Bupivacaine 0.5 % versus articaine 4 % for the removal of lower third molars. A crossover randomized controlled trial

Objective: To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed. Study Design: Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests. Results: Both solutions exhibited similar latency times and intraoperative efficacy. Statistical significant lower pain levels were observed with bupivacaine between the fifth (p=0.011) and the ninth (p=0.007) postoperative hours. Bupivacaine provided significantly longer lasting soft tissue anesthesia (p<0.05). Systolic blood pressure and heart rate values were significantly higher with articaine. Conclusions: Bupivacaine could be a valid alternative to articaine especially due to its early postoperative pain prevention ability.

Study on the removal of biodegradable NOM from seawater using biofiltration

Despite the low biodegradability of seawater NOM, problems associated with biofouling are common in facilities that handle seawater. In this work, a fixed-film aerobic biofilter is proposed as an effective unit for preventing biofouling in such facilities. A packed-bed biofilter with an EBCT = 6 - 11 min was employed. The results demonstrated that the DOC is reduced by 6% and the BOD7 is reduced up to 15%. The LC-OCD analysis revealed that biofiltration abates the LMW neutrals and biopolymer fractions by 33 and 17%, respectively. However, the fractionation with UF membrane showed that the biofiltration process is able to degrade the more biodegradable compounds that have molecular weights that are greater than 1 kDa and compounds with molecular weights of less than 1 kDa. After biofiltration, the biological activity measured in terms of ATP removal was reduced by 60%. Finally, a test to evaluate the biofilm formation capacity of a water sample revealed reductions of ~94% when comparing biofiltered and non-biofiltered seawater. Therefore, a fixed-film aerobic biofiltration process could be a useful treatment for the removal of biodegradable organic matter from seawater and for improving the water quality in terms of less biofilm formation capacity.

Eosinophilic oesophagitis: relationship of quality of life with clinical, endoscopic and histological activity.

BACKGROUND: Knowledge about determinants of quality of life (QoL) in eosinophilic oesophagitis (EoO) patients helps to identify patients at risk of experiencing poor QoL and to tailor therapeutic interventions accordingly. AIM: To evaluate the impact of symptom severity, endoscopic and histological activity on EoE-specific QoL in adult EoE patients. METHODS: Ninety-eight adult EoE patients were prospectively included (64% male, median age 39 years). Patients completed two validated instruments to assess EoE-specific QoL (EoO-QoL-A) and symptom severity (adult EoE activity index patient-reported outcome) and then underwent esophagogastroduodenoscopy with biopsy sampling. Physicians reported standardised information on EoE-associated endoscopic and histological alterations. The Spearman's rank correlation coefficient was calculated to determine the relationship between QoL and symptom severity. Linear regression and analysis of variance was used to quantify the extent to which variations in severity of EoE symptoms, endoscopic and histological findings explain variations in QoL. RESULTS: Quality of life strongly correlated with symptom severity (r = 0.610, P < 0.001). While the variation in severity of symptoms, endoscopic and histological findings alone explained 38%, 35% and 22% of the variability in EoE-related QoL, respectively, these together explained 60% of variation. Symptom severity explained 18-35% of the variation in each of the five QoL subscale scores. CONCLUSIONS: Eosinophilic oesophagitis symptom severity and biological disease activity determine QoL in adult patients with eosinophilic oesophagitis. Therefore, reduction in both eosinophilic oesophagitis symptoms as well as biological disease activity is essential for improvement of QoL in adult patients. Clinicaltrials.gov number, NCT00939263.

Big band -sovitus kappaleesta "(Surrounded by) Zip-Zip" : Sovituksen analysoiminen puhallinsektioiden näkökulmasta

Opinnäytetyö käsittelee big bandia sekä sille sovittamista. Keskityn tarkastelemaan ennen kaikkea 1930-40-lukujen musiikillista murrosta, jolloin syntyi uusi tapa käsitellä useasti suurimpien orkestereiden kokoonpanoon kuuluneita puhaltimia. Tuona ajanjaksona orkestereiden puhallinryhmistä sekä komppisoittimista alettiin yleisesti muodostaa sektioita. Tämä kokoonpano sai nimekseen ”big band”. Opinnäytetyön tavoitteena oli syventää tietojani big bandin puhallinsektioiden toiminnasta sekä niiden yleisimmistä tehtävistä. Tehtäviä selventääkseni tein big band -sovituksen omasta kappaleestani, missä peilasin 1930-40-luvuilla yleistynyttä tyyliä sovittaa. Sovitustyön valmistuminen pohjautui kolmeen seikkaan: historian tuntemus, sovitussuunnitelman teko sekä musiikin teorian tuntemus. Historian tuntemus loi pohjan sovitussuunnitelmalle, minkä avulla loin kehykset sovitustyön tekemiselle. Sovituksen tekninen suoritus sekä valmistuminen pohjautuivat musiikin teorian ymmärtämiseen sekä kokemukseeni sovittajana. Sovitukseni analyysi-osiossa käyn sovituksen läpi osa kerrallaan, selventäen kuinka puhallinsektiot kussakin osassa toimivat. Opinnäytetyön suunnittelu sekä tiukka rajaus eivät poissulkeneet täysin aiheen moniulotteisuutta. Pelkkiin puhallinsektioihin keskittyminen aiheutti ongelmallisia tilanteita, jotka vaativat suurien kompromissien tekemistä. Muun muassa teorian ja reharmonisoinnin syvempi analysoiminen tässä jää tekemättä. Sovituksellisten sekä soinnullisien ratkaisuiden olemassaolo vaatisi yleensä rinnalleen syvempää perustelua. Näin varsinkin nyt, kun ratkaisut harmoniassa ovat aika ajoin jopa radikaaleja. Tulin kuitenkin siihen päätelmään, että kaikki tekstissä ilmenevä tieto mikä ei koskisi puhallinsektioiden käyttäytymistä olisi irrelevanttia. Lopputuloksen oli tarkoitus olla jäsennelty esittely siitä, mitä big bandin puhallinsektiot ovat ja tekevät. Käyn opinnäytteessäni lyhyesti läpi myös sovitukseni esikuvat. Tämä lyhyt historia-osuus kertoo tiivistetysti mistä ajalta mallintamani sovitustyyli on peräisin ja ketkä ovat edesauttaneet sen yleistymisessä. Historia osuus toimii mainiosti suppeana avainsanastona aiheesta enemmän kiinnostuneelle.

Extended Endoscopic Endonasal Approaches for Cerebral Aneurysms: Anatomical, Virtual Reality and Morphometric Study

Introduction. The purpose of the present contribution is to perform a detailed anatomic and virtual reality three-dimensional stereoscopic study in order to test the effectiveness of the extended endoscopic endonasal approaches for selected anterior and posterior circulation aneurysms. Methods. The study was divided in two main steps: (1) simulation step, using a dedicated Virtual Reality System (Dextroscope, Volume Interactions); (2) dissection step, in which the feasibility to reach specific vascular territory via the nose was verified in the anatomical laboratory. Results. Good visualization and proximal and distal vascular control of the main midline anterior and posterior circulation territory were achieved during the simulation step as well as in the dissection step (anterior communicating complex, internal carotid, ophthalmic, superior hypophyseal, posterior cerebral and posterior communicating, basilar, superior cerebellar, anterior inferior cerebellar, vertebral, and posterior inferior cerebellar arteries). Conclusion. The present contribution is intended as strictly anatomic study in which we highlighted some specific anterior and posterior circulation aneurysms that can be reached via the nose. For clinical applications of these approaches, some relevant complications, mainly related to the endonasal route, such as proximal and distal vascular control, major arterial bleeding, postoperative cerebrospinal fluid leak, and olfactory disturbances must be considered

Risques et bénéfices d'une approche interventionnelle face aux corps étrangers digestifs [Digestive foreign body management].

Foreign body (FB) ingestion is a frequent reason for gastroenterology consulting. Eighty percent of these ingestions are accidental and observed among paediatric subjects. However, intentional repetitive ingestions are also observed, especially amongst prisoners or psychiatric patients. Most FBs pass throughout the digestive tract without any complication and without any need for surgical or endoscopic intervention. Nevertheless, around 10-20% of cases require an endoscopy examination and 1% will lead to a surgical intervention. Management approaches should favor inter-disciplinarity, balance benefits and risks of FB removal based on its location, and integrate psychiatric comorbidities into the decision process.

Symptoms Have Modest Accuracy in Detecting Endoscopic and Histologic Remission in Adults With Eosinophilic Esophagitis.

BACKGROUND & AIMS: It is not clear whether symptoms alone can be used to estimate the biologic activity of eosinophilic esophagitis (EoE). We aimed to evaluate whether symptoms can be used to identify patients with endoscopic and histologic features of remission. METHODS: Between April 2011 and June 2014, we performed a prospective, observational study and recruited 269 consecutive adults with EoE (67% male; median age, 39 years old) in Switzerland and the United States. Patients first completed the validated symptom-based EoE activity index patient-reported outcome instrument and then underwent esophagogastroduodenoscopy with esophageal biopsy collection. Endoscopic and histologic findings were evaluated with a validated grading system and standardized instrument, respectively. Clinical remission was defined as symptom score <20 (range, 0-100); histologic remission was defined as a peak count of <20 eosinophils/mm(2) in a high-power field (corresponds to approximately <5 eosinophils/median high-power field); and endoscopic remission as absence of white exudates, moderate or severe rings, strictures, or combination of furrows and edema. We used receiver operating characteristic analysis to determine the best symptom score cutoff values for detection of remission. RESULTS: Of the study subjects, 111 were in clinical remission (41.3%), 79 were in endoscopic remission (29.7%), and 75 were in histologic remission (27.9%). When the symptom score was used as a continuous variable, patients in endoscopic, histologic, and combined (endoscopic and histologic remission) remission were detected with area under the curve values of 0.67, 0.60, and 0.67, respectively. A symptom score of 20 identified patients in endoscopic remission with 65.1% accuracy and histologic remission with 62.1% accuracy; a symptom score of 15 identified patients with both types of remission with 67.7% accuracy. CONCLUSIONS: In patients with EoE, endoscopic or histologic remission can be identified with only modest accuracy based on symptoms alone. At any given time, physicians cannot rely on lack of symptoms to make assumptions about lack of biologic disease activity in adults with EoE. ClinicalTrials.gov, Number: NCT00939263.

Sonography of the iliotibial band: spectrum of findings

Iliotibial band lesions constitute a potential source of discomfort and are frequently confounded with other conditions which cause pain on the lateral aspect of the hip, thigh and knee. Ultrasonography is usually regarded as a first-line imaging modality in the assessment of such conditions because of its excellent diagnostic accuracy, low cost and wide availability. The correct identification of the structure involved in the production of symptoms leads to an appropriate management and to a higher probability of resolution of the clinical complaint. The present article is aimed at reviewing the different sonographic presentations of iliotibial band syndromes.

Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil

AbstractObjective:To report the results of computed tomography (CT)-guided percutaneous resection of the nidus in 18 cases of osteoid osteoma.Materials and Methods:The medical records of 18 cases of osteoid osteoma in children, adolescents and young adults, who underwent CT-guided removal of the nidus between November, 2004 and March, 2009 were reviewed retrospectively for demographic data, lesion site, clinical outcome and complications after procedure.Results:Clinical follow-up was available for all cases at a median of 29 months (range 6–60 months). No persistence of pre-procedural pain was noted on 17 patients. Only one patient experienced recurrence of symptoms 12 months after percutaneous resection, and was successfully retreated by the same technique, resulting in a secondary success rate of 18/18 (100%).Conclusion:CT-guided removal or destruction of the nidus is a safe and effective alternative to surgical resection of the osteoid osteoma nidus.

A Computer program for estimating population size by the removal method

A BASIC computer program (REMOVAL) was developed to compute in a VAXNMS environment all the calculations of the removal method for population size estimation (catch-effort method for closed populations with constant sampling effort). The program follows the maximum likelihood methodology,checks the failure conditions, applies the appropriate formula, and displays the estimates of population size and catchability, with their standard deviations and coefficients of variation, and two goodness-of-fit statistics with their significance levels. Data of removal experiments for the cyprinodontid fish Aphanius iberus in the Alt Emporda wetlands are used to exemplify the use of the program

A Theta-Band EEG Based Index for Early Diagnosis of Alzheimer’s Disease

Despite recent advances, early diagnosis of Alzheimer’s disease (AD) from electroencephalography (EEG) remains a difficult task. In this paper, we offer an added measure through which such early diagnoses can potentially be improved. One feature that has been used for discriminative classification is changes in EEG synchrony. So far, only the decrease of synchrony in the higher frequencies has been deeply analyzed. In this paper, we investigate the increase of synchrony found in narrow frequency ranges within the θ band. This particular increase of synchrony is used with the well-known decrease of synchrony in the band to enhance detectable differences between AD patients and healthy subjects. We propose a new synchrony ratio that maximizes the differences between two populations. The ratio is tested using two different data sets, one of them containing mild cognitive impairment patients and healthy subjects, and another one, containing mild AD patients and healthy subjects. The results presented in this paper show that classification rate is improved, and the statistical difference between AD patients and healthy subjects is increased using the proposed ratio.

Brook Trout Removal as a Conservation Tool to Restore Eagle Lake Rainbow Trout

Nonnative brook trout Salvelinus fontinalis are abundant in Pine Creek and its main tributary, Bogard Spring Creek, California. These creeks historically provided the most spawning and rearing habitat for endemic Eagle Lake rainbow trout Oncorhynchus mykiss aquilarum. Three-pass electrofishing removal was conducted in 2007–2009 over the entire 2.8-km length of Bogard Spring Creek to determine whether brook trout removal was a feasible restoration tool and to document the life history characteristics of brook trout in a California meadow stream. After the first 2 years of removal, brook trout density and biomass were severely reduced from 15,803 to 1,192 fish/ha and from 277 to 31 kg/ha, respectively. Average removal efficiency was 92–97%, and most of the remaining fish were removed in the third year. The lack of a decrease in age-0 brook trout abundance between 2007 and 2008 after the removal of more than 4,000 adults in 2007 suggests compensatory reproduction of mature fish that survived and higher survival of age-0 fish. However, recruitment was greatly reduced after 2 years of removal and is likely to be even more depressed after the third year of removal assuming that immigration of fish from outside the creek continues to be minimal. Brook trout condition, growth, and fecundity indicated a stunted population at the start of the study, but all three features increased significantly every year, demonstrating compensatory effects. Although highly labor intensive, the use of electrofishing to eradicate brook trout may be feasible in Bogard Spring Creek and similar small streams if removal and monitoring are continued annually and if other control measures (e.g., construction of barriers) are implemented. Our evidence shows that if brook trout control measures continue and if only Eagle Lake rainbow trout are allowed access to the creek, then a self-sustaining population ofEagle Lake rainbow trout can become reestablished

Photometric and Halpha observations of LSI+61·303: detection of a 26 day V and JHK band modulation

We present new optical and infrared photometric observations and high resolution H α spectra of the periodic radio star LSI+61◦303. The optical photometric data set covers the time interval 1985-1993 and amounts to about a hundred nights. A period of ∼26 days is found in the V band. The infrared data also present evidence for a similar periodicity, but with higher amplitude of variation ((0.m 2). The spectroscopic observations include 16 intermediate and high dispersion spectra of LSI+61◦303 collected between January 1989 and February 1993. The H α emission line profile and its variations are analyzed. Several emission line parameters -- among them the H α EW and the width of the H α red hump -- change strongly at or close to radio maximum, and may exhibit periodic variability. We also observe a significant change in the peak separation. The H α profile of LSI+61◦303 does not seem peculiar for a Be star. However, several of the observed variations of the H α profile can probably be associated with the presence of the compact, secondary star.

V-band observations of V4641 Sagittarii

In this note we report high time resolution V Johnson photometry of the microquasar V4641 Sgr (SAX J1819.3-2525 - XTE J1819-254). This source was discovered as an X-ray transient by BeppoSAX and RossiXTE satellites (In't Zand et al. 1999; Markwardt et al. 1999). On 1999 September, a very fast transient optical and X-ray outburst was observed, reaching up to ...

Removal of chromium (vi) in aqueous environments using cork and heat-treated cork samples from quercus cerris and quercus suber

Chromium (VI) removal and its reduction to chromium (III) from aqueous solution by untreated and heat-treated Quercus cerris and heat-treated Quercus suber black agglomerate cork granules was investigated. Initial screening studies revealed that among the sorbents tested, untreated Q. cerris and Q. suber black agglomerate are the most efficient in the removal of Cr(VI) ions and were selected for adsorption essays. Heat treatment adversely affected chromium adsorption and chromium (VI) reduction in Q. cerris cork. The highest metal uptake was found at pH 3.0 for Q. cerris and pH 2.0 for black agglomerate. The experimental data fitted the Langmuir model and the calculated qmax was 22.98 mg/g in black agglomerate and 21.69 mg/g in untreated Q. cerris cork. The FTIR results indicated that while in black agglomerate, lignin is the sole component responsible for Cr(VI) sorption, and in untreated Q. cerris cork, suberin and polysaccharides also play a significant role on the sorption. The SEM-EDX results imply that chromium has a homogenous distribution within both cork granules. Also, phloemic residues in Q. cerris granules showed higher chromium concentration. The results obtained in this study show that untreated Q. cerris and black agglomerate cork granules can be an effective and economical alternative to more costly materials for the treatment of liquid wastes containing chromium