in the digestion liquor. The integrity of the methane filters (MFs) was maintained throughout the period of operation, producing biogas with 60–78% methane content. A stable effluent pH showed that the methanogenic reactors had good ability to withstand the variations in load and volatile fatty acid concentrations that occurred in the two-stage process. The results of this pilot-scale study show that the two-stage anaerobic digestion system is suitable for effective conversion of semi-solid agricultural residues as potato waste and sugar beet leaves.
|
|
