Analgesic efficacy of intravenous perfusion of lidocaine, ketamine or a combination after laparotomy in a placebo-controlled, randomized, double-blind prospective study

In acute postoperative pain management intravenous lidocaine and/or ketamine have been advocated because of their morphine-sparing effect. The goal of this prospective, randomised, double-blind study was to assess morphine consumption with different regimens of intravenous infusion of lidocaine, ketamine or both during 48 hours following laparotomy. Patients were randomised into four groups. Group L, K, and KL received intravenous lidocaine, ketamine or a combination, respectively, before incision and during 48 hours postoperatively. The control group (C) received a similar volume of saline bolus and infusion. Postoperative analgesia included morphine delivered by a patient-controlled analgesia device. Primary outcome was the cumulative morphine consumption and pain, sedation scores, pressure algometry and side effects were our secondary outcomes. Cognition and psychomotor performance were also tested. Out of 57 eligible patients, 44 completed the study. Lidocaine reduced the cumulative morphine consumption compared with the control group (mean 0.456 mg.kg-1 +/- 0.244 (SD) versus 0.705 +/- 0.442, respectively, Ρ < 0.001). Pain scores during movement were statistically lower in all three treatment groups. Psychometric tests showed that the lidocaine group expressed more depressed feelings and sadness compared to the control group. Lidocaine administration had a morphine-sparing effect with a 36% reduction of morphine consumption while ketamine alone or combined with lidocaine did not. As a whole, our results suggest that intravenous lidocaine may offer advantages for postoperative analgesia. We propose lidocaine as a new alternative for pain control that needs to be studied further in future multicentric studies.

Atlas-manuel des maladies du larynx (2e éd.) / par le Dr L. Grünwald ; édition française par A. Castex,... P. Collinet,...

Collection : Atlas-manuels de médecine

Breeding sites of Neotropical Drosophilidae (Diptera): IV. living and fallen flowers of Sessea brasiliensis and Cestrum spp. (Solanaceae)

The flowering phenologies of Sessea brasiliensis and three species of Cestrum (C. amictum, C. schlechtendalii and C. sendtnerianum), all belonging to the Solanaceae, were monitored in a fragment of the montane Atlantic rain forest within São Paulo city from July 1993 through June 1995. A total of 11,021 flies belonging to five species of the flavopilosa group of Drosophila (D. cestri, D. cordeiroi, D. hollisae, D. incompta and D. mariaehelenae), plus 1,244 flies belonging to four species of Zygothrica (Z. dispar, Z. vittimaculosa, Z. vittinubila and Z. aff. vittipunctata) emerged from 33,955 sampled flowers. Cestrum amictum, C. sendtnerianum and Sessea brasiliensis are recorded for the first time as host plants for the species of the Neotropical flavopilosa group ofDrosophila. Additionally, at least ten less abundant taxa belonging also to the Drosophilidae, plus 1,073 microhymenopteran parasitoids (Braconidae, Eucoilidae, and Pteromalidae), emerged from the sampled flowers of S. brasiliensis e Cestrum spp. The present study raised from nine to eleven the number of species of Cestrum previously recorded as breeding sites for these flies. A comprehensive list of species of Solanaceae known to host six species of Drosophila and four species of Zygothrica in southeastern and southern Brazil is included.

Impact and cost of a 2-week community-based screening and awareness program for diabetes and cardiovascular risk factors in a Swiss canton.

BACKGROUND: Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place. INTERVENTION AND METHODS: A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000) in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG), and A1c if RBG was >/=7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program. RESULTS: A total of 4222 participants (0.76% of all persons aged >/=18 years) underwent the screening program (median age: 53 years, 63% females). Among participants not treated for diabetes, 3.7% had RBG >/= 7.8 mmol/L and 1.8% had both RBG >/= 7.0 mmol/L and A1c >/= 6.5. Untreated blood pressure >/=140/90 mmHg and/or untreated cholesterol >/=5.2 mmol/L were found in 50.5% of participants. One or several treated or untreated modifiable risk factors were found in 78% of participants. The telephone survey showed that 53% of all adults in the canton were sensitized by the campaign. Excluding fees paid by the participants, the program incurred a cost of CHF 330,600. CONCLUSION: A community-based screening program had low efficiency for detecting new cases of diabetes, but it identified large numbers of persons with elevated other cardiovascular risk factors. Our findings suggest the convenience of A1c for mass screening of diabetes, the usefulness of extending diabetes screening to other cardiovascular risk factors, and the importance of a robust background communication campaign.

Informe preliminar del Crucero 6608 - 09 de invierno 1966 (Máncora - Ilo)

Describe las acciones desplegadas por el crucero del B.A.P. Unanue, correspondiente al invierno de 1967, en el que se investigó el área entre el 04º00´s y 17º35´S ocupándose de 168 estaciones de rutina distribuidas en 20 perfiles. Durante todo el recorrido se investigó la presencia de cardúmenes de peces por medio de los equipos de ecosonda y radar y se realizaron observaciones sobre presencia de aves y mamíferos marinos.

Vuorineuvos Ilmo Nurmela 12/10 1965

Kirje

Situación de la población de merluza (Merluccius gayi peruanus) en otoño de 1995 (Cr. BIC SNP-1 9505-06, Evaluación de recurso merluza)

Se efectuó un crucero de evaluación del recurso merluza aplicando la metodología de Área Barrida, para determinar el nivel poblacional y la estructura por tamaños del stock disponible sobre la plataforma. Se estimó una biomasa de 244 mil toneladas con límites de confianza del 28 % para un nivel de significación del 90 %. El stock presentó una estructura por edades con una fuerte presencia de ejemplares de 1, 2 y 3 años de edad que en conjunto representaron más del 80 % de la biomasa. Las mayores concentraciones se presentaron en la subárea O (06"S). Se estima que este nivel poblacional es uno de los más bajos en los últimos años, pero dadas las características de la estructura por edades, se espera un reforzamiento del stock explotable en el corto plazo.

[Berliini] [Olympisches Dorf, den] 4/8 36

Kirje 4.8.1936

Piispa Olavi Kares 12/10 1965

Kirje 12.10.1965

Carte des environs de Paris / par Bonhomme graveur géographe

Échelle(s) : [ca 1:192 000], 10 Kilomètres [ = 5,2 cm]