Nebulized 0.5, 2.5 and 5 ml L-epinephrine for post-extubation stridor in children: a prospective, randomized, double-blind clinical trial

Nebulized l-epinephrine has been recommended for the treatment of viral croup. However, the few studies assessing its effect on post-extubation stridor (PES) have shown conflicting results. We compared the efficacy and safety of nebulized l-epinephrine at three different doses for the treatment of PES. We conducted a prospective, randomized, double-blind trial including all consecutive children with a PES score of a parts per thousand yen4 (Westley score). The primary efficacy outcome was change in PES score at 40 min. A reduction of a parts per thousand yen2 points in stridor score was defined as clinically significant. A total of 96 patients were randomly assigned to receive one of three doses of nebulized l-epinephrine upon achieving a PES score of 4 or more following extubation. Stridor score and vital signs were recorded before treatment, and at 20, 40, 60 and 180 min after nebulization. Baseline characteristics were similar among all study groups. No significant difference was detected among the treatments based on change in Westley score by intent-to-treat analysis. In addition, the difference in the number of patients who clinically improved among the treatment groups was not significant (p = 0.54). Patients receiving 5 ml nebulized epinephrine had a significant increase of systolic and diastolic blood pressure at 40 and 180 min. Nebulized l-epinephrine at doses of 0.5, 2.5 and 5 ml demonstrated a lack of dose response in effect on PES and a modestly clinically significant increase in undesired side effects (heart rate and blood pressure) at higher doses.

Constraining H-0 in general dark energy models from Sunyaev-Zeldovich/X-ray technique and complementary probes

In accelerating dark energy models, the estimates of the Hubble constant, Ho, from Sunyaev-Zerdovich effect (SZE) and X-ray surface brightness of galaxy clusters may depend on the matter content (Omega(M)), the curvature (Omega(K)) and the equation of state parameter GO. In this article, by using a sample of 25 angular diameter distances of galaxy clusters described by the elliptical beta model obtained through the SZE/X-ray technique, we constrain Ho in the framework of a general ACDM model (arbitrary curvature) and a flat XCDM model with a constant equation of state parameter omega = p(x)/rho(x). In order to avoid the use of priors in the cosmological parameters, we apply a joint analysis involving the baryon acoustic oscillations (BA()) and the (MB Shift Parameter signature. By taking into account the statistical and systematic errors of the SZE/X-ray technique we obtain for nonflat ACDM model H-0 = 74(-4.0)(+5.0) km s(-1) Mpc(-1) (1 sigma) whereas for a fiat universe with constant equation of state parameter we find H-0 = 72(-4.0)(+5.5) km s(-1) Mpc(-1)(1 sigma). By assuming that galaxy clusters are described by a spherical beta model these results change to H-0 = 6(-7.0)(+8.0) and H-0 = 59(-6.0)(+9.0) km s(-1) Mpc(-1)(1 sigma), respectively. The results from elliptical description are in good agreement with independent studies from the Hubble Space Telescope key project and recent estimates based on the Wilkinson Microwave Anisotropy Probe, thereby suggesting that the combination of these three independent phenomena provides an interesting method to constrain the Bubble constant. As an extra bonus, the adoption of the elliptical description is revealed to be a quite realistic assumption. Finally, by comparing these results with a recent determination for a, flat ACDM model using only the SZE/X-ray technique and BAO, we see that the geometry has a very weak influence on H-0 estimates for this combination of data.

Underlying Event measurements in pp collisions at root s=0.9 and 7 TeV with the ALICE experiment at the LHC

We present measurements of Underlying Event observables in pp collisions at root s = 0 : 9 and 7 TeV. The analysis is performed as a function of the highest charged-particle transverse momentum p(T),L-T in the event. Different regions are defined with respect to the azimuthal direction of the leading (highest transverse momentum) track: Toward, Transverse and Away. The Toward and Away regions collect the fragmentation products of the hardest partonic interaction. The Transverse region is expected to be most sensitive to the Underlying Event activity. The study is performed with charged particles above three different p(T) thresholds: 0.15, 0.5 and 1.0 GeV/c. In the Transverse region we observe an increase in the multiplicity of a factor 2-3 between the lower and higher collision energies, depending on the track p(T) threshold considered. Data are compared to PYTHIA 6.4, PYTHIA 8.1 and PHOJET. On average, all models considered underestimate the multiplicity and summed p(T) in the Transverse region by about 10-30%.

A Phase I clinical trial of lodenafil carbonate, a new phosphodiesterase Type 5 (PDE5) inhibitor, in healthy male volunteers

Lodenafil carbonate is a new phosphodiesterase Type 5 (PDE5) inhibitor used in treatment of erectile dysfunction. Objective: The present study was conducted to evaluate the safety, tolerability, and pharmacokinetics of lodenafil carbonate after administering ascending (1 - 100 mg) single oral doses to healthy male volunteers (n = 33). Methods: The study was an open-label, dose-escalation, Phase I clinical trial involving the administration of single oral doses of lodenafil carbonate. Lodenafil carbonate was administered sequentially, escalating in single doses of 1 mg - 100 mg with a washout period of at least 1 week between each dose. The progression to the next dose was allowed after clinical and laboratory exams, Ambulatory Monitoring of Arterial Pressure (AMAP) without relevant clinical modifications and adverse events without clinical relevancy. Blood samples were collected at pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 7, 8, 10, 12, 14, 16, 20 and 24 h post-dosing. Plasma samples for measurement of lodenafil carbonate and lodenafil were analyzed by liquid chromatography coupled to tandem mass spectrometry. Results: No serious adverse events were observed, and none of the subjects discontinued the study due to intolerance. The AMAP measurements, clinical and laboratory exams and ECG revealed no significant changes even at higher doses. Lodenafil carbonate was not detected in any samples, indicating that it acts as a prodrug. The mean lodenafil pharmacokinetic parameters for t(max) and t(1/2) were 1.6 (+/- 0.4) h and 3.3 (+/- 1.1) h, respectively. This study demonstrated that lodenafil carbonate was well tolerated and showed a good safety profile in healthy male volunteers.

Production of K*(892)(0) and phi(1020) in pp collisions at root s=7 TeV

The production of K*(892)(0) and phi(1020) in pp collisions at root s = 7 TeV was measured by the ALICE experiment at the LHC. The yields and the transverse momentum spectra d(2)N/dydp(T) at midrapidity vertical bar y vertical bar < 0.5 in the range 0 < p(T) < 6 GeV/c for K*(892)(0) and 0.4 < p(T) < 6 GeV/c for phi(1020) are reported and compared to model predictions. Using the yield of pions, kaons, and Omega baryons measured previously by ALICE at root s = 7 TeV, the ratios K*/K-, phi/K*, phi/ K-, phi/pi(-), and (Omega + <(Omega)over bar>)/phi are presented. The values of the K*/K-, phi/K* and phi/K- ratios are similar to those found at lower centre-of-mass energies. In contrast, the phi/pi(-) ratio, which has been observed to increase with energy, seems to saturate above 200 GeV. The (Omega + (Omega) over bar)/phi ratio in the p(T) range 1-5 GeV/ c is found to be in good agreement with the prediction of the HIJING/B (B) over bar v2.0model with a strong colour field.

1(--) and 0(++) heavy four-quark and molecule states in QCD

We estimate the masses of the 1(--) heavy four-quark and molecule states by combining exponential Laplace (LSR) and finite energy (FESR) sum rules known perturbatively to lowest order (LO) in alpha(s) but including non-perturbative terms up to the complete dimension-six condensate contributions. This approach allows to fix more precisely the value of the QCD continuum threshold (often taken ad hoc) at which the optimal result is extracted. We use double ratio of sum rules (DRSR) for determining the SU(3) breakings terms. We also study the effects of the heavy quark mass definitions on these LO results. The SU(3) mass-splittings of about (50-110) MeV and the ones of about (250-300) MeV between the lowest ground states and their 1st radial excitations are (almost) heavy-flavor independent. The mass predictions summarized in Table 4 are compared with the ones in the literature (when available) and with the three Y-c(4260, 4360, 4660) and Y-b(10890) 1(--) experimental candidates. We conclude (to this order approximation) that the lowest observed state cannot be a pure 1(--) four-quark nor a pure molecule but may result from their mixings. We extend the above analyzes to the 0(++) four-quark and molecule states which are about (0.5-1) GeV heavier than the corresponding 1(--) states, while the splittings between the 0(++) lowest ground state and the 1st radial excitation is about (300-500) MeV. We complete the analysis by estimating the decay constants of the 1(--) and 0(++) four-quark states which are tiny and which exhibit a 1/M-Q behavior. Our predictions can be further tested using some alternative non-perturbative approaches or/and at LHCb and some other hadron factories. (c) 2012 Elsevier B.V. All rights reserved.

Transverse sphericity of primary charged particles in minimum bias proton-proton collisions at root s=0.9, 2.76 and 7 TeV

Measurements of the sphericity of primary charged particles in minimum bias proton-proton collisions at root s = 0.9, 2.76 and 7 TeV with the ALICE detector at the LHC are presented. The observable is measured in the plane perpendicular to the beam direction using primary charged tracks with p(T) > 0.5 GeV/c in vertical bar eta vertical bar < 0.8. The mean sphericity as a function of the charged particle multiplicity at mid-rapidity (N-ch) is reported for events with different p(T) scales ("soft" and "hard") defined by the transverse momentum of the leading particle. In addition, the mean charged particle transverse momentum versus multiplicity is presented for the different event classes, and the sphericity distributions in bins of multiplicity are presented. The data are compared with calculations of standard Monte Carlo event generators. The transverse sphericity is found to grow with multiplicity at all collision energies, with a steeper rise at low N-ch, whereas the event generators show an opposite tendency. The combined study of the sphericity and the mean p(T) with multiplicity indicates that most of the tested event generators produce events with higher multiplicity by generating more back-to-back jets resulting in decreased sphericity (and isotropy). The PYTHIA6 generator with tune PERUGIA-2011 exhibits a noticeable improvement in describing the data, compared to the other tested generators.