Effects of magnesium sulphate on the pharmacodynamics of rocuronium in patients aged 60 years and older: A randomised trial

BACKGROUND There is little information on the interaction between magnesium sulphate (MgSO4) and rocuronium in elderly patients. With a growing number of older patients who need surgical procedures, it is increasingly important to study this age group. OBJECTIVE To evaluate the effects of MgSO4 administration on the pharmacodynamics of rocuronium in patients aged 60 years or older. DESIGN A randomised controlled trial. SETTING A tertiary care hospital. PATIENTS Sixty-four patients, aged 60 years or older, American Society of Anesthesiologists (ASA) physical status classes I to III, scheduled for elective oncological head and neck surgery. Exclusion criteria were severe renal insufficiency (calculated creatinine clearance <30 ml min-1), preoperatorive serum magnesium concentration of more than 1.25 mmol l1 and patients receiving drugs known to affect neuromuscular function. INTERVENTIONS Patients were randomly allocated to one of two groups: in the magnesium group, patients received MgSO4 30mgkg1 intravenously, for 10 min, and then a continuous intravenous infusion at a rate of 1 g h-1. The control group received the same volume of physiological saline. Neuromuscular function was evaluated continuously in both groups. MAIN OUTCOME MEASURES Total recovery time was the primary outcome. Onset time, clinical duration, recovery index and recovery time were considered as secondary endpoints. Values are given as mean [SD]. RESULTS Total recovery time from neuromuscular block (NMB) was 113 [36] min in the magnesium group and 101 [39] min in the control group. Clinical duration was 69 [23] min in the magnesium group and 59 [28] min in the control group. Recovery index was 19 [36] min in the magnesium group and 17 [6] min in the control group. Recovery timewas 44 [22] min in the magnesium group and 42 [18] min in the control group. There were no statistically significant differences between the groups in any of the recovery indices. In the magnesium group, the mean onset time was 144 [58] s, significantly shorter than the onset time in the group that received physiological saline, which was 187 [90] s (P-0.03). Group variances were compared using an F test: onset time varied significantly less in the magnesium group (P-0.02). CONCLUSION In oncology patients of 60 or more years of age, preadministration of MgSO4, with the doses used in this study, significantly reduced the onset time of NMB induced by rocuronium. © 2013 European Society of Anaesthesiology.

Country report of Aruba on recent developments relating to the follow-up of the Madrid Plan of Action on Ageing and the regional strategy on ageing in occasion of the Caribbean Symposium on Population Ageing

Documento complementario a edición impresa ingresada en Biblioteca (101803)

Ageing and Development Newsletter No. 3

Karoline Schmid: Caribbean challenges o f a global phenom enon. Harold Robinson: Information is the basis for effective action. Implementation of the Regional Strategy. Caribbean steps towards a society for all ages Montevideo: ECLAC called the attention of countries on social protection.

Lower limb muscle coactivation levels in healthy younger and older adults during functional dual-task gait

The purpose of this study was to investigate the influence of daily cognitive task on stiffness of old and young female adults during the gait. The study included 17 physically active younger and 18 older women, with low risk of falls. The volunteers were asked to walk on the treadmill at two different gait conditions: normal gait and functional dual-task gait. The electromyographic signals were collected of the lower limb muscles. The percentage of coactivation for the tibialis anterior/gastrocnemius lateralis and tibialis anterior/soleus were significantly higher in elderly than in younger in the normal gait and dual-task gait. Our results suggest that the elderly have a greater stiffness in the ankle joint during gait normal and daily dual task gait. Thus, we conclude that challenging cognitively situations during the gait may increase the risk of falls in this population.

Tecnologias virtuais e análise videográfica: o YouTube® como recurso de pesquisa para compreensão sobre a imagem do idoso brasileiro = Virtual technologies and videographic analysis : YouTube® as research resource for understanding about brazilian elderly imagem

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The effects of high doses of nandrolone decanoate and exercise on prostate microvasculature of adult and older rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Contextual and individual inequalities in dental pain prevalence among Brazilian adults and elders

This study aimed to assess the prevalence of dental pain among adults and older people living in Brazil's State capitals. Information was gathered from the Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases (VIGITEL) in 2009 (n = 54,367). Dental pain was the outcome. Geographic region, age, gender, race, schooling, private health coverage, smoking, and soft drink consumption were the explanatory variables. Multilevel Poisson regression models were performed. Prevalence of dental pain was 15.2%; Macapa and Sao Luis had prevalence rates greater than 20%; all capitals in the South and Southeast, plus Cuiaba, Campo Grande, Maceio, Recife, and Natal had prevalence rates less than 15%. Factors associated with increased prevalence of dental pain were the North and Northeast regions, female gender, black/brown skin color, lack of private health insurance, smoking, and soft drink consumption. Dental pain is a public health problem that should be monitored by health surveillance systems.

The school environment as a teacher. The role of space and place in enhancing ecological literacy and social competence development in children and young people

Can space and place foster child development, and in particular social competence and ecological literacy? If yes, how can space and place do that? This study shows that the answer to the first question is positive and then tries to explain the way space and place can make a difference. The thesis begins with the review of literature from different disciplines – child development and child psychology, education, environmental psychology, architecture and landscape architecture. Some bridges among such disciplines are created and in some cases the ideas from the different areas of research merge: thus, this is an interdisciplinary study. The interdisciplinary knowledge from these disciplines is translated into a range of design suggestions that can foster the development of social competence and ecological literacy. Using scientific knowledge from different disciplines is a way of introducing forms of evidence into the development of design criteria. However, the definition of design criteria also has to pass through the study of a series of school buildings and un-built projects: case studies can give a positive contribution to the criteria because examples and good practices can help “translating” the theoretical knowledge into design ideas and illustrations. To do that, the different case studies have to be assessed in relation to the various themes that emerged in the literature review. Finally, research by design can be used to help define the illustrated design criteria: based on all the background knowledge that has been built, the role of the architect is to provide a series of different design solutions that can give answers to the different “questions” emerged in the literature review.

Evidence-based polytherapies and long-term mortality after acute myocardial infarction in very old subjects compared with elderly and adults: a nested case-control study

Background: Clinical trials have demonstrated that selected secondary prevention medications for patients after acute myocardial infarction (AMI) reduce mortality. Yet, these medications are generally underprescribed in daily practice, and older people are often absent from drug trials. Objectives: To examine the relationship between adherence to evidence-based (EB) drugs and post-AMI mortality, focusing on the effects of single therapy and polytherapy in very old patients (≥80 years) compared with elderly and adults (<80 years). Methods: Patients hospitalised for AMI between 01/01/2008 and 30/06/2011 and resident in the Local Health Authority of Bologna were followed up until 31/12/2011. Medication adherence was calculated as the proportion of days covered for filled prescriptions of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), β-blockers, antiplatelet drugs, and statins. We adopted a risk set sampling method, and the adjusted relationship between medication adherence (PDC≥75%) and mortality was investigated using conditional multiple logistic regression. Results: The study population comprised 4861 patients. During a median follow-up of 2.8 years, 1116 deaths (23.0%) were observed. Adherence to the 4 EB drugs was 7.1%, while nonadherence to any of the drugs was 19.7%. For both patients aged ≥80 years and those aged <80 years, rate ratios of death linearly decreased as the number of EB drugs taken increased. There was a significant inverse relationship between adherence to each of 4 medications and mortality, although its magnitude was higher for ACEIs/ARBs (adj. rate ratio=0.60, 95%CI=0.52–0.69) and statins (0.60, 0.50–0.72), and lower for β-blockers (0.75, 0.61–0.92) and antiplatelet drugs (0.73, 0.63–0.84). Conclusions: The beneficial effect of EB polytherapy on long-term mortality following AMI is evident also in nontrial older populations. Given that adherence to combination therapies is largely suboptimal, the implementation of strategies and initiatives to increase the use of post-AMI secondary preventive medications in old patients is crucial.

The relationship between eating behavior and psychological distress among overweight and obese people: is there a role for mindfulness?

This research based on 3 indipendent studies, sought to explore the nature of the relationship between overweight/obesity, eating behaviors and psychological distress; the construct of Mindful eating trough the validation of the Italian adaptation of the Mindful Eating Questionnaire (MEQ); the role of mindfulnessand mindful eating as respectively potential mediator and moderator between overeating behavior (binge eating and emotional overeating) and negative outcomes (psychological distress, body dissatisfaction). All the samples were divided in normal weight, overweight and obese according to BMI categories. STUDY1: In a sample of 691 subjects (69.6% female, mean aged 39.26 years) was found that BMI was not associated with psychological distress, whereas binge eating increases the psychopathological level. BMI and male gender represent negative predictors of psychological distress, but certain types of overeating (i.e., NES/grazing, overeating during or out of meals, and guilt/restraint) result as positive predictors.. STUDY 2 : A sample of 1067 subjects (61.4% female, mean aged 34 years) was analized. The Italian MEQ resulted in a 26-item 4-factor model measuring Disinhibition, Awareness, Distraction, and Emotional response. Internal consistency and test-retest reliability were acceptable MEQ correlated positively with mindfulness (FMI) and it was associated with sociodemographic variables, BMI, meditation. type of exercise and diet. STUDY 3, based on a sample of 502 subjects (68.8% female, mean aged 39.42 years) showed that MEQ and FMI negatively correlated with BES, EOQ, SCL-90-R, and BIAQ. Obese people showed lower level of mindful eating and higher levels of binge eating, emotional overeating, and body dissatisfaction, compared to the other groups Mindfulness resulted to partially mediates the relationship between a) binge eating and psychological distress, b) emotional overeating and psychological distress, c) binge eating and mental well-being, d) emotional overeating and menal well-being. Mindful eating was a moderator only in the relationship between emotional overeating and body dissatisfaction.

Gilded bronze conservation: assessment of protective treatments by accelerated ageing and of treatment removal procedures by laser cleaning

In the current study, we analyze the effectiveness of an organosilane compound, 3-mercapto-propyl-tri-methoxy-silane (abbreviated PropS-SH), in the corrosion protection of fire-gilded bronzes. Firstly, the coating was applied on as-gilded bronze. Subsequently, it was also applied on pre-patinated bronze, because the substrate on which protective coatings are applied in real conservation interventions are corroded artifacts (cleaning procedures never remove all the corrosion products). Aiming to obtain results that simulate the situation of real artifacts, a dropping test that simulates outdoor exposure in runoff conditions (unsheltered areas of monuments) was employed in order to prepatinate the gilded bronze samples, which are the substrate for applying the protective coating. The preparation of the samples by applying the protective coating was performed in collaboration with the Corrosion Studies Centre “Aldo Daccò” from Ferrara University. After the artificial exposure cycles the samples underwent investigations through a variety of spectroscopic methods including SEM, Raman, FIB, AAS and color measurements. In order to evaluate the possible removal of the organosilane coating, protected samples were subjected to laser cleaning tests and characterized by SEM/EDS so as to assess the changes in composition and morphology of the treated surfaces. The laser cleaning treatment was performed at the Institute of Applied Physics “Nello Carrara” (CNR Sesto Fiorentino (FI)). The morphology and chemical composition of the samples was observed before and after the operation in order to obtain information about the fluence and type of laser which are best suited to the removal of this type of coating.